中国人溃疡病流行状况及其治疗依从性

An investigation on the epidemic situation of peptic ulcer and patients′ compliance with doctors′ orders in China

目的 获取中国人溃疡病的流行状况并观察溃疡病人对医嘱的依从性及其对疗效的影响。方法 采用同时性、前瞻性方法 ,调查溃疡病 11983例 ,了解不同性别、年龄、职业、文化程度患者溃疡病的发病情况和幽门螺杆菌 (Hp)的感染率 ,并就病人对医嘱的依从性及溃疡病的疗效、复发情况进行调查。结果 消化性溃疡病的年发病率根据标化人口统计约为 0 84‰ ,男女患病比为 3 6∶1;管理人员发病率最高 ,达 0 40 % ;高峰年龄组为 30～ 49岁 ;十二指肠球部溃疡与胃溃疡的发病比为1 9∶1;溃疡直径 <10mm占 80 %以上 ;Hp感染阳性率为 73 8% ;溃疡年复发率为 6 8% ,Hp阳性对溃疡的复发影响显著 (P <0 0 1)。溃疡病人对医嘱的依从率仅为 47 1% ;依从者的溃疡治愈率达97 4% ,而不依从者仅为 5 8 8%。结论 消化性溃疡病仍是我国的一种多发疾病 ,对我国劳动力资源危害严重 ;Hp阳性溃疡病的比例与发达国家接近 ;溃疡病人对医嘱的依从性较低且其对疗效影响显著。

Objective To know the epidemic situation of peptic ulcer and ulcer patients′ compliance with doctors′ orders in China Methods A simultaneous and prospective investigation was conducted in 11 983 patients Patients with active peptic ulcers diagnosed with gastroscopic and pathologic examinations and followed up at 100 selected hospitals of ten districts in Zhejiang province of China were recruited for this investigation Investigation forms were designed which included patients′ sex, age, occupation; location, sizeand number of ulcers; Helicobacter pylori (Hp) infection; symptom change, gastroscopic and pathologic examination results before and after treatments; compliance with doctor′s orders for medication and follow up and/or reasons for noncompliance, etc Results The incidence of ulcers within one year was about 0 84‰ with the rate for males and females 3 6:1 The peak age was during 30～49 years old, and the highest incidence among different occupational groups was 0 40% found in administrators The incidence of duodenal ulcer was 1 9 times as many as gastric ones The most common size of ulcers was less than 10 mm, representing over 80% Hp positive rate was 73 8% The compliance rate of ulcer patients was 47 1% The cure rate for those compliance with doctors′ orders was 97 4%, while only 58 8% for noncompliant patients The rate of recurrence within one year was 6 8% Conclusion Peptic ulcer is a common disease in China The disease is a severe threat to the labor resource in China The rate of Hp infection in peptic ulcer cases is as high as that in advanced countries Compliance with doctors′ orders exerts a significant influence on the curative effect