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目的 从胃酸及幽门螺杆菌 (H·pylori)感染角度探讨ABO血型影响十二指肠球部溃疡 (DU)发病的因素。方法 取 1995～ 2 0 0 3年 80例DU患者入选为DU组并比较其与北京地区 10 6 1位健康对照者血型分布的差别。比较DU组不同血型发病年龄。利用快速尿素酶实验、病理学及13 C呼吸实验确定DU组不同血型者H·pylori感染率并进行比较 ;利用 2 4h胃pH监测比较DU组不同血型者一天中不同时项胃pH分布。结果 DU组O型血者占 5 6 3% ,明显高于O型血在正常人群中的分布 2 8 7% (χ2 =2 6 6 9,P <0 0 0 5 )。不同血型者DU平均发病年龄差异无显著性 (P >0 0 5 )。DU组不同血型者H·pylori感染率无统计学差别 (P >0 0 5 ) ;且一天中直立位 (主要指白天空腹时 )、卧位 (主要指夜间 )、进餐期及餐后期各时段胃内平均pH值及胃内pH值在 0～ 1,0～ 2 ,0～ 3,0～ 4……的累计时间百分比无统计学差别 (P >0 0 5 )。结论 O型血者易患DU不是通过影响H·pylori感染率或胃酸分泌来起作用的。O型血可能是DU发病的另一独立危险因素。O血型DU发病年龄不早于其他血型。其致病机制仍有待进一步研究。
OBJECTIVE: To investigate the influence of ABO blood group on the pathogenesis of duodenal ulcer (DU) from the perspective of gastric acid and Helicobacter pylori infection. Methods Eighty DU patients from 1995 to 2003 were enrolled as DU group and compared with those of 106 healthy controls in Beijing area. Compare the different blood group age of onset in DU group. The rate of H · pylori infection in different blood types of DU patients was determined by rapid urease test, pathology and 13 C respiration test. The gastric pH distribution of different blood types of DU patients at different time points was compared by 24 h gastric pH monitoring. Results The number of O blood type in DU group was 56.3%, which was significantly higher than that in O type blood group in normal population (χ2 = 2696, P <0 055). There was no significant difference in mean age of onset of DU among different blood types (P> 0.05). There were no significant differences in the H. pylori infection rates between different blood groups in DU group (P> 0.05). In the same day, the prevalence of H · pylori in the blood group was mainly in the abdomen, mainly in the night, meal time and postprandial period There was no significant difference between the mean intragastric pH value and the intragastric pH value in 0-1, 0-2, 0-3, 0-4 ... (P> 0.05). Conclusion The susceptibility of DU to O-type blood is not mediated by H · pylori infection or gastric acid secretion. O blood may be another independent risk factor for the pathogenesis of DU. O blood group DU age of onset is not earlier than other blood groups. Its pathogenesis remains to be further studied.