中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2011年
5期
289-293
,共5页
余莲英%王启仪%岑荣英%沙卫红
餘蓮英%王啟儀%岑榮英%沙衛紅
여련영%왕계의%잠영영%사위홍
胃肠出血%消化性溃疡出血%胃黏膜%抗炎药,非甾类%年龄分布
胃腸齣血%消化性潰瘍齣血%胃黏膜%抗炎藥,非甾類%年齡分佈
위장출혈%소화성궤양출혈%위점막%항염약,비치류%년령분포
Gastrointestinal hemorrhages Peptic ulcer hemorrhage%Gastric mucosa%Antiinflammatory agents,non-steroidal%Age distibution
目的 探讨近20年来广东地区上消化道出血(UGIB)的病因及死亡率变化.方法 回顾性分析1990年1月至2009年10月广东省人民医院确诊的UGIB患者共3140例,按入院时间顺序及年龄分组,对比UGIB病因的变化及其影响因素.结果 UGIB患者中男性多于女性,性别比为2.5∶1,前后10年性别构成比未发生明显变化;消化性溃疡(PU)出血是中青年(<60岁)UGIB患者最主要病因,特别是十二指肠溃疡(DU)出血(45.0%),其次为急性胃黏膜病变(AGML)(16.6%);老年组(≥60岁)患者中,AGML(40.5%)是最主要病因,较中青年(16.6%)明显多(P<0.01).前、后10年相比,PU总体呈下降趋势(57.4%比42.8%,P<0.01),其中DU、复合溃疡出血较前明显减少,(43.8%比27.7%,P<0.01;7.7%比5.5%,P<0.05),胃溃疡(7.4%比8.1%,P>0.05)及食管胃底静脉曲张出血(EVB)(11.7%比12.9%,P>0.05)相对稳定.AGML出血较前明显增加(18.8%比32.4%,P<0.01),已超过Du成为UGIB最主要病因之一.结论 PU仍为广东地区UGIB的主要原因,AGML成为老年患者UGIB的另一重要病因,可能与非甾体抗炎药、抗血小板及抗肿瘤药物等使用增加有关.
目的 探討近20年來廣東地區上消化道齣血(UGIB)的病因及死亡率變化.方法 迴顧性分析1990年1月至2009年10月廣東省人民醫院確診的UGIB患者共3140例,按入院時間順序及年齡分組,對比UGIB病因的變化及其影響因素.結果 UGIB患者中男性多于女性,性彆比為2.5∶1,前後10年性彆構成比未髮生明顯變化;消化性潰瘍(PU)齣血是中青年(<60歲)UGIB患者最主要病因,特彆是十二指腸潰瘍(DU)齣血(45.0%),其次為急性胃黏膜病變(AGML)(16.6%);老年組(≥60歲)患者中,AGML(40.5%)是最主要病因,較中青年(16.6%)明顯多(P<0.01).前、後10年相比,PU總體呈下降趨勢(57.4%比42.8%,P<0.01),其中DU、複閤潰瘍齣血較前明顯減少,(43.8%比27.7%,P<0.01;7.7%比5.5%,P<0.05),胃潰瘍(7.4%比8.1%,P>0.05)及食管胃底靜脈麯張齣血(EVB)(11.7%比12.9%,P>0.05)相對穩定.AGML齣血較前明顯增加(18.8%比32.4%,P<0.01),已超過Du成為UGIB最主要病因之一.結論 PU仍為廣東地區UGIB的主要原因,AGML成為老年患者UGIB的另一重要病因,可能與非甾體抗炎藥、抗血小闆及抗腫瘤藥物等使用增加有關.
목적 탐토근20년래엄동지구상소화도출혈(UGIB)적병인급사망솔변화.방법 회고성분석1990년1월지2009년10월광동성인민의원학진적UGIB환자공3140례,안입원시간순서급년령분조,대비UGIB병인적변화급기영향인소.결과 UGIB환자중남성다우녀성,성별비위2.5∶1,전후10년성별구성비미발생명현변화;소화성궤양(PU)출혈시중청년(<60세)UGIB환자최주요병인,특별시십이지장궤양(DU)출혈(45.0%),기차위급성위점막병변(AGML)(16.6%);노년조(≥60세)환자중,AGML(40.5%)시최주요병인,교중청년(16.6%)명현다(P<0.01).전、후10년상비,PU총체정하강추세(57.4%비42.8%,P<0.01),기중DU、복합궤양출혈교전명현감소,(43.8%비27.7%,P<0.01;7.7%비5.5%,P<0.05),위궤양(7.4%비8.1%,P>0.05)급식관위저정맥곡장출혈(EVB)(11.7%비12.9%,P>0.05)상대은정.AGML출혈교전명현증가(18.8%비32.4%,P<0.01),이초과Du성위UGIB최주요병인지일.결론 PU잉위엄동지구UGIB적주요원인,AGML성위노년환자UGIB적령일중요병인,가능여비치체항염약、항혈소판급항종류약물등사용증가유관.
Objective To explore the changes of etiology and mortality of upper gastrointestinal bleeding (UGIB) in the last 20 years in Guangdong region. Methods A total of 3140 UGIB cases diagnosed in Guangdong General Hospital from January 1990 to October 2009 were analyzed with retrospective analysis. Groups were divided according to admission chronological order and age to analyze the causes of UGIB to get the trend of changes and influencing factors. Results UGIB occurred more in men than in women, the gender ratio was 2. 5∶1. There was no significant change in gender composition between the first and later 10 years. Peptic ulcer bleeding (PUB) was the main cause of UGIB in young and middle-age patients (age<60 years), especially duodenal ulcer (DU)bleeding (45. 0%) , and secondary was acute gastric mucosal lesion ( AGML) (16. 6%). While in elder patients group (age≥60 years), the main cause of UGIB was AGML (40. 5%), the frequency was significantly higher compared with the young and middle-age group (40. 5% vs 16. 6%,P<0. 01).Compared the first 10 years with the later 10 years, the occurrence rate of PUB was overall in downward trend (57. 4% vs 42. 8%, P<0.01), of which DU and compound ulcer(CU) bleeding reduced significantly (DU: 43.8% vs 27.7%, P<0. 01 and CU: 7.7% to 5.5%, P<0. 05). While the incidence of gastric ulcer (GU) (7.4% vs 8. 1% ,P>0. 05) and esophagogastric variceal bleeding (EVB) (11. 7% vs 12. 9%, P>0.05) remained stable. The occurrence of AGML bleeding significantly increased than before (32. 4% vs 18. 8%,P<0. 01), and became one of the most important causes of UGIB. Conclusions PUB is still the most important cause of UGIB in Guangdong region. AGML becomes another important cause of UGIB in elder patients, which may relate to the increasing use of non-steroidal anti-inflammatory drugs (NSAIDs), anti-platelet and antineoplastic medicine.
