高原地区胃癌及某些胃癌前期疾病的遗传度和ABO血型的相关研究

目的探讨青海高原地区胃癌和胃癌前期疾病为先证者的一级亲属中胃癌及癌前期疾病患病情况。方法根据胃癌和癌前期疾病的群体患病率，按Ｆａｌｃｏｎｅｒ估计阈值性状遗传度的公式，计算出ＣＵ、ＤＵ、ＧＵ、ＣＡＧ以及ＧＣ的遗传度和血型分布情况。结果ＰＵ、ＣＡＧ、及ＧＣ的遗传度分别为７３１０％±３１９％、６３６８％±４７４％、５９７６％±１２１３％、６４２２％±３３５％和３９００％±７９４％，符合多基因遗传方式。ＰＵ、ＣＡＧ与血型Ｏ在统计学上确有相关，ＧＣ与血型Ａ有相关。结论胃癌前期疾病的发生可能是个体易感性与环境共同作用的结果，其个体易感性占较强优势；而ＧＣ在高海拔低氧的地理环境下和饮食习惯等与遗传相比是主要患病因素。ＡＢＯ血型的遗传特征是参与形成溃疡和发生ＧＣ的遗传因素的共同因素。早期对如上疾病采取相应措施，预防ＰＵ的发生，以减少ＰＵ和慢性胃炎发生后的并发症的出现非常重要。     

老年消化性溃疡222例临床特征

目的探讨老年消化性溃疡（ＰＵＡ）的临床及内镜下特点．方法１９８５－１９９４年６０岁以上消化性溃疡（ＰＵ）住院患者２２２例，以同期６０岁以下ＰＵ１００例为对照进行临床内镜分析．结果老年胃溃疡占同期胃溃疡住院人数的构成比已由１９８５年的１０９％递增至１９９４年的２４０％．ＰＵＡ上腹痛、节律性腹痛、反酸、烧心症状发生率依次为５７８％，２２５％，３１５％和１０４％，对照组依次为８７０％，４５０％，４８０％和３８０％（Ｐ＜００１）．并发症发生率ＰＵＡ组为６０８％，对照组为４００％（Ｐ＜００１）．ＰＵＡ直径大于３ｃｍ者占２２５％，对照组为４０％（Ｐ＜００１）．行手术治疗者ＰＵＡ组为２１６％，对照组为１１０％（Ｐ＜００１）．结论ＰＵＡ临床症状不典型，并发症发生率高，巨大溃疡常见，出血难止，手术机率增加     

乙型肝炎病毒感染与消化性溃疡的关系

目的探讨乙型肝炎病毒（ＨＢＶ）感染与消化性溃疡（ＰＵ）之间的关系及其在ＰＵ形成中的作用机制．方法１９８９１０／１９９５０９因消化道症状而进行内镜检查及血清ＨＢＶＭ检测的３３４例患者，并对结果进行统计学处理分析．结果在３３４例患者中有４６例感染了ＨＢＶ，列为ＨＢＶ感染组，检出ＰＵ１９例（４１３％），其余２８８例列为ＨＢＶ非感染组，检出ＰＵ６６例（２２９％），两组有极显著差异（Ｐ＜００１）．在３３４例患者中有ＰＵ８５例，列为ＰＵ组，血清ＨＢＶＭ阳性率为２２４％，其中胃溃疡（ＧＵ）３１例（３６５％），十二指肠溃疡（ＤＵ）３５例（４１２％），复合性溃疡（ＣＵ）１９例（２２３％），ＧＵ，ＤＵ及ＣＵ血清ＨＢＶＭ阳性率分别为２５８％（８／３１），２２９％（８／３５）及１５８％（３／１９），三组相互间比较无显著性差异（Ｐ＞００５）；其余２４９例列为非ＰＵ组，血清ＨＢＶＭ阳性率１０８％，两组有极显著差异（Ｐ＜００１）．ＰＵ组与全国城市人群标化ＨＢＶＭ阳性率７９％比较有极显著差异（Ｐ＜００１）．结论ＨＢＶ感染与ＰＵ关系密切，是参与ＰＵ发病的一个因素．     

