| Objective:Through a retrospective analysis of patients who are peptic ulcers in patients with type 2 diabetes mellitus and simple peptic ulcer patients,which compare the differences of patients who are peptic ulcers in patients with type 2 diabetes mellitus and simple peptic ulcer patients in general information,clinical manifestation,ulcer occurrence location,the number of ulcer,size of ulcer,complications,Hp infection and eradication,ulcer healing;compare the difference of Hp infection and eradication、ulcer healing for groups of different duration of diabetes and groups of different Hb A1 c to analyze the clinical characteristics of type 2 diabetes mellitus with peptic ulcer,and study the effects of diabetes on peptic ulcer,to improve the understanding of peptic ulcer associated with type 2 diabetes,then provide guidance for further treatment.Methods:A total of 1035 peptic ulcers patients who were diagnosed by endoscopy and admitted to the Department of the First Hospital of Jilin University between January2011 and December 2020 were selected from were retrospectively analyzed.Among them,172 patients with type 2 diabetes were collected in an observation group,and 863 patients with simple peptic ulcer without diabetes were collected in a control group.The observation group and the control group were compared in terms of general information such as gender,age,smoking,drinking,blood routine,blood coagulation routine,albumin,blood lipid levels,clinical manifestation,ulcer occurrence location,the number of ulcer,size of ulcer,complications,Hp infection and eradication,ulcer healing;compare the difference of Hp infection and eradication,ulcer healing for groups of different duration of diabetes and groups of different Hb A1 c.To explore the influencing factors of ulcer healing and summarize the clinical characteristics of peptic ulcer associated with type 2 diabetes.Results:1、There is no significant differences in gender,smoking,alcohol consumption,activated partial thromboplastin time,hemoglobin,albumin,cholesterol,low density lipoprotein cholesterol between the two groups(P>0.05).The proportion of patients aged larger than 60 years in the observation group was higher than that in the control group,the difference was statistically significant(P<0.001).The proportion of patients with abnormal prothrombin time in the observation group was lower than that in the control group,the difference was statistically significant(P=0.017).The proportion of patients with abnormal prothrombin activity in the observation group was lower than that in the control group,the difference was statistically significant(P=0.004).The proportion of patients with platelet abnormality in the observation group was higher than that in the control group,the difference was statistically significant(P=0.016).The proportion of patients with abnormal uric acid in the observation group was higher than that in the control group,the difference was statistically significant(P=0.042).The proportion of patients with abnormal triglyceride in the observation group was higher than that in the control group,the difference was statistically significant(P<0.001).2、The incidence of hematemesis,nausea,vomiting,acid reflux,heartburn in the observation group was lower than that in the control group,the difference was not statistically significant(P>0.05).Compared with the control group,the incidence of melena and abdominal pain in the observation group was lower,the difference was statistically significant(P < 0.05).The incidence of abdominal distension and asymptomatic in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).3、The incidence of gastric ulcer in observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The incidence of duodenal ulcer was lower than that in the control group,the difference was statistically Significant(P<0.05),while complex ulcer incidence in the observation group was lower compared with the control group,without statistically significant(P>0.05).The number and size of ulcer between two groups was no obvious difference(P>0.05).The proportion of hemorrhage and obstruction in the observation group was significantly lower than that in the control group(P<0.05).4、Compared with the control group,The proportion of Hp infection in the observation group was higher,the difference was not statistically significant(P>0.05).But positive Hp eradication rate was significantly lower than that in the control group(P<0.05).The proportion of ulcer failure in the observation group was significantly higher than that in the control group(P<0.05).The risk of ulcer failure in the observation group was 16.572 times that of the control group(OR=16.572,95%CI=4.185-65.618);After anti-Hp therapy,the risk of ulcer failure in patients with Hp uneradicated was 16.456 times higher than in patients with Hp eradicated(OR=16.456,95%CI=4.114-65.830).5、The observation group was divided into three groups according to the duration of diabetes: <5 group,5-10 group,≥10 group.≥10 group had the highest Hp infection rate,with statistically significance compared with the 5-10 group(P<0.05),while the other every two groups showed no difference(P>0.05).There was no significant difference in Hp eradication rate and ulcer healing among the every two groups(P<0.05).6、The observation group was divided into three groups according to Hb A1 c level:≤7 group,7-9 group,>9 group,there was no difference in Hp infection among the three groups.With the increasing of Hb A1 c level,Hp eradication and ulcer healing decreased,the difference was statistically significant(P<0.05).Conclusion:1、Compared with simple peptic ulcer patients,gastric ulcer incidence in patients with type 2 diabetes combined with peptic ulcer is relatively high,while the incidence of duodenal ulcer is relatively low.2、Compared with simple peptic ulcer patients,patients with peptic ulcer patients associated with Type 2 diabetes have lower Hp eradication and worse ulcer healing effect.3、With the increase of Hb A1 c level in patients of Type 2 diabetes combined with peptic ulcer,the Hp eradication rate decrease and the ulcer healing effect is worse.4、Diabetes mellitus and Hp uneradicated are the independent influencing factors for the failure of peptic ulcer treatment.Controlling blood glucose stability and eradicating Hp are beneficial to improve ulcer healing. |
