Talamini Giorgio, Tommasi Marina, Amadei Valeria, Pajusco Benedetta, Fratucello Anna, Lechi Alessandro, Scroccaro Giovanna, Vantini Italo
Gastroenterology and Endoscopy Unit, Department of Internal Medicine, University of Verona, Verona, Italy.
J Clin Gastroenterol. 2008 Apr;42(4):373-80. doi: 10.1097/MCG.0b013e3180318ac5.
Over the past few years, major changes have taken place in the treatment of gastroduodenal peptic ulcer.
To evaluate risk factors associated with the incidence of peptic ulcer in inpatients.
From 2001 to 2004, the number of prescriptions of H2-antagonists and proton pump inhibitors (PPIs) in each department of Verona University Hospital was monitored. Over the same period we prospectively recorded the number of upper endoscopies per department for inpatients with a diagnosis of peptic ulcer.
We analyzed 4943 inpatients. A significantly decreasing trend in H(2)-antagonist prescriptions (r=-0,88; P<0.001) and an increasing trend in PPI prescriptions (r=0.97; P<0.001) were observed. The endoscopic incidence of duodenal ulcers decreased linearly from 2001 to 2004 as follows: 6.5% (94/1439) in 2001, 5.6% (82/1473) in 2002, 4.5% (63/1411) in 2003, and 3.1% (22/702) (P<0.001) in 2004. Gastric ulcer incidence, sex, age, indication for endoscopy, use of nonsteroidal anti-inflammatory drugs (NSAIDs), presence of Helicobacter pylori (32%), and smoking and drinking habits showed no significant changes over the study period. Considering time-dependent variables, multivariate regression analysis identified only PPI use and NSAID use as factors predictive of duodenal ulcer but not of gastric ulcer.
In inpatients, PPIs are associated with a reduced risk of duodenal ulcer, whereas NSAIDs are associated with an increased risk. Gastric ulcer was not associated with any increased or degreased risk with the 2 above-mentioned variables.
在过去几年中，胃十二指肠消化性溃疡的治疗发生了重大变化。
评估住院患者消化性溃疡发病的相关危险因素。
2001年至2004年，监测了维罗纳大学医院各科室H2拮抗剂和质子泵抑制剂（PPI）的处方数量。在同一时期，我们前瞻性地记录了各科室诊断为消化性溃疡的住院患者的上消化道内镜检查数量。
我们分析了4943例住院患者。观察到H2拮抗剂处方呈显著下降趋势（r = -0.88；P < 0.001），PPI处方呈上升趋势（r = 0.97；P < 0.001）。十二指肠溃疡的内镜发病率从2001年至2004年呈线性下降，如下所示：2001年为6.5%（94/1439），2002年为5.6%（82/1473），2003年为4.5%（63/1411），2004年为3.1%（22/702）（P < 0.001）。胃溃疡发病率、性别、年龄、内镜检查指征、非甾体抗炎药（NSAIDs）的使用、幽门螺杆菌感染情况（32%）以及吸烟和饮酒习惯在研究期间均无显著变化。考虑时间依赖性变量，多因素回归分析仅确定PPI使用和NSAIDs使用是十二指肠溃疡的预测因素，而非胃溃疡的预测因素。
在住院患者中，PPI与十二指肠溃疡风险降低相关，而NSAIDs与风险增加相关。胃溃疡与上述两个变量的任何风险增加或降低均无关。
