Kang J Y, Elders A, Majeed A, Maxwell J D, Bardhan K D
Department of Gastroenterology, St George's Hospital, London, UK.
Aliment Pharmacol Ther. 2006 Jul 1;24(1):65-79. doi: 10.1111/j.1365-2036.2006.02960.x.
While overall hospital admission rates for peptic ulcer declined in England in the 1990 s, they increased among the elderly, especially for complicated ulcer. However, peptic ulcer admissions fell for all age groups in the United States.
To examine time trends in the incidence of hospital admissions, mortality and operations because of peptic ulcer in Scotland from 1982 to 2002, and the use of various drugs relevant to the aetiology and treatment of peptic ulcer from 1992 to 2002.
There was a general decrease in admission rates, especially for younger individuals. For individuals aged above 74 years, admission rates actually increased for gastric ulcer with haemorrhage among men, and for duodenal ulcer haemorrhage between both sexes. The number of operations fell dramatically, especially for younger patients. Mortality rates generally declined. Case fatality rates were greater for women than men, and declined over the study period for gastric ulcer, but increased for duodenal ulcer. The use of low-dose aspirin, oral anticoagulants, selective serotonin reuptake inhibitors and proton-pump inhibitors increased while those of non-steroidal anti-inflammatory drugs and histamine-2 antagonists declined.
Admission rates for peptic ulcer generally fell for younger individuals, but increased for older people with haemorrhage.
20世纪90年代,英格兰消化性溃疡的总体住院率有所下降,但老年人的住院率上升,尤其是复杂性溃疡患者。然而,美国所有年龄组的消化性溃疡住院率均有所下降。
研究1982年至2002年苏格兰因消化性溃疡住院、死亡及手术发生率的时间趋势,以及1992年至2002年与消化性溃疡病因及治疗相关的各类药物的使用情况。
住院率普遍下降,尤其是年轻人。74岁以上人群中,男性胃溃疡出血及两性十二指肠溃疡出血的住院率实际上升。手术数量大幅下降,尤其是年轻患者。死亡率总体下降。女性的病死率高于男性,胃溃疡的病死率在研究期间下降,但十二指肠溃疡的病死率上升。低剂量阿司匹林、口服抗凝剂、选择性5-羟色胺再摄取抑制剂和质子泵抑制剂的使用增加,而非甾体抗炎药和组胺-2拮抗剂的使用减少。
消化性溃疡的住院率在年轻人中普遍下降,但出血的老年人住院率上升。