Long-term symptom patterns in duodenal ulcer: psychosocial factors.
Long-term symptom patterns in duodenal ulcer: psychosocial factors.
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十二指肠溃疡的长期症状模式：心理社会因素。
DOI：
10.1016/s0022-3999(96)00196-1
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发表时间：
1996
影响因子：
4.7
通讯作者：
Berto,E
中科院分区：
文献类型：
--
作者：
Levenstein,S;Prantera,C;Varvo,V;Arca,M;Scribano,ML;Spinella,S;Berto,E
75例近期发作的消化不良和内镜下可见的十二指肠溃疡患者进行了心理评估。雷尼替丁治疗后，他们定期重新采访了12至76个月（平均38.6）。溃疡症状出现在平均14.9%的随访月。如果患者在基线时有低地位职业、低教育、抑郁、压力性生活事件或明尼苏达多相人格调查表异常，则他们的表现明显更差。在回忆起病前生活压力的患者中，MMPI正常的患者的病程特别良性，而MMPI异常的患者的病程特别差（6%对29%的有症状月; p<0.04）。年龄、性别、吸烟、饮酒、抗生素、胃蛋白酶原、幽门螺杆菌滴度和初始愈合对预后无影响。低社会经济地位、生活压力、抑郁症和精神病理学均预测十二指肠溃疡抗分泌治疗的症状结局相对较差，但心理稳定的个体在压力下发生溃疡的长期预后良好。
Seventy-five patients with recent-onset dyspepsia and endoscopically visible duodenal ulcer underwent psychological evaluation. Following ranitidine treatment, they were reinterviewed periodically for 12 to 76 months (mean 38.6). Ulcer symptoms were present during a mean of 14.9% of follow-up months. Patients did significantly worse if they had a low-status occupation, low education, depression, stressful life events, or abnormal Minnesota Multiphasic Personality Inventory at baseline. Of patients recalling premorbid life stress, those with a normal MMPI had a particularly benign course, whereas those with an abnormal MMPI did particularly poorly (6% versus 29% of months symptomatic; p<0.04). Age, gender, smoking, drinking, antiinflammatory drugs, pepsinogen, Helicobacter pylori titers, and initial healing had no prognostic effect. Low socioeconomic status, life stress, depression, and psychopathology each predict a relatively poor symptom outcome for duodenal ulcer treated with antisecretory therapy, but psychologically stable individuals who develop an ulcer under stress have an excellent long-term prognosis.