非幽门螺杆菌非NSAID溃疡临床特征分析

Analysis of characteristics of non-Helicobacter pylori and non-NSAID peptic ulcer disease

目的:探讨非幽门螺杆菌(Hp)非非甾体类抗炎药(NSAID)溃疡的临床特征。方法:2011年1月-2013年12月期间在温州市人民医院接受胃镜检查诊断为消化性溃疡的473例患者均进行组织学和/或13C尿素呼气试验检查及病史询问,分为4组:非Hp非NSAID溃疡组(A组),单Hp感染所致溃疡组(B组),单NSAID所致溃疡组(C组),Hp感染和NSAID共同所致溃疡组(D组)。统计A组所占比率,及其性别、年龄分布特点;比较A组与B组、C组、D组消化性溃疡在临床症状和内镜表现方面的差异。结果:A组患者56例,占消化性溃疡的11.8%(56/473);A组同其他组比较性别构成差异无统计学意义(均P>0.05),年龄分布同B组比较差异有统计学意义(P<0.05);A组同其他组比较,腹痛、腹胀等症状发生率差异无统计学意义(均P>0.05),消化道出血较D组少见(P<0.05),腹部压痛体征较B组、C组和D组多见(均P<0.05);A组有吸烟史者所占比率高于其他组(均P<0.05),同B组比较在既往消化性溃疡病史方面差异有统计学意义(P<0.05);A组胃底溃疡和单发溃疡同B组比较差异有统计学意义(P<0.05),同其他组比较溃疡大小差异无统计学意义(均P>0.05)。结论:非Hp非NSAID溃疡在消化性溃疡中占有一定的比例,好发年龄较大,腹部压痛较多见,胃底溃疡及单发溃疡较单Hp感染所致溃疡多见。吸烟可能是非Hp非NSAID溃疡的病因之一。

Objective：To expplore the characteristics of non-Helicobacter pylori （Hp） and non-NSAID peptic ulcer disease. Methods：A total of 473 cases with peptic ulcer disease were recruited in the study between 2011 and 2013. Hp status was assessed by histology and/or ^13C-urea breath test. These cases were divided into group of non-Hp and non-NSAID peptic ulcer disease （group A）, group of Hp positive only （group B）, group of NSAID only （group C） and group of Hp positive and NSAID （group D）. The proportion of non-Hp and non-NSAID peptic ulcer disease （group A）, Gender and ages of these patients were collected. The characteristics of group A, group B, group C and group D were analyzed and compared. Results：Fifty six patients with non-Hp and non-NSAID peptic ulcer disease （group A） were diagnosed and the proportion was 11.8%（56/473）. There was no signiifcant difference between group A and other groups in distribution of gender （P〉0.05）. There was signiifcant difference between group A and group B in distribution of age （P〈0.05）. There was no signiifcant dif-ference between group A and other groups in clinical symptoms, such as abdominal pain, abdominal distension and so on （P〉0.05）. There was signiifcant difference between group A and group D in gastrointestinal bleeding （P〈0.05）.There was signiifcant difference among group A,group B, group C and group D in abdominal tenderness （P〈0.05）. The rate of smoker in group A was signiifcantly higher than that of the other groups （all P〈0.05）. The proportions of ulcer at stomach and single ulcer of group A were signiifcant higher than that of group B （P〈0.05）. There were no signiifcant difference among the four groups in sizes of ulcer （P〉0.05）. Conclusion：Non-Hp and non-NSAID peptic ulcer disease has an important proportion among peptic ulcer disease, the patients are old and the tenderness was common. The proportions of fudus of stomach and single ulcer are signiifcant higher than that of the group of Hp positive only. Smoking is one of the possible causes of non-Hp and non-NSAID peptic ulcer disease.