消化性溃疡发病相关因素演变的统计分析

Statistical Analysis of Changes in Peptic Ulcer-related Factors

背景:近几十年来,消化性溃疡的流行病学特征在世界范围内发生了一些变化,但其在国人中的演变有待进一步了解。目的:研究消化性溃疡发病相关因素的演变情况。方法:对1987年1月～2003年12月在仁济医院接受胃镜检查而被诊断为消化性溃疡者的年龄、溃疡类型、幽门螺杆菌(H.pylori)感染等情况进行统计分析。将整个观察期分为1987～1990年、1991～1994年、1995～1999年和2000～2003年4个时间段作进一步分析。结果:在4个时间段中,十二指肠溃疡(DU)和胃溃疡(GU)的平均发病年龄均呈上升趋势(P<0.01),DU患者的平均年龄依次为42.5岁、43.6岁、44.6岁和47.4岁,GU依次为48.9岁、50.1岁、49.5岁和52.6岁。DU患者的平均年龄较GU年轻近6岁。DU与GU的总体发病人数之比介于1.84和2.99之间。男性的DU和GU检出率均高于女性,DU男女之比为1.45∶1～2.59∶1,GU为2.08∶1～4.27∶1。1997年,全体接受胃镜检查者、DU患者和GU患者的H.pylori阳性率分别为51.5%、78.5%和71.9%,至2003年则分别为31.0%、63.5%和58.0%。各组前后差异均有显著性(P<0.01)。结论:近年来消化性溃疡,包括DU和GU的平均患病年龄有逐渐上升的趋势,患者仍以男性为主。胃镜检查者和消化性溃疡患者的H.pylori阳性率均有逐年下降的趋势。

Background： The epidemiological characteristics of peptic ulcer had been changing worldwide during the past decades. However, its changing pattern in Chinese patients remains to be further investigated. Aims： To investigate the changes in factors related to peptic ulcer. Methods： The age, ulcer type and Helicobacter pylori （ H. pylori ） status among peptic ulcer patients who received gastroscopy in Renji Hospital from January 1987 to December 2003 were statistically analyzed. The sole observation period was divided into four time periods： 1987-1990, 1991-1994, 1995-1999 and 2000- 2003. Results： At the aforementioned four time periods, the average age of both duodenal ulcer （DU） and gastric ulcer （GU） patients increased gradually （DU： 42.5, 43.6, 44.6.47.4 years, respectively and GU： 48.9, 50.1, 49.5, 52.6 years, respectively; P〈0.01）. In average, DU patients were ahnost 6 years younger than GU patients. The ratio of DU to GU was 1.84-2.99 in the above four time periods. The prevalence of both DU and GU in males were higher than those in females. The ratios of male to female of DU ranged from 1.45：1-2.59：1, that of GU ranged from 2.08：1-4.27：1. Among the H. pylori -positive proportions of all individuals received gastroscopy, DU patients and GU patients were 51.5%, 78.5%, 71.9% in 1997 and 31.0%, 63.5%, 58.0% in 2003. There were statistically significant differences between the previous and recent data of each group （P〈0.01）. Conclusions： There is a steady, gradual increase in the average age of peptic ulcer disease including DU and GU during our observational time periods. Male was still more susceptible to peptic ulcer disease. The positivity rate of H. pylori infection in all individuals received gastroscopy and in peptic ulcer patients have been declining gradually in recent years.