青年人胃溃疡157例临床分析

A Clinical Analysis of 157 Young Patients with Gastric Ulcer

目的探讨青年人胃溃疡的临床及病理特点。方法对157例患者临床病理资料进行系统性回顾，并与381例中年患者和210例老年患者作对比分析。结果病因分析：青年组以幽门螺杆菌（Hp）感染者和长期吸烟多见。临床表现：青年组有上腹痛者占大多数，与中年组相近而多于老年组；无症状者仅占5．7％，低于中年组（10．2％，P〈0．05）和老年组（21．9％，P〈0．01）。好发部位：青年组远端胃（胃窦、胃角）为好发部位，近端胃明显少于老年组，胃底少于中年组。溃疡形态与大小：青中年组溃疡均深而较小，老年组浅而较大。组织学改变：青年组粘膜萎缩，肠上皮化生和上皮内瘤变均明显少于中老年组。并发症：青年组总发生率为21．0％，与中年组相似而低于老年组。结论青年人胃溃疡主要病因可能是Hp感染和长期吸烟；大多数有上腹痛；好发于远端胃，溃疡较小而深，恶变的可能性不大；并发症少见。

Objective To investigate the clinical and pathological characteristics of gastric ulcer in youth. Methods The clinical and pathological features of 157 young patients with gastric ulcer were analyzed retrospectively and compared with those of 381 middle -aged and 210 aged patients respectively. Results Ratios of young patients with H. pylori infection and heavy smoking were 72.6% and 51.0% respectively, that of young patients treated with NSAIDs was only 1.9%. There were more cases with epigastric pain in the youth than in the aged group, but similar to the middle - aged group. Rratio of young patients with no symptom was 5.7%, lower than that of the middle -aged （10.2% ,P 〈0.05） and the aged （21.9% ,P 〈 0.01 ）. The ulcers in the youth were mostly located in the lower partion of stomach （ gastric antrum and angle）, deeper and smaller than those of the aged. Conclusion Occurrence of gastric ulcer in the youth might be related to H. pylori infection and heavy smoking. Epigastric pain is common in most of the young cases, however complications are seldom found in them. Ulcers in youth are deeper and smaller, and seem to have less probability of canceration.