Kenichi Yamanaka, Misaki Nakano, Department of Gastroenterology, Iwate Prefectural Kamaishi Hospital, Kamaishi 026-8550, Japan.
World J Gastroenterol. 2013 Nov 14;19(42):7426-32. doi: 10.3748/wjg.v19.i42.7426.
To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district.
Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively. The subjects were 27 patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11, 2011. This period was divided into two phases: the acute stress phase, comprising the first month after the earthquake disaster, and the chronic stress phase, from the second through the sixth month. The following items were analyzed according to these phases: age, sex, sites and number of ulcers, peptic ulcer history, status of Helicobacter pylori (H. pylori) infection, intake of non-steroidal anti-inflammatory drugs, and degree of impact of the earthquake disaster.
In the acute stress phase from 10 d to 1 mo after the disaster, the number of patients increased rapidly, with a nearly equal male-to-female ratio, and the rate of multiple ulcers was significantly higher than in the previous year (88.9% vs 25%, P < 0.005). In the chronic stress phase starting 1 mo after the earthquake disaster, the number of patients decreased to a level similar to that of the previous year. There were more male patients during this period, and many patients tended to have a solitary ulcer. All patients with duodenal ulcers found in the acute stress phase were negative for serum H. pylori antibodies, and this was significantly different from the previous year's positive rate of 75% (P < 0.05).
Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers.
阐明一个医疗区内震后时期出血性胃/十二指肠溃疡的特征。
回顾性分析 2011 年 3 月 11 日至 6 个月内，日本东北地区大地震灾害后岩手县釜石医院的出血性胃/十二指肠溃疡患者。将以呕血或便血为主诉并经上消化道内镜诊断为出血性胃/十二指肠溃疡的 27 例患者作为研究对象。该时期分为两个阶段：地震灾害后第一个月的急性应激期和第二个月至第六个月的慢性应激期。根据这两个阶段分析以下项目：年龄、性别、溃疡部位和数量、消化性溃疡病史、幽门螺杆菌（H. pylori）感染状态、非甾体抗炎药的使用情况以及地震灾害的影响程度。
在灾害后 10 天至 1 个月的急性应激期，患者数量迅速增加，男女比例几乎相等，多发性溃疡的比例明显高于前一年（88.9%比 25%，P < 0.005）。在地震灾害后 1 个月开始的慢性应激期，患者数量减少到与前一年相似的水平。此期间男性患者较多，许多患者倾向于出现单个溃疡。在急性应激期发现的所有十二指肠溃疡患者的血清 H. pylori 抗体均为阴性，与前一年的阳性率 75%显著不同（P < 0.05）。
地震灾害引起的严重应激可能影响出血性胃/十二指肠溃疡的特征。
