Okada M, Yao T, Imamura K, Maeda K, Yamamoto T, Koga T, Fuchigami T, Iida M, Okada Y
Department of Internal Medicine and Gastroenterology, Fukuoka University Chikushi Hospital, Japan.
Am J Gastroenterol. 1989 May;84(5):501-5.
Factors influencing the healing rate were evaluated by multivariate analysis on 148 patients with gastric ulcer who were under treatment with cimetidine at a daily dose of 800 mg. Factors used were age, sex, therapeutic environment, duration of present ulcer pain, past history of gastric ulcer, the amount of tobacco, alcohol, and coffee consumed before and during the treatment, the period until symptoms disappeared after the commencement of the treatment, and the characteristics of the ulcers themselves. Of these factors, the five factors that had a significant delaying effect on the healing of gastric ulcers were: 1) having a past history of gastric ulcers, 2) symptoms not disappearing within 1 wk after the commencement of the treatment, 3) size over 20 mm, 4) ulcer located in an angle, and 5) round or oval shape of the ulcer. The patients with less than one of the unfavorable factors (n = 36) had the best healing rate (97.2%), compared with those with two (n = 61), three (n = 39), or four or more (n = 12) unfavorable factors. The healing rate of the latter three groups was 75.4%, 53.8%, and 33.3%, respectively (p less than 0.01). Thus, a prognostic score based on these five factors represents the severity of gastric ulcers with regard to the healing in patients prescribed cimetidine.
对148例接受西咪替丁每日800mg治疗的胃溃疡患者,通过多因素分析评估影响愈合率的因素。所采用的因素包括年龄、性别、治疗环境、当前溃疡疼痛持续时间、胃溃疡既往史、治疗前及治疗期间吸烟、饮酒和喝咖啡的量、治疗开始至症状消失的时间以及溃疡本身的特征。在这些因素中,对胃溃疡愈合有显著延迟作用的五个因素为:1)有胃溃疡既往史;2)治疗开始后1周内症状未消失;3)大小超过20mm;4)溃疡位于胃角处;5)溃疡呈圆形或椭圆形。不利因素少于1个的患者(n = 36)愈合率最佳(97.2%),相比之下,有2个(n = 61)、3个(n = 39)或4个及以上(n = 12)不利因素的患者,后三组的愈合率分别为75.4%、53.8%和33.3%(p < 0.01)。因此,基于这五个因素的预后评分代表了服用西咪替丁患者胃溃疡愈合方面的严重程度。