老年者消化性潰ようにおけるＨｅｌｉｃｏｂａｃｔｅｒ ｐｙｌｏｒｉ感染 内視鏡的胃粘膜性状との関連を含めて

Abstract

I examined the characteristics of Helicobacter pylori (H. pylori) infection in elderly patients with peptic ulcer and its relation to the endoscopic appearance of the gastric mucosa. 1) Infection with H. pylori was more common in middle-aged patients (those over 40 and younger than 59 years old, 80.4%) than in younger patients (those less than 39 years old, 63.0%). Elderly patients were less likely than younger patients to be infected (60's: 77.7%, 70's: 70.8%, over 80 years old: 65.8%). The percentage was higher in men than in women, in all age groups. 2) Oshima's classification was used to divide the patients into 5 groups, according to the endoscopic appearance of blood vessels of the gastric mucosa. Infection was found in 71.7% of the patients without atrophy, in 86.3% of those with mild atrophy, and in 88.9% of those with moderate atrophy. In contrast, infection was found in only 78.4% of the patients with severe atrophy. Similar results were found in patients with peptic ulcer and in subjects with no lesion except atrophic gastritis. 4) The percentage of patients with gastric ulcer disease who had atrophic gastric mucosa was higher in those with ulcers above the middle of the stomach (46.3%) than in those with ulcers in the antrum (30.2%, p < 0.05). Almost all patients with gastric ulcers in the lower part of the stomach and in the angulus were found to be infected with H. pylori (93.3% and 94.0%, respectively). The percentage of patients with ulcers low in the stomach who were infected was lower (59.4%). All of the location-related differences in infection were significant (p < 0.001).