Pantea Monica, Negovan Anca, Banescu Claudia, Bataga Simona, Neagoe Radu, Mocan Simona, Iancu Mihaela
Clinical Science-Internal Medicine, University of Medicine and Pharmacy, Gheorghe Marinescu 38, Tirgu Mureș, 540139 Mures, Romania.
Center for Advanced Medical and Pharmaceutical Research, University of Medicine and Pharmacy, Gheorghe Marinescu 38, Tirgu Mureș, 540139 Mures, Romania.
Gastroenterol Res Pract. 2018 Nov 4;2018:8319481. doi: 10.1155/2018/8319481. eCollection 2018.
We aimed to establish the independent predictive factors (from infection, biliary reflux, histologic features of the gastric mucosa, drugs, comorbidities, and social habits) for gastric stump ulcer occurrence more than 15 years after surgery.
76 patients with previous gastric surgery were included: 21 patients with gastric ulcer (marginal ulcer or ulcer of the rest of the gastric remnant-study group) and 55 controls (nonulcer group).
infection tended to be higher in the control group than in the ulcer group (14.5% vs. 4.8%, = 0.43), without statistical significance. Alcohol consumption had a significant positive association with ulcer ( = 0.008), while smoking ( = 0.064), low-dose aspirin ( = 0.063), and biliary reflux ( = 0.106) had a tendency toward statistical signification for positive association. On univariate analysis, smoking ( = 0.048, OR = 3.15, 95% CI: 1.01-9.93) and low-dose aspirin consumption ( = 0.067, OR = 2.63, 95% CI: 0.95-7.68) were significantly associated with ulcer. According to the multivariable regression model, alcohol consumption (OR = 6.68, 95% CI: 1.29-41.14) and biliary reflux (OR = 6.12, 95% CI: 1.36-38.26) remained significantly associated with increased odds of stump ulcer.
Biliary reflux and alcohol consumption, but not infection or gastrotoxic drug, seem to be the most important predictors for ulcer recurrence in patients with gastric surgery for peptic ulcer after more than 15 years.
我们旨在确定术后超过15年发生胃残端溃疡的独立预测因素（包括感染、胆汁反流、胃黏膜组织学特征、药物、合并症和社会习惯）。
纳入76例曾接受过胃部手术的患者：21例胃溃疡患者（边缘溃疡或胃残余其他部位溃疡——研究组）和55例对照（非溃疡组）。
对照组的感染率倾向于高于溃疡组（14.5%对4.8%，P = 0.43），无统计学意义。饮酒与溃疡有显著正相关（P = 0.008），而吸烟（P = 0.064）、低剂量阿司匹林（P = 0.063）和胆汁反流（P = 0.106）有正相关的统计学意义倾向。单因素分析显示，吸烟（P = 0.048，OR = 3.15，95%CI：1.01 - 9.93）和低剂量阿司匹林服用（P = 0.067，OR = 2.63，95%CI：0.95 - 7.68）与溃疡显著相关。根据多变量回归模型，饮酒（OR = 6.68，95%CI：1.29 - 41.14）和胆汁反流（OR = 6.12，95%CI：1.36 - 38.26）仍然与残端溃疡发生几率增加显著相关。
胆汁反流和饮酒，而非感染或胃毒性药物，似乎是消化性溃疡胃手术后超过15年患者溃疡复发的最重要预测因素。
