摘要
目的：探讨近期消化性溃疡病例的临床特点和发病的主要相关因素,为制定消化性溃疡的预防措施提供调查依据。
方法：采用以医院为基础的病例-对照研究方法,按统一的纳入和排除标准,随机选择2010年5月1日～2010年11月1日期间经湘雅二医院胃镜室确诊为新发消化性溃疡的病人作为病例组,另随机选择经胃镜检查为非萎缩性胃炎病例作为对照组。对上述研究对象进行问卷调查,内容包括：一般资料、生活习惯、饮食习惯、疾病史、临床症状等。采用SPSS13.0统计软件进行X2检验和logistic回归分析,对资料进行单因素和多因素分析,以了解消化性溃疡的发病相关因素。
结果：本次调查消化性溃疡组病例共253例,其中男182例,女71例,非萎缩性胃炎组125例,男72例,女53例。消化性溃疡组的男女性别比为2.6：1,40岁以下消化性溃疡病例占37.5%,41～50岁病例占29.7%,51-60岁病例占22.9%,60岁以上病例占9.9%,临床表现以规律性腹痛最多见,病例行胃镜检查时,活动期溃疡最多。
消化性溃疡发病相关因素的分析：1.单因素分析结果表明：男性多于女性,中学文化程度病例居多,从事体力劳动职业、生活无规律、吸烟、饮酒、缺乏睡眠、饮食无规律、食用牛奶、食用咖啡、食用煎炸食品、有心血管疾病史等因素与消化性溃疡的发生有关(均P<0.05)；而年龄、主食种类、食用辣椒、食用坚果类、有自身免疫性疾病史等因素则与消化性溃疡的发生无关(均P>0.05)。2.多因素logistic回归分析结果显示：生活不规律、抽烟、缺乏睡眠、饮食不规律、食用油炸食品、有心血管疾病史是消化性溃疡发病的主要危险因素(均OR>1)；食用牛奶与消化性溃疡发生呈负相关(OR<1)。
结论：近期消化性溃疡临床特点是男性的发病率高于女性,以青中年病例为主,临床表现以规律性腹痛为主,胃镜检查时机以活动期溃疡为主。
消化性溃疡发生的相关因素为男性、中学文化程度、从事体力劳动职业、生活无规律、吸烟、饮酒、缺乏睡眠、饮食无规律、食用咖啡、食用煎炸食品、有心血管疾病史,其中主要相关因素有生活无规律、抽烟、缺乏睡眠、饮食无规律、食用油炸食品、心血管疾病史；而食用牛奶与消化性溃疡发生负相关。
Objective:To explore the clinical characteristics and the main relative factors of the recent peptic ulcer, and provide preventive measures to cure peptic ulcer on a scientific basis.
Methods:This paper adopts a hospital-based case-control study method. Based on the uniform inclusion and exclusion criteria, the case group consists of patients who are randomly-selected new cases of peptic ulcer confirmed by the Gastro-Endoscopic Room of the Second Xiangya Hospital from May 1,2010 to November 1,2010, while the control group is made up of randomly-selected patients suffering from non-atrophic gastritis confirmed by the Gastro-Endoscopic Room of the same hospital. A questionnaire survey has been conducted among those subjects, concerning their general physical conditions, living habits, dietary habits, medical history and clinical symptoms ect.
Results:This questionnaire survey has peptic ulcer patients 253,the number of male patients is 182,and female 71, this questionnaire survey has has non-atrophic gastritis 125, the number of male patients is 72,and female 53.In the peptic ulcer group,male patients' to female patients' ratio of 2010 group is 2.6:1.37.5% of the patients are under the age of 40, and 29.7% of them are between the age of 41 and 50, while 22.9% of them are between the age of 51 and 60, and 9.9% of the patients are over 60. the main clinical manifestation is regular abdominal pain; Patients' visiting time is still concentrated in the active period。
The analysis of factors related to PU:1. Univariate analysis results showed:gender secondary education, engaged in manual occupations, living without the law, smoking, drinking Wine, lack of sleep, irregular diet, consumption of milk, consumption of coffee, consumption of fried foods, A history of cardiovascular disease and the pathogenesis of PU (P< 0.05); and age, the staple food types, edible nuts, pepper, a history of autoimmune disease were not related with the incidence of PU (P>0.05) 2.Multivariate logistic regression analysis results showed that:irregular lifestyle, smoking,lack of sleep time,eating disorders, consumption of fried foods, cardiovascular disease history are risk factors for peptic ulcer (OR>1); consumption of milk are the protective factors of peptic ulcer disease(OR<1).
Conclusions:The characteristics of the illness and clinical symptoms of peptic ulcer is the incidence rate for male patients is higher than female patients, and they are mainly young and middle-aged, and their clinical manifestations is the rule pain; and thier treatment time is mainly in the active phase。
In the case-control study, univariate analysis results showed that the factors related to peptic ulcer disease include the male gender, secondary education background, being engaged in manual labor occupations, irregular lifestyle, smoking, drinking, irregular eating habits, consumption of coffee, fried food, and the history of cardiovascular disease, while plenty sleep and the consumption of milk have some effects on avoiding the occurrence of peptic ulcer. Multivariate analysis results showed that irregular lifestyle, smoking, irregular eating habits, consumption of milk, eating fried food, the amount of sleep, and the history of cardiovascular disease are all associated with the pathogenesis of PU.
引文
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