CAJ | 학술논문

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。
목적：탐토비유문라간균（Hp）비비치체류항염약（NSAID）궤양적림상특정。방법：2011년1월－2013년12월기간재온주시인민의원접수위경검사진단위소화성궤양적473례환자균진행조직학화/혹13C뇨소호기시험검사급병사순문，분위4조：비Hp비NSAID궤양조（A조），단Hp감염소치궤양조（B조），단NSAID소치궤양조（C조），Hp감염화NSAID공동소치궤양조（D조）。통계A조소점비솔，급기성별、년령분포특점；비교A조여B조、C조、D조소화성궤양재림상증상화내경표현방면적차이。결과：A조환자56례，점소화성궤양적11.8%（56/473）；A조동기타조비교성별구성차이무통계학의의（균P＞0.05），년령분포동B조비교차이유통계학의의（P＜0.05）；A조동기타조비교，복통、복창등증상발생솔차이무통계학의의（균P＞0.05），소화도출혈교D조소견（P＜0.05），복부압통체정교B조、C조화D조다견（균P＜0.05）；A조유흡연사자소점비솔고우기타조（균P＜0.05），동B조비교재기왕소화성궤양병사방면차이유통계학의의（P＜0.05）；A조위저궤양화단발궤양동B조비교차이유통계학의의（P＜0.05），동기타조비교궤양대소차이무통계학의의（균P＞0.05）。결론：비Hp비NSAID궤양재소화성궤양중점유일정적비례，호발년령교대，복부압통교다견，위저궤양급단발궤양교단Hp감염소치궤양다견。흡연가능시비Hp비NSAID궤양적병인지일。
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.