Opposing time trends of peptic ulcer and reflux disease
Opposing time trends of peptic ulcer and reflux disease
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DOI：
10.1136/gut.43.3.327
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发表时间：
1998-09-01
期刊：
影响因子：
24.5
通讯作者：
Sonnenberg, A
中科院分区：
文献类型：
--
作者：
El-Serag, HB;Sonnenberg, A
背景-据推测，幽门螺杆菌感染的历史性下降导致消化性溃疡的下降，并伴随着反流病的上升。Aims -研究消化性溃疡和反流病的时间趋势。方法住院率进行了分析，从1970年到1995年使用的计算机数据库的美国退伍军人事务部。死亡率计算从生命统计的美国。结果-从1970年至1995年，胃和十二指肠溃疡，以及胃癌的住院率下降，而胃食管反流病和食管腺癌的住院率显着上升。在死亡率方面观察到类似的时间趋势。存在明显的种族差异。白色受试者发生率较高的反流性疾病和食管腺癌和胃溃疡或癌症的发病率较低，与non-whites.Conclusions -的种族差异和相反的时间趋势胃十二指肠与食管疾病是一致的假设，即在一般人群中幽门螺杆菌感染率下降，导致胃十二指肠疾病的发生率上升。食管反流病和相关的食管腺癌。
Background - Gastritis associated hypochlorhydria may be protective against gastro-oesophageal reflux disease. It was hypothesised that the historic decline in Helicobacter pylori infection resulted in a decline in peptic ulcer and a concomitant rise in reflux disease.Aims - To study the time trends of peptic ulcer and reflux disease. Methods-Hospitalisation rates were analysed using the computerised database of the US Department of Veterans Affairs from 1970 until 1995. Death rates were calculated from the Vital Statistics of the United States.Results - From 1970 to 1995, hospitalisation rates for gastric and duodenal ulcer, as well as gastric cancer fell, while the hospitalisation rates for gastro-oesophageal reflux disease and those for oesophageal adenocarcinoma rose significantly. Similar time trends were observed with respect to the death rates. There were notable ethnic differences. White subjects incurred higher rates of reflux disease and oesophageal adenocarcinoma and lower rates of gastric ulcer or cancer compared with non-whites.Conclusions - The ethnic variations and the opposing time trends of gastroduodenal versus oesophageal disease are consistent with the hypothesis that the declining infection rates of H pylori in the general population have led to a rise in the occurrence of gastro-oesophageal reflux disease and associated oesophageal adenocarcinoma.