女性消化性溃疡的某些流行病学特点——附1157例女性消化性溃疡的内镜资料分析

ENDOSCOPIC ANALYSIS OF 1,157 FEMALE PATIENTS WITH PEPTIC UICERS

该文回顾总结了近１７年胃镜检出的１１５７例女性消化性溃疡（ＰＵ）的内镜资料，结合近二年胃粘膜幽门螺杆菌检测结果，发现女性消化性溃疡的特点与男性有许多差异。女性十二指肠溃疡（ＤＵ）的平均年龄４４．１岁，胃溃疡（ＧＵ）的平均年龄为４８．３岁，与男性相比，ＧＵ的发病年龄一致，而ＤＵ的发病年龄要晚５～１０年。女性ＧＵ的四季检出率无明显差异（Ｐ＜０．０５），而ＤＵ的发病率有季节差异，以冬季最高。女性ＰＵ中ＤＵ占５６．９６％，与男性的４９．７２％无异，但ＧＵ占３７．３２％，较男性的４９．７２％为低，而复合溃疡，吻合口溃疡的比例二者无差异。女性ＰＵ的ＨＰ感染率（６６．５３％）低于男性（７０．３７％），其中ＤＵ和ＨＰ的感染率女性（７０．６６％）与男性（７１．２４）相近，而ＧＵ和ＨＰ感染率女性（５３．７３％）明显低于男性（６５．９３％）（Ｐ＜０．０１）。女性ＧＵ的好发部位与男性相比，胃角溃疡的比例增高，胃窦、胃体溃疡的比例下降。女性ＧＵ的溃疡面大小平均比男性要小，巨大溃疡的比例和多发性溃疡的比例女性均低于男性。结果表明，女性ＰＵ的发病情况，ＨＰ感染率及溃疡部位、大小与男性的差异。

The records of 49,304 endoscopic examinations of the upper gastrointestinal traect performed in our hospital from 1980 to 1996 were reviewed. Among them, 6,749 cases revealed the presence of peptic ulcers (PU), of which 1,157 female patients were analysed. The average age of women with duodenal ulcers (DY) was 5～10 years older than that of men, while the average age of women with gastric ulcers (GU) was similar to that of men. In women, no significant seasonal differences were noted in the incidence of GU, but seasonal differences in the incidence of DU were observed, with the highest occurence rate in winter (1.71%) and the lowest in summer (1.17%). The HP infection rates in PU in women (66.53%) were somewhat lower than that of men (70.37%), the HP infection rates in DU were similar in women (70.66%) and men (71.24%),and the HP infection rates in GU were significantly lower in women (53.73%) than in men (65.93%). In women, GU was found in the gastric angle (46.2%), gastric antrum (23.46%), pyloric canal ulcers were significantly more common in women than in men. Gastric angle ulcers were mnore common in women than in men, while gastric body and antrum ulcers were less common in women than in men. In women, the mean size of GU was smaller than that of men. HP infection rates and the size and location of PU may be related to the life role and endocrinal mechanism of women.