胃舒胶囊治疗消化性溃疡236例

目的观察胃舒胶囊治疗消化性溃疡（ＰＵ）的临床疗效．方法用胃舒胶囊（６粒，ｐｏ，３次／ｄ×２ｗｋ×２）治疗ＰＵ２３６例（男１９２例，女４４例；年龄１８岁～７４岁，平均３２岁±７岁；病程１ａ～１５ａ，平均４９ａ±３５ａ；ＤＵ１０６例，ＧＵ８３例，ＣＵ４７例），用纤维内镜观察不同证型ＰＵ患者的治疗效果．结果用胃舒胶囊两个疗程，对消化道症状改善率达９１２％～１００％，溃疡愈合率达９２８％，对肝胃气滞、寒邪犯胃、脾胃虚寒、胃热炽盛和瘀血阻络各型的治愈率分别为９２８％，９３５％，９４２％，８００％和８５７％．治疗组的疗效明显优于西咪替丁加胃必治组（Ｐ＜００１）．结论胃舒胶囊治疗ＰＵ具有显著疗效，其治疗作用可能与保护胃粘膜，中和胃酸和杀灭Ｈｐ等有关．     

南京市干部脂肪肝的流行病学研究

目的探讨脂肪肝在干部群体中发病率和流行病学．方法对南京市１１１９名体检干部作了常规肝胆Ｂ超检查．结果脂肪肝群体发病率为１０．２％，随年龄增长而增高，其中５０＿６０岁年龄组最高，是中青年组的两倍；男性群体脂肪肝发病率早于且高于女性群体（１１４％比６８％，Ｐ＜００２５）；男性脂肪肝百分比明显高于女性（８２５％比１７５％，Ｐ＜００５），１１４例脂肪肝中以中、重型为主（约为７８１％）．脂肪肝多伴是中等度以上肥胖体型或营养状况较好个体，且与个人饮食习惯、嗜酒爱好及胆囊炎／胆石症病史密切相关（分别为３８６％，４０５％和３０７％）．结论中等度以上肥胖体型、喜油腻饮食、嗜酒爱好或伴有胆囊炎／胆石症个体，尤其男性个体，应做定期体检和肝胆Ｂ超检查．一旦发现，应加以积极预防和治疗．     

柳氮磺胺吡啶对大鼠乙酸性溃疡性结肠炎肠组织中氧自由基的影响

目的探讨柳氮磺胺吡啶（ＳＡＳＰ）治疗大鼠乙酸性溃疡性结肠炎（ＵＣ）时清除氧自由基（ＯＦＲ）的特性．方法ＳＡＳＰ灌胃治疗大鼠乙酸性ＵＣ后，检测肠组织中的超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）含量，评价其炎症指数，并与生理盐水（ＮＳ）治疗对照组比较．结果ＳＡＳＰ组和ＮＳ组ＳＯＤ含量（Ｕ／ｇ）分别为７９９８±３４４１和６３６４±２４５５．ＳＡＳＰ组和ＮＳ组ＭＤＡ含量（ｎｍｏｌ／ｇ）分别为２１５６±２０８、３５２４±４４８．ＮＳ组和ＳＡＳＰ组炎症指数分别为１６５±５１９、６３０±１２５．ＳＡＳＰ组ＳＯＤ含量显著高于ＮＳ组（７９９８±３４４１对６３６４±２４５５，Ｐ＜００１），ＳＡＳＰ组ＭＤＡ含量明显低于ＮＳ组（２１５６±２０８对３５２４±４４８，Ｐ＜００１）．ＮＳ组炎症指数明显高于ＳＡＳＰ组（１６５±５１９对６３０±１２５，Ｐ＜００１）．结论ＳＡＳＰ为氧自由基清除剂，是治疗溃疡性结肠炎的主要机理之一．     

