Seasonal Variation On Occurrence Of Hepatogenic Ulcer And The Analysis Of Hepatogenic Ulcer And The Liver Dysfunction

Objective: The hepatogenic ulcer was occurred on the base ofchronic hepatic disease, especial hepatocirrhosis with portalhypertension. The incidence of it was two-three times of the ordinarypeptic ulcer (the incidence of the ordinary peptic ulcer is 6.8%-10% inour country). Because most of the patients were asymptomatic, or thesymptom was covered by the symptom of liver cirrhosis itself, manycases had not been diagnosised timely or correctly. With thedevelopment and application of the technique of Gastroscopy in theclinic, more and more clinician began to realize this kind of ulcer. Itwas different from the ordinary peptic ulcer, the pathogenesis of it wasassociated with not only gastric acid and pepsin secretion, Hp etc, butalso the gore of portal vein caused by portal hypertension and liverdysfunction. The hepatogenic ulcer healing rate tended to be lower, ithad a higher frequency of complication such as upper gastrointestinaltract bleeding than the ordinary peptic ulcer, and the death rate seemedto increase in these patients. In order to understand this kind of ulcerwell, our study intended to investigate the seasonal variation onoccurrence of hepatogenic ulcer and analyze separately the connectionof gastric ulcer, duodenal ulcer with the liver dysfunction. Methods:Gastroscopy was performed in 46 cases with hepatogenic ulcer inpatients, the month of the ulcer occurred, the degree of esophagealvaricosity, the location of the ulcer and the different grades of liverfunction were respectively analyzed. Results: Of all the 46 patients,the number of hepatogenic ulcer increased in the intersecting periodsof spring-summer and autumn-winter, and the number of latter washigher than former;The location of the ulcer was different with thedifferent grade of liver function, in the grade of A of the liver function,the majority ulcer was duodenal ulcer, but the percentage of the gastriculcer was 80.0% of all the hepatogenic ulcer patients in the grade of C,the incidence of the gastric ulcer was obviously higher than that of theduodenal ulcer (P<0.05). Conclusion: The incidence of hepatogeniculcer showed significantly seasonally fluctuation, which increased inthe intersecting periods of spring-summer and autumn-winter, so weshould pay more attention to the prevention of ulcer at these seasons.The reason for this seasonal fluctuation was that in these seasons thetension of the portal vein changed with the variety of the climate. Inhot weather, patients tend to become anxious and nervous, which maybe the reason of that the incidence in the intersecting period ofspring-summer is higher than that of autumn-winter. With theincreased grade of liver function, the location of ulcer changed fromduodenal ulcer to compound ulcer and even to gastric ulcer, and thegastric acid secretion increased at first, but it decreased gradually withthat. The factors that could affect the portal hypertension and liverfunction would affect the occurrence of the hepatogenic ulcer, so thetherapy of the portal hypertension and the liver dysfunction were veryimportant in the therapy of the hepatogenic ulcer.