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非幽门螺杆菌、非非甾体抗炎药相关性消化性溃疡:对转诊至塔莱加尼医院的上消化道出血患者的描述性研究

Non-Helicobacter pylori, non-NSAIDs peptic ulcers: a descriptive study on patients referred to Taleghani hospital with upper gastrointestinal bleeding.

作者信息

Rajabalinia Hasan, Ghobakhlou Mehdi, Nikpour Shahriar, Dabiri Reza, Bahriny Rasoul, Sherafat Somayeh Jahani, Moghaddam Pardis Ketabi, Alizadeh Amirhoushang Mohammad

机构信息

Taleghani Hospital, Internal Medicine Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Loghman Hakim Hospital, Internal Medicine Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Gastroenterol Hepatol Bed Bench. 2012 Fall;5(4):190-6.

Abstract

AIM

The purpose of the present study was to evaluate the number and proportion of various causes of upper gastrointestinal bleeding and actual numbers of non-NSAID, non-Helicobacter pylori (H.pylori) peptic ulcers seen in endoscopy of these patients.

BACKGROUND

The number and the proportion of patients with non- H.pylori, non-NSAIDs peptic ulcer disease leading to upper gastrointestinal bleeding is believed to be increasing after eradication therapy for H.pylori.

PATIENTS AND METHODS

Medical records of patients referred to the emergency room of Taleghani hospital from 2010 with a clinical diagnosis of upper gastrointestinal bleeding (hematemesis, coffee ground vomiting and melena) were included in this study. Patients with hematochezia with evidence of a source of bleeding from upper gastrointestinal tract in endoscopy were also included in this study.

RESULTS

In this study, peptic ulcer disease (all kinds of ulcers) was seen in 61 patients which were about 44.85% of abnormalities seen on endoscopy of patients. Among these 61 ulcers, 44 were duodenal ulcer, 22 gastric ulcer (5 patients had the both duodenal and gastric ulcers). Multiple biopsies were taken and be sent to laboratory for Rapid Urease Test and pathological examination. About 65.53% of patients had ulcers associated with H.pylori, 9.83% had peptic ulcer disease associated with NSAIDs and 11.47% of patients had ulcers associated with both H.pylori and consumption of NSAIDs. 13.11% of patients had non-NSAIDs non- H.pylori peptic ulcer disease.

CONCLUSION

The results of this study supports the results of other studies that suggest the incidence of H.pylori infection related with duodenal ulcer is common, and that non-H pylori and non-NSAIDs duodenal ulcer is also common.

摘要

目的

本研究旨在评估上消化道出血各种病因的数量和比例,以及这些患者内镜检查中所见非非甾体抗炎药(NSAID)、非幽门螺杆菌(H.pylori)消化性溃疡的实际数量。

背景

据信,在幽门螺杆菌根除治疗后,由非幽门螺杆菌、非NSAID消化性溃疡病导致上消化道出血的患者数量和比例正在增加。

患者与方法

本研究纳入了2010年转诊至塔莱加尼医院急诊室、临床诊断为上消化道出血(呕血、咖啡渣样呕吐物和黑便)的患者的病历。内镜检查显示有上消化道出血源证据的便血患者也纳入本研究。

结果

在本研究中,61例患者被发现患有消化性溃疡病(各种溃疡),约占患者内镜检查异常的44.85%。在这61例溃疡中,44例为十二指肠溃疡,22例为胃溃疡(5例同时患有十二指肠溃疡和胃溃疡)。进行了多次活检并送实验室进行快速尿素酶试验和病理检查。约65.53%的患者溃疡与幽门螺杆菌有关,9.83%的患者患有与NSAID相关的消化性溃疡病,11.47%的患者溃疡与幽门螺杆菌和NSAID的使用均有关。13.11%的患者患有非NSAID非幽门螺杆菌消化性溃疡病。

结论

本研究结果支持其他研究的结果,即幽门螺杆菌感染与十二指肠溃疡相关的发生率很高,非幽门螺杆菌和非NSAID十二指肠溃疡也很常见。

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