Massarrat S, Saberi-Firoozi M, Soleimani A, Himmelmann G W, Hitzges M, Keshavarz H
Tehran University of Medical Sciences, Iran.
Eur J Gastroenterol Hepatol. 1995 May;7(5):427-33.
To determine the prevalence of peptic ulcer disease, irritable bowel syndrome (IBS) and chronic constipation in two Iranian populations (pastoral nomads and industrial labourers) with different life styles, and to evaluate the risk factors associated with these diseases.
A total of 455 randomly selected pastoral nomads and 492 industrial labourers (all male) aged between 35-55 years.
Demographic and social data were obtained by interviews. An upper gastrointestinal tract endoscopy was performed and biopsy specimens were taken from subjects complaining of abdominal symptoms and randomly selected asymptomatic subjects. A urease test was performed on antral specimens. Serum pepsinogen I concentrations and Helicobacter pylori antibody titres were measured by radioimmunoassay and immunoglobulin (Ig) G enzyme-linked immunosorbent assay tests, respectively.
Serum pepsinogen I concentrations were similar in both nomads and industrial labourers, and the percentage with positive antibody titres for H. pylori was high in both populations (86.3 and 91% in nomads and industrial labourers, respectively). Industrial labourers were twice as likely to have duodenal ulcer (P < 0.05) than nomads. The prevalence of duodenal ulcer disease and gastric ulcer was 4.6 and 0.6% in nomads and 10.3 and 0.4% in industrial labourers, respectively. The prevalence of IBS was similar in nomads (3.1%) and industrial labourers (3.6%). Fewer nomads (1.4%) than industrial labourers (3.3%) had chronic constipation. Logistic regression analysis showed that being an industrial labourer, or smoker and having undergone previous non-gastric surgery were risk factors for duodenal ulcer disease. When the variable 'urease test' was included in the logistic regression analysis, smoking, a positive urease test and the quantity of fruit eaten per week were associated risk factors. The risk factors associated with IBS were the use of analgesics and back pain. The only risk factor associated with chronic constipation was being an industrial labourer.
Industrial labourers were twice as likely to have duodenal ulcer disease as nomads. The prevalence of IBS and chronic constipation in the two male Iranian populations was lower than that found in western countries. Duodenal ulcer disease was associated with H. pylori colonization but not with a positive serum antibody titre for H. pylori. H. pylori colonization of the antral mucosa and smoking are causative factors for duodenal ulcer disease and fruit intake is possibly an associated factor.
确定两种生活方式不同的伊朗人群（游牧民和产业工人）中消化性溃疡病、肠易激综合征（IBS）和慢性便秘的患病率，并评估与这些疾病相关的危险因素。
共随机选取455名年龄在35至55岁之间的游牧民和492名产业工人（均为男性）。
通过访谈获取人口统计学和社会数据。对主诉腹部症状的受试者以及随机选取的无症状受试者进行上消化道内镜检查并采集活检标本。对胃窦标本进行尿素酶试验。分别通过放射免疫测定法和免疫球蛋白（Ig）G酶联免疫吸附测定法测量血清胃蛋白酶原I浓度和幽门螺杆菌抗体滴度。
游牧民和产业工人的血清胃蛋白酶原I浓度相似，且两组人群中幽门螺杆菌抗体滴度呈阳性的比例均较高（游牧民和产业工人中分别为86.3%和91%）。产业工人患十二指肠溃疡的可能性是游牧民的两倍（P<0.05）。游牧民和产业工人中十二指肠溃疡病和胃溃疡的患病率分别为4.6%和0.6%，以及10.3%和0.4%。游牧民（3.1%）和产业工人（3.6%）中IBS的患病率相似。患有慢性便秘的游牧民（1.4%）比产业工人（3.3%）少。逻辑回归分析表明，身为产业工人、吸烟者以及曾接受过非胃部手术是十二指肠溃疡病的危险因素。当将变量“尿素酶试验”纳入逻辑回归分析时，吸烟、尿素酶试验呈阳性以及每周食用水果的量是相关的危险因素。与IBS相关的危险因素是使用镇痛药和背痛。与慢性便秘相关的唯一危险因素是身为产业工人。
产业工人患十二指肠溃疡病的可能性是游牧民的两倍。这两个伊朗男性人群中IBS和慢性便秘的患病率低于西方国家。十二指肠溃疡病与幽门螺杆菌定植有关，但与幽门螺杆菌血清抗体滴度呈阳性无关。胃窦黏膜幽门螺杆菌定植和吸烟是十二指肠溃疡病的致病因素，水果摄入量可能是一个相关因素。
