急诊科就诊的老年非溃疡性消化不良患者相关致病因素分析

摘要

目的 探讨急诊科就诊的老年非溃疡性消化不良(NUD)的相关致病因素. 方法 2011年1月至2013年12月在开滦总医院急诊科就诊的97例老年NUD患者(NUD组),选择同期116例健康查体的老年人为对照组,收集一般临床资料、幽门螺杆菌(HP)感染、不良生活习惯、焦虑、抑郁及长期口服非甾体抗炎药等临床致病因素,进行比较分析. 结果 NUD组患者HP感染率为70.1％(68/97),对照组为54.3％(63/116),差异有统计学意义(x2=5.565,P＜0.05).老年NUD组患者不良生活习惯中饮食习惯、吸烟、饮酒、缺乏规律运动的发生率高于对照组(均P＜0.05);老年NUD患者中无焦虑和(或)抑郁状态发生率低于对照组(P＜0.05),可疑焦虑和(或)抑郁状态、肯定焦虑和(或)抑郁状态的发生率高于对照组(P＜0.05);NUD组中长期(半年以上)非甾体抗炎药服用率30.9％(30例),高于对照组10.3％(12例),差异有统计学意义(x2=14.138,P＜0.05).NUD组患者血清PGⅠ、PGⅡ水平高于对照组[(178.7±13.6)μg/L与(125.2±10.5)μg/L、(28.8±5.3) μg/L与(14.7±3.8)μg/L],差异有统计学意义(t值分别为1.971、1.960,均P＜0.01). 结论 老年NUD患者与HP感染、不良生活习惯、长期服用非甾体消炎药及焦虑和(或)抑郁状态密切相关.血清胃蛋白酶酶原Ⅰ、Ⅱ可用于在老年消化不良患者病因的筛查.%Objective To identify etiological factors for non-ulcer dyspepsia (NUD) in elderly patients presenting to the emergency department.Methods A total of 97 elderly patients with NUD presenting to the emergency department from January 2011 to December 2013 were enrolled in the NUD group and 116 elderly people undergoing annual physical examinations served as the control group.Clinical data,including Helicobacter pylori (HP) infection,unhealthy living habits,anxiety,depression and regular intake,were collected and compared between the two groups.Results Compared with the control group,the NUP group showed a higher HP infection rate [70.1％ (68/97)vs.54.3％ (63/116),x2 =5.565,P＜0.05],a higher incidence of unhealthy living habits (unhealthy dietary habits,smoking,drinking,and lack of regular exercise) (P＜0.05),a higher incidence of suspect anxiety/anxiety and a higher incidence of regular intake [30.9％ (30/97) vs 10.3％ (12/116),x2=14.138,P＜0.05].SerumpepsinogenⅠ(PGⅠ) [(178.7±13.6) μg/L vs.(125.2±10.5)μg/L,t=1.971,P＜0.01] and serum pepsinogen Ⅱ(PG Ⅱ) [(28.8±5.3) μg/L vs.(14.7±3.8)μg/L,t=1.960,P＜0.01] levels were also higher in the elderly NUD patients than in the control group.Conclusions HP infection,unhealthy living habits,anxiety and/or depression,and regular intake are closely associated with NUD in the elderly.Serum PGⅠ and PGⅡ could be used as markers in screening for malignant lesions in elderly patients with dyspepsia.