Petersen H, Kristensen P, Johannessen T, Kleveland P M, Dybdahl J H, Myrvold H
Dept. of Medicine, University of Trondheim, Norway.
Scand J Gastroenterol. 1995 Jan;30(1):17-24. doi: 10.3109/00365529509093230.
Little is known about today's natural course of peptic ulcer disease (PUD).
A follow-up study based on a structured telephone interview was attempted in 728 patients with an endoscopic diagnosis of peptic ulcer in 1980-84.
Seven patients (1%) died because of PUD during the 8- to 10-year follow-up period. Of the 441 interviewed patients 15.2% had experienced no further clinical manifestations of PUD, 10.9% had had bleeding and 0.7% perforation, and 17.5% had been operated on. The operated patients reported fewer symptoms (p < 0.01) during the last 2 weeks before the interview than those not operated on. On an average the unoperated patients had had symptoms and had used histamine-2-receptor antagonists (H2RA) 12 and 10 weeks per year, respectively. Long-term treatment with H2RA was reported by 18%. More than one-third (36%) of the unoperated patients stated that the symptoms had had a significant negative impact on their lives. Age at onset of disease and index ulcer, family history, use of anti-inflammatory drugs and alcohol, bleeding, and another chronic disease were found to be significant predictors of the course.
In more than one-third of the patients with PUD the course is still burdened with many symptoms and complications.
关于当今消化性溃疡疾病（PUD）的自然病程知之甚少。
对1980 - 1984年经内镜诊断为消化性溃疡的728例患者进行了一项基于结构化电话访谈的随访研究。
在8至10年的随访期内，7例患者（1%）死于PUD。在441例接受访谈的患者中，15.2%未出现PUD的进一步临床表现，10.9%有出血，0.7%有穿孔，17.5%接受了手术治疗。接受手术治疗的患者在访谈前最后2周报告的症状比未接受手术治疗的患者少（p < 0.01）。未接受手术治疗的患者平均每年分别有症状和使用组胺-2受体拮抗剂（H2RA）12周和10周。18%的患者报告长期使用H2RA。超过三分之一（36%）未接受手术治疗的患者表示症状对他们的生活有显著负面影响。发现发病年龄和指数溃疡、家族史、抗炎药和酒精的使用、出血以及另一种慢性病是病程的重要预测因素。
超过三分之一的PUD患者病程仍伴有许多症状和并发症。
