Bernersen B, Johnsen R, Straume B
Institute of Clinical Medicine, University of Tromsø, Norway.
Gut. 1996 Jun;38(6):822-5. doi: 10.1136/gut.38.6.822.
The aetiology of non-ulcer dyspepsia and a possible connection to peptic ulcer disease is debated. This paper discusses this problem in a population based study.
The relation between non-ulcer dyspepsia and peptic ulcer disease was explored by the distribution in the general population and their associations to demographic, lifestyle, and psychological factors.
All inhabitants of a community aged 20-69 years received a questionnaire concerning abdominal complaints, health, lifestyle, diet, and social conditions. Reports on peptic ulcer were verified with medical records. Dyspeptic subjects and matched healthy, non-dyspeptic controls were endoscoped in a blinded procedure.
Of 2027 persons invited, 1802 (88.9%) returned the questionnaire from which dyspeptic subjects and controls were identified. Of 782 subjects invited to endoscopy, 309 dyspeptic and 310 control subjects (79.2%), participated.
Men reported dyspepsia (30.4%) and peptic ulcer (8.7%) more often than women (24.1% and 5.2%, respectively). Non-ulcer dyspepsia was frequent (between 10.6% and 17.2%) in both sexes and age groups up to 60 years, with a lower frequency in both men and women above this age (3.0% and 6.8%). Non-ulcer dyspepsia was associated with having a family history of dyspepsia and of peptic ulcer and the use of tranquillisers. Nearly one third of dyspeptic persons above the age of 40 years had peptic ulcer, but peptic ulcer prevalence was low under this age. Peptic ulcer was associated with a family history of peptic ulcer, smoking, and daily life stress, and also with poor living conditions during childhood, frequent recurrence of herpes labialis, conditions that were associated with Helicobacter pylori infection.
Non-ulcer dyspepsia and peptic ulcer have different patterns of relations to lifestyle, social, and psychological factors. The results perhaps support the hypothesis of peptic ulcer being an infectious disease in contrast with non-ulcer dyspepsia.
非溃疡性消化不良的病因以及与消化性溃疡疾病可能存在的联系存在争议。本文在一项基于人群的研究中探讨了这一问题。
通过在普通人群中的分布情况以及它们与人口统计学、生活方式和心理因素的关联，探究非溃疡性消化不良与消化性溃疡疾病之间的关系。
某社区所有年龄在20 - 69岁的居民都收到了一份关于腹部不适、健康状况、生活方式、饮食和社会状况的问卷。关于消化性溃疡的报告通过病历进行核实。消化不良受试者和匹配的健康非消化不良对照者接受了盲法内镜检查。
在2027名受邀者中，1802人（88.9%）返回了问卷，从中确定了消化不良受试者和对照者。在782名受邀接受内镜检查的受试者中，309名消化不良受试者和310名对照者（79.2%）参与了检查。
男性报告消化不良（30.4%）和消化性溃疡（8.7%）的比例高于女性（分别为24.1%和5.2%）。在60岁及以下的男女各年龄组中，非溃疡性消化不良都较为常见（在10.6%至17.2%之间），而在这个年龄以上的男性和女性中频率较低（分别为3.0%和6.8%）。非溃疡性消化不良与有消化不良家族史、消化性溃疡家族史以及使用镇静剂有关。40岁以上的消化不良者中近三分之一患有消化性溃疡，但在这个年龄以下消化性溃疡的患病率较低。消化性溃疡与消化性溃疡家族史、吸烟、日常生活压力有关，还与童年时期生活条件差、唇疱疹频繁复发等与幽门螺杆菌感染相关的情况有关。
非溃疡性消化不良和消化性溃疡与生活方式、社会和心理因素的关系模式不同。这些结果可能支持消化性溃疡是一种传染病这一假说，与非溃疡性消化不良形成对比。
