Patterns of biologic and psychologic risk factors in duodenal ulcer patients.
Patterns of biologic and psychologic risk factors in duodenal ulcer patients.
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十二指肠溃疡患者的生物和心理危险因素模式。
DOI：
10.1097/00004836-199509000-00010
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发表时间：
1995
影响因子：
2.9
通讯作者：
Lanari,G
中科院分区：
文献类型：
--
作者：
Levenstein,S;Prantera,C;Varvo,V;Scribano,ML;Berto,E;Spinella,S;Lanari,G
为了阐明心理因素是否以及如何导致消化性溃疡，在这项研究中，我们探讨了溃疡患者的心理特征与已知生物危险因素之间的关系。对75例新近发病的有症状的十二指肠溃疡患者，研究了三种潜在心理危险因素（生活压力事件、明尼苏达多相人格量表异常、情绪障碍）与历史危险因素（性别、年龄、季节性、家族史、吸烟、饮酒、喝咖啡、使用非甾体类抗炎药）、血型、血清胃蛋白酶原I和幽门螺杆菌抗体滴度的关系。患者病史中的危险因素越多，他或她出现精神病理或压力的可能性就越小（r= - 0.45, p= 0.0007）。3种心理危险因素均存在的患者常规危险因素平均为2.7个，无心理危险因素的患者常规危险因素平均为4.4个；相反，在有5个及以上生物危险因素的患者中，心理因素的平均数量为0.9个，在有少于3个生物危险因素的患者中，心理因素的平均数量为2.1个。这种负相关在没有溃疡史的患者中最为明显。心理因素也与幽门螺杆菌抗体滴度呈负相关，但与O型血或胃蛋白酶原无关。就其传统危险因素而言，不典型的十二指肠溃疡患者可能情绪脆弱，承受压力，或两者兼而有之，特别是在首次出现溃疡症状时。临床医生在诊断一个不符合通常患者特征的个体的溃疡时，应该注意心理因素。
To clarify whether and how psychologic factors might contribute to peptic ulcer, in this study we addressed the relations between psychologic characteristics and known biologic risk factors among ulcer patients. In 75 patients with recent-onset, symptomatic duodenal ulcer, an index of three potential psychologic risk factors (stressful life events, abnormal Minnesota Multiphasic Personality Inventory, mood disturbance) was examined in relation to historical risk factors (sex, age, seasonality, family history, smoking, alcohol use, coffee consumption, nonsteroidal antiinflammatory drug use), and to blood type, serum pepsinogen I, and Helicobacter pylori antibody titers. The more risk factors in a patient's history, the less likely he or she was to have psychopathology or stress (r=− 0.45, p= 0.0007). The mean number of conventional risk factors was 2.7 in patients with all three psychologic risk factors and 4.4 in patients with none; conversely, the mean number of psychologic factors was 0.9 among patients with five or more biologic risk factors and 2.1 among patients with fewer than three risk factors. This negative association was strongest among patients with no previous ulcer history. The psychologic factors also tended to vary inversely with H. pylori antibody titers but not with blood type O or pepsinogen. Duodenal ulcer patients who are atypical in terms of their conventional risk factors are likely to be emotionally fragile, under stress, or both, especially at the time of their first ulcer symptoms. A clinician diagnosing an ulcer in an individual who does not match the usual patient profile should be on the lookout for psychologic factors.