2013—2019年幽门螺杆菌阳性消化性溃疡变化特点

Characteristics of Helicobacter pylori-positive Peptic Ulcer From 2013 to 2019

背景:尽管幽门螺杆菌感染率有所下降,但消化性溃疡在我国仍是一个主要的健康负担。目的:探讨近年消化性溃疡的变化趋势,特别是幽门螺杆菌阳性消化性溃疡的变化特点,为消化性溃疡的防治提供理论基础。方法:回顾性分析2013年1月—2019年12月上海仁济医院接受胃镜检查确诊为消化性溃疡患者的性别、年龄以及幽门螺杆菌感染状态等,总结其临床和流行病学特点。结果:研究期间共383413例患者接受胃镜检查,检出40385例消化性溃疡患者,其中胃溃疡15114例,十二指肠溃疡25271例;男女性别比为2.02∶1;幽门螺杆菌感染率为60.0%(其中胃溃疡为48.5%,十二指肠溃疡为66.9%)。随着年龄的增加,幽门螺杆菌阳性的消化性溃疡检出率明显下降。在2013—2019年中,幽门螺杆菌阳性的胃溃疡检出率由52.2%降至49.3%,幽门螺杆菌阳性的十二指肠溃疡检出率由70.0%降至63.9%。结论:随着幽门螺杆菌感染率的下降,幽门螺杆菌阳性的消化性溃疡特别是十二指肠溃疡的发病率显著减少,非幽门螺杆菌相关性溃疡的发病率上升,需引起足够的重视。

Background:Despite the decline in prevalence of Helicobacter pylori infection,peptic ulcer remains a major health burden in China.Aims:To investigate the trends of peptic ulcer in recent years,especially the changes of Helicobacter pylori-positive peptic ulcer,and to provide a theoretical basis for the prevention and treatment of peptic ulcer.Methods:Gender,age,and Helicobacter pylori status of patients diagnosed as peptic ulcer by gastroscopy from January 2013 to December 2019 at Shanghai Renji Hospital were retrospectively reviewed,and clinical and epidemiological characteristics were analyzed.Results:During the study period,peptic ulcer was found in 40385 of the 383413 patients undergoing gastroscopy,including gastric ulcer 15114 patients and duodenal ulcer 25271 patients.The ratio of male to female of peptic ulcer patients was 2.02∶1.Helicobacter pylori was present in 60.0%of peptic ulcer patients(48.5%in gastric ulcer,66.9%in duodenal ulcer).The detection rate of Helicobacter pylori-positive peptic ulcer was decreased with the increasing year of patients.The detection rate of Helicobacter pylori-positive gastric ulcer declined from 52.2%to 49.3%during 2013 to 2019,and Helicobacter pylori-positive duodenal ulcer from 70.0%to 63.9%.Conclusions:With the decrease of Helicobacter pylori infection rate,the incidence of Helicobacter pylori-positive peptic ulcer,especially duodenal ulcer,decreased significantly,and the incidence of non-Helicobacter pylori ulcer increased,which should be paid more attention.