消化性溃疡出血流行病学的时间趋势

作     者：Ohmann C. Imhof M. Ruppert C. 赵菊辉 

作者机构：Coordination Centre for Clinical Trials Medical Faculty Heinrich- Heine University Moorenstraβe 5 DE- 40225 Dü sseldorf Germany 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第12期

页      面：58-59页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：消化性溃疡出血 时间趋势 溃疡发病率 风险预测 应激性出血 医院内科 日至 

摘      要：Objective. Despite the introduction of effective medical treatment of peptic ulcer disease, bleeding is still a frequent complication. The aim of this study was to investigate whether the incidence and the risk profile of peptic ulcer haemorrhage have changed within a 10- year period. Material and methods. In a prospective epidemiological and observational study the incidence and risk profile of peptic ulcer haemorrhage in Dü sseldorf, Germany were compared between two time periods (period A: 1.3.89- 28.2.90 and period B: 1.4.99- 31.3.2000), involving nine hospitals with both surgical and medical departments. Patients with proven peptic ulcer haemorrhage at endoscopy or operation were included in the study; those with bleeding under defined severe stress conditions were excluded. Results. No differences in bleeding ulcer incidence were observed between periods A and B (51.4 per 100,000 person- years versus 48.7), or for duodenal ulcer (24.9 versus 25.7) or for gastric ulcer bleeding (26.5 versus 23.0). A marked increase in incidence rates was observed with increasing age. In period B, patients with bleeding ulcers were older (56% versus 41% 70 years or older), were usually taking non- steroidal anti- inflammatory drugs (NSAIDs) (45% versus 27% ) and were less likely to have a history of ulcer (25% versus 59% ) compared with patients in period A. Conclusions. The persisting high incidence of peptic ulcer disease is a superimposing of two trends: a higher incidence in the growing population of elderly patient with a higher intake of NSAIDs and a lower incidence among younger patients due to a decrease in incidence and improved medical treatment.