消化性溃疡作为上消化道出血病因的发生率被夸大了。

The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated.

作者信息

Boonpongmanee Somprak, Fleischer David E, Pezzullo John C, Collier Kevin, Mayoral William, Al-Kawas Firas, Chutkan Robynne, Lewis James H, Tio Thian L, Benjamin Stanley B

机构信息

Pharmacology Department, Georgetown University Medical Center, Washington, DC, USA.

出版信息

Gastrointest Endosc. 2004 Jun;59(7):788-94. doi: 10.1016/s0016-5107(04)00181-6.

DOI:10.1016/s0016-5107(04)00181-6

PMID:15173790

Abstract

BACKGROUND

Peptic ulcer disease is considered the cause of upper-GI bleeding in 50% of cases. A recent decline in the proportion of cases of upper-GI bleeding because of a peptic ulcer was noted by us. The objectives of this study were to evaluate the frequency of peptic ulcer in patients with upper-GI bleeding and the proportion of bleeding peptic ulcers with a non-bleeding visible vessel.

METHODS

Patients with upper-GI bleeding seen from December 1999 until April 2001 at a tertiary, university-affiliated medical center were studied prospectively. The Clinical Outcome Research Initiative (CORI) database was used to correlate the single institution data with nationwide data. Endoscopic data in the CORI database for patients who had endoscopy for upper-GI bleeding between December 1999 and July 2001 were retrieved and analyzed.

RESULTS

A total of 126 patients were included in the prospective study. The endoscopic findings were: peptic ulcer in 31.8%: 95% confidence interval (CI) [23.7%, 40.6%] of patients; a non-bleeding visible vessel was present in 10%: 95% CI[2.8%, 23.7%] of these peptic ulcers. From the nationwide CORI database, data for 7822 patients with upper-GI bleeding were obtained. The endoscopic findings were: peptic ulcer in 20.6%:95% CI[19.7%, 21.5%] of patients with upper-GI bleeding; a non-bleeding visible vessel was present in 7.3%: 95% CI[6.1%, 8.6%] of the ulcers.

CONCLUSIONS

The frequency of peptic ulcer in patients with upper-GI bleeding and the proportion of bleeding ulcers with a non-bleeding visible vessel are less than previously reported.

摘要

背景

消化性溃疡病被认为是50%的上消化道出血病例的病因。我们注意到近期因消化性溃疡导致的上消化道出血病例比例有所下降。本研究的目的是评估上消化道出血患者中消化性溃疡的发生率以及有非出血性可见血管的出血性消化性溃疡的比例。

方法

对1999年12月至2001年4月在一所大学附属三级医疗中心就诊的上消化道出血患者进行前瞻性研究。使用临床结局研究计划（CORI）数据库将单机构数据与全国数据进行关联。检索并分析了CORI数据库中1999年12月至2001年7月因上消化道出血接受内镜检查的患者的内镜数据。

结果

前瞻性研究共纳入126例患者。内镜检查结果显示：31.8%的患者患有消化性溃疡，95%置信区间（CI）为[23.7%，40.6%]；这些消化性溃疡中有10%存在非出血性可见血管，95%CI为[2.8%，23.7%]。从全国性的CORI数据库中，获取了7822例上消化道出血患者的数据。内镜检查结果显示：20.6%的上消化道出血患者患有消化性溃疡，95%CI为[19.7%，21.5%]；7.3%的溃疡存在非出血性可见血管，95%CI为[6.1%，8.6%]。