胃、十二指肠溃疡幽门螺杆菌感染及相关病因回顾性分析204例

Helicobacter pylori infection and other risk factors associated with peptic ulcers:an analysis of 204 cases

目的:研究福建省立医院胃、十二指肠溃疡患者幽门螺杆菌(H.pylori)感染及其他致病因素对疾病发生的作用.方法:选取2003-2008年福建省立医院胃镜中心进行检查并确诊为消化性溃疡的患者204例,所有患者在胃镜检查前记录详细情况,包括H.pylori感染,胃黏膜活检尿素酶法(14C-UBT),吸烟史(每日>10支),饮酒史,非甾体类药物服用史.结果:H.pylori阳性的胃溃疡患者与阿司匹林(P=0.0010)、饮酒(P=0.0091)和其他非甾体类服用(P=0.0321)单独因素间呈显著性相关;H.pylori阳性的十二指肠溃疡与吸烟、饮酒、其他非甾体类服用三者共同作用呈显著性相关(P=0.0256),与阿司匹林、饮酒共同作用呈显著性相关(P=0.0020),与阿司匹林/吸烟共同作用呈显著性相关(P=0.0221);H.pylori阴性的胃溃疡患者与饮酒/其他非甾体类服用共同作用呈显著性相关(P=0.0435),与单纯非甾体类服用呈显著性相关(P=0.0431);H.pylori阴性的十二指肠溃疡患者与吸烟、饮酒、其他非甾体类服用共同作用呈显著性相关(P=0.0014),与阿司匹林、非甾体类服用呈显著性相关(P=0.0331),与阿司匹林、饮酒显著性相关(P=0.0032).结论:H.pylori感染、服用阿司匹林、饮酒和服用非甾体药物均是加重胃溃疡的发生的独立因素,而对于十二指肠溃疡,只有以上病因联合作用才能加重溃疡发生.

AIM：To study the impact of Helicobacter pylori（H.pylori） infection and other risk factors on the development of gastric ulcer（GU） and duodenal ulcer（DU）.METHODS：A total of 204 patients who were treated at our hospital from 2003 to 2008 were included.The association of H.pylori infection status（14C-UBT）,endoscopic findings,personal habits（smoking,alcohol intake）,and medication（non-steroidal anti-inflammatory drugs（NSAIDs）,aspirin intake） with the development of GU and DU was investigated using multiway frequency analysis.RESULTS：GU in the presence of H.pylori had significant association with aspirin（P = 0.0010）,alcohol（P = 0.0091） and NSAIDs（P = 0.0321）.DU in the presence of H.pylori had significant association with aspirin/smoking/NSAIDs（P = 0.0256）,aspirin/alcohol（P = 0.0020） and aspirin/smoking（P = 0.0221）.In the absence of H.pylori,GU had significant association with alcohol/NSAIDs（P = 0.0435） and NSAIDs（P = 0.0431）,while DU had significant association with smoking/alcohol/NSAIDs（P = 0.0014）,aspirin/NSAIDs（P = 0.0331）,and aspirin/alcohol（P = 0.0032）.CONCLUSION：In the presence of H.pylori,intake of aspirin,alcohol or NSAIDs acts as independent risk factors for the occurrence of GU but affects the occurrence of DU only when combined together.