2型糖尿病伴发消化性溃疡愈合质量及其复发的临床评析  

Clinical evaluation of quality of ulcer healing and recurrence of peptic ulcer patients complicated with type 2 diabetes mellitus after treatment

作　　者：李波静[1] 聂志红[1] 韦庭炫[1] 朱庆云[1] 李传元[1] 田涛[1] 谢平平[1] 

机构地区：[1]上海市浦东新区公利医院消化科,上海200135

出　　处：《胃肠病学和肝病学杂志》2010年第12期1124-1126,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)伴发消化性溃疡(peptic ulcer,PU)愈合质量及复发的临床特点。方法随访观察72例T2DM伴发PU患者和74例同期诊断明确的非糖尿病PU患者,并进行对照分析。所有患者均为活动期溃疡合并幽门螺杆菌(Helicobacter pylori,H.pylori)感染,胃溃疡(gastric ulcer,GU)和复合性溃疡共96例患者接受8周奥美拉唑治疗,十二指肠球部溃疡(duodenal ulcer,DU)50例患者接受6周奥美拉唑治疗;同时加用克拉霉素、阿莫西林或甲硝唑抗H.pylori治疗2周。治疗结束后1个月和12个月分别进行胃镜检查和H.pylori检测。结果治疗结束后1个月随访,T2DM组Sc期溃疡愈合率低于非T2DM组(P<0.01);H.pylori根除者溃疡高质量愈合率明显高于H.pylori未根除者(P<0.01)。治疗结束后12个月随访,T2DM组的溃疡年复发率高于非T2DM组(P<0.05);H.pylori根除者溃疡年复发率低于H.pylori未根除者(P<0.01)。结论虽然H.pylori根除后溃疡可获得高质量愈合,且溃疡复发率显著降低,但T2DM伴发PU溃疡愈合质量差,溃疡年复发率高。应重视对T2DM伴发PU患者H.pylori和胃镜的随访和复查。Objective To investigate the quality of ulcer healing（QOUH） and recurrence of peptic ulcer（PU） patients complicated with type 2 diabetes mellitus（T2DM） within one month and 12 months after treatment.Methods Of all patients,72 were PU patients complicated with type 2 diabetes mellitus,74 were PU patients without type 2 diabetes mellitus.All patients were active ulcer with Helicobacter pylori（H.pylori） infection.Ninety-six patients with gastric ulcer（GU） and complex ulcer were treated with Omeprazole for 8 weeks,50 patients with duodenal ulcer（DU） were treated with Omeprazole for 6 weeks.And all patients received Clarthromycin,Amoxicillin or Metronidazole on treatment H.pylori infection for 2 weeks.Those subjects were followed up by endoscopy and 14C-UBT after treatment of one month and 12 months.Results At one month after treatment,the ulcer healing rate of T2DM group was lower than that in the group without T2DM（P0.01）.The QOUH rate of H.pylori eradication group was higher than that in the H.pylori eradication failure group（P0.01）.At 12 months after treatment,the ulcer recurrence rate of T2DM group was higher than that in the group without T2DM（P0.05）.The ulcer recurrence rate of H.pylori eradication group was lower than that in the H.pylori eradication failure group（P0.01）.Conclusion PU complicated with T2DM had lower QOUH,but higher recurrence rates.After H.pylori eradication,recurrence rate of peptic ulcer markedly reduced and QOUH increased in the all treatment groups.It is suggested that H.pylori infection is an important pathogenic factor of peptic ulcer disease.It is important for PU patients complicated with T2DM followed by endoscopy and H.pylori study.

关 键 词：消化性溃疡 2型糖尿病 幽门螺杆菌 愈合质量 复发 

分 类 号：R573.1[医药卫生—消化系统] R587.1[医药卫生—内科学]