摘要
目的研究作战部队在高应激（强训练／射弹）状态下胃粘膜损伤的防治．方法某应急作战部队高射炮兵自愿受试者１２０例，在射弹前后１ｄ～３ｄ内分别经电子胃镜、光镜、电镜观察胃粘膜征象及组织形态学改变，同时检测Ｈｐ，并做放射免疫法测定血清促胃液素、胰岛素、皮质醇及睾酮，分析其与胃粘膜病变的相关性．随机分观察组与预防组（射弹前１ｗｋ口服Ｈ２－受体阻滞剂西咪替丁４０ｍｇ，２次／ｄ，早晚空腹服；胃泌治２片，３次／ｄ；谷维素２０ｍｇ，３次／ｄ）各６０例对比，并经统计学处理．结果受试者１２０例，射弹前经内镜检查，显示浅表性胃炎６９例（５７５％），胆汁反流性胃炎５１例（４２５％）．射弹后观察组６０例中，显示糜烂性胃炎４２例（７００％），应激性胃溃疡１４例（２３３％），十二指肠溃疡４例（６７％）与射弹前比较有显著差异性（χ２＝８７０，Ｐ＜００１）．但预防组６０例中，射弹后与射弹前比较无显著性差异（χ２＝４４３，Ｐ＞００５）．两组对比有显著性差异（χ２＝１０５３９，Ｐ＜００１）．幽门螺杆菌（Ｈｐ）两组对比无显著性差异（χ２＝００７５，Ｐ＞００５），血清促胃液素射弹前比射弹后高，但无显著性差异（Ｐ＞００５），?
AIM To study the preventive and therapeutic method of gastric mucosal lesions induced by stress in Chinese army. METHODS From an emergency anti aircraft artillery unit 120 soldier volunteers were selected and electron endoscopic, optical and electron microscopic examinations were given to observe the histomorphological changes of gastric mucosa 1-3 days before and after volley firing respectively. Helicobacter pylori (Hp) was detected and serum gastrin, insulin, cortisol and tetosteron were also immunoradioassayed to investigate their relationship with gastric mucosal lesions. The subjects were divided into two groups: an observation group ( n =60) and a preventive group ( n =60, cimetidine 40mg twice a day; bismuthi aluminatis 2 tablets, three times a day; oryzanol 20mg three times a day; were administered orally one week before volley firing). Results were analysed statistically. RESULTS Of the 120 volunteers, superficial gastritis was endoscopically deteceted in 69 (57 5%) and bile reflux gastritis in 51 (42 5%) before volley firing. In 60 of the observation group, erosive gastritis was found in 42 (70 0%), stress gastric ulcer in 14 (23 3%), and duodenal ulcer in 4 (6 7%) after firing, which showed a significant difference (χ 2=87 0, P <0 01) in comparison with that before firing. In 60 of the preventive group, there was no significant difference between prefiring and postfiring (χ 2=443, P >0 05). There was a significant difference between the two groups (χ 2=105 39, P <0 01). The comparison of Hp infections in the two groups showed no significant difference (χ 2=0 075, P >0 05). Although the level of serum gastrin was higher beforefiring than afterfiring, the difference was not significant ( P >0 05). The levels of insulin, cortisol and tetosteron were higher beforefiring than afterfiring ( P <0 05, P <0 05 and P <0 01 respectively). CONCLUSION Under many stress factors such as strenuous manoeuvre and/or noisy circumstances, the serum levels of endocrines increased and Hp infection occurred. Preventive drugs are recommended to reduce the occurrence of gastric mucosal lesion before strenuous drill or volley firing.
出处
《世界华人消化杂志》
CAS
1999年第6期487-490,共4页
World Chinese Journal of Digestology
基金
济南军区重点科研课题
关键词
胃粘膜
胃疾病
应激
防治
gastric mucosa/pathology
stomach disease
stress
gastroscopy
