Recurrence of duodenal ulcer under continuous antisecretory treatment: an approach to the detection of predictive markers.
Seventy consecutive duodenal ulcer patients endoscopically followed up and treated after ulcer scarring with maintenance dosages of effective antisecretory drugs for 1 year were studied in order to identify the factors associated with ulcer relapse. Logrank test, discriminant analysis (Rao's method), and chi 2 were used in evaluating the results. Nineteen patients (27.1%) relapsed. Duodenal ulcer was found to relapse more frequently in patients with total serum pepsinogen more than 109 micrograms tyr X ml-1 X 24 h-1 and in patients with maximal acid output more than 60 mmol/h (Logrank test; both p less than 0.025). Discriminant analysis showed that blood group, age at onset of the disease, and sex were together useful in recognizing subjects relapsing within 6 months' maintenance treatment (77.1% cases correctly classified); age at onset of the disease, alcohol intake, and smoking habit were together useful in picking out subjects relapsing throughout the entire observation period (1 year) (61.76% cases correctly classified). Our data suggest that: 1) duodenal ulcer subjects with elevated serum pepsinogen or maximal acid output are significantly more prone to relapse than patients with normal or slightly increased values; 2) genetic and acquired factors (such as blood group A, early onset of the disease, male sex, alcohol intake, and cigarette consumption) may have a role in influencing ulcer relapse.
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001570:Benzodiazepinones / Q000627:therapeutic use; D001789:Blood Group Antigens; D002927:Cimetidine / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood; D010890:Pirenzepine; D011899:Ranitidine / Q000627:therapeutic use; D012008:Recurrence; D012737:Sex Factors; D012907:Smoking
D000897:Anti-Ulcer Agents; D001570:Benzodiazepinones; D001789:Blood Group Antigens; D010435:Pepsinogens; D010890:Pirenzepine; D002927:Cimetidine; D011899:Ranitidine