Chen Tseng-Shing, Lee Ying-Chiao, Li Fen-Yau, Chang Full-Young
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University, Taipei, Taiwan, R.O.C.
J Clin Gastroenterol. 2005 Sep;39(8):699-703. doi: 10.1097/01.mcg.0000173854.55172.ee.
Although Helicobacter pylori has been established as a major etiologic factor of chronic gastritis and makes an important contribution to peptic ulceration, the reason why H. pylori causes different gastroduodenal diseases in different people is at present not clear.
The aim of this study is to identify risk factors associated with duodenal ulcers in H. pylori-infected patients in a multivariate context.
Demographic data, personal habits, stressful life events, psychologic distress, severity of histology of antral mucosa, and serum pepsinogen I concentrations were studied in 54 consecutive dyspeptic patients with duodenal ulcers and 40 patients with functional dyspepsia.
As compared with functional dyspepsia patients, duodenal ulcer patients had more smokers (53.7% vs. 12.5%, P=0.000), higher pepsinogen I levels (median 96.0 vs. 74.5 ng/mL; P=0.002), more males (74.1% vs. 42.5%, P=0.004), more single (22.6% vs. 7.5%, P<0.05), and less in religion belief (44% vs. 70%, P<0.05). Only smoking remained significant on multivariate analysis (odds ratio=10.86, 95% CI=2.92-40.41, P<0.001). Among nonsmokers, only serum pepsinogen I level was found higher in duodenal ulcer patients as compared with functional dyspepsia patients (88 vs. 71, P<0.05).
Smoking and hyperpepsinogenemia are associated with increased risk for duodenal ulcer in H. pylori-infected patients.
尽管幽门螺杆菌已被确认为慢性胃炎的主要病因，并对消化性溃疡的形成起重要作用，但目前尚不清楚幽门螺杆菌为何在不同个体中导致不同的胃十二指肠疾病。
本研究旨在多变量背景下确定幽门螺杆菌感染患者十二指肠溃疡的相关危险因素。
对54例连续性消化不良十二指肠溃疡患者和40例功能性消化不良患者的人口统计学数据、个人习惯、生活应激事件、心理困扰、胃窦黏膜组织学严重程度及血清胃蛋白酶原I浓度进行研究。
与功能性消化不良患者相比，十二指肠溃疡患者吸烟者更多（53.7% 对12.5%，P = 0.000），胃蛋白酶原I水平更高（中位数96.0对74.5 ng/mL；P = 0.002），男性更多（74.1% 对42.5%，P = 0.004），单身者更多（22.6% 对7.5%，P < 0.05），宗教信仰者更少（44% 对70%，P < 0.05）。多变量分析显示只有吸烟具有显著意义（比值比 = 10.86，95%可信区间 = 2.92 - 40.41，P < 0.001）。在非吸烟者中，十二指肠溃疡患者的血清胃蛋白酶原I水平高于功能性消化不良患者（88对71，P < 0.05）。
吸烟和高胃蛋白酶原血症与幽门螺杆菌感染患者十二指肠溃疡风险增加有关。