梗阻性黄疸内毒素血症与细胞免疫功能的关系

目的研究梗阻性黄疸免疫功能及其与内毒素血症的相关性．方法检测２８例梗阻性黄疸患者及２０例健康对照者血清内毒素，Ｔ淋巴细胞亚群及血清ＳＩＬ２Ｒ的水平．结果梗阻性黄疸患者血清内毒素和ＳＩＬ２Ｒ水平较对照组明显升高（４７０ｎｇ／Ｌ±１１３ｎｇ／Ｌ和７２５ｋＵ／Ｌ±２０１ｋＵ／Ｌｖｓ２８４ｎｇ／Ｌ±１０３ｎｇ／Ｌ和３２４ｋＵ／Ｌ±１１６ｋＵ／Ｌ，Ｐ＜００１），Ｔ淋巴细胞亚群ＣＤ３，ＣＤ４，ＣＤ４／ＣＤ８明显降低（５０４％±３３％和２９９％±３８％ｖｓ６３８％±４４％和３８３％±２８％，Ｐ＜００１；１２２±０３２ｖｓ１４３±０３７，Ｐ＜００５），同时亦发现梗阻性黄疸内毒素血症组较非内毒素血症组ＣＤ３，ＣＤ４水平明显减低，ＳＩＬ２Ｒ水平明显升高（４７４％±５１％和２７６％±５２％和８６７ｋＵ／Ｌ±２３１ｋＵ／Ｌｖｓ５２３％±５２％和３１２％±４３％和６７４ｋＵ／Ｌ±１８９ｋＵ／Ｌ，Ｐ＜００５）．相关分析显示血清内毒素水平与血清ＳＩＬ２Ｒ水平呈显著正相关（ｒ＝０８５１７，Ｐ＜００１）．结论梗阻性黄疸时内毒素血症与免疫功能状态密切相关．     

慢性病毒性肝病时胃十二指肠病变的研究

目的研究慢性病毒性肝病与胃十二指肠粘膜病变之间的关系以及慢性病毒性肝病时胃十二指肠粘膜病变的发病机制．方法内镜检查患者１２７例，检查前临床诊断为慢性病毒性肝病组４６例（其中男３９例，女７例，年龄４０３岁±１２９岁）和胃肠病组８１例（其中男５３例，女２８例，年龄３９８岁±１３４岁），进行内镜检查结果比较．结果慢性病毒性肝病组和胃肠病组的ＰＵ，ＣＳＧ发生率分别为３９１％，１００％和４３２％，９８８％，无统计学差异（Ｐ＞００５）．慢性病毒性肝病组的ＧＥＶ，ＤＩ，ＥＩ和ＢＲＧ发生率分别为４０３％，６９６％，３０４％和６０９％，胃肠病组为７４％，２８４％，６２％和１２４％，二者间有显著性差异（Ｐ＜００１）．ＧＥＶ检出率在慢性病毒性肝病组中，活动型肝硬变、慢性肝炎重度与慢性肝炎轻中度比较差异显著（分别为６６７％，５３１％和００％，Ｐ＜００１）．结论慢性病毒性肝病时胃十二指肠粘膜病变发生率较高，肝功能减退及肝炎病毒感染等在胃十二指肠粘膜病变的发病中起重要作用．     

大鼠烫伤致肠道免疫屏障损伤与血浆内毒素变化的关系

目的探讨导致烧伤后血浆内毒素水平升高和肠源性脓毒症的肠道免疫学因素．方法采用４０％体表面积（ＴＢＳＡ）Ⅲ度烫伤大鼠模型（ｎ＝４０），对肠道内ＩｇＡ含量、肠道细菌ＩｇＡ包被率和血浆内毒素的变化进行动态观察．结果伤后血浆内毒素水平（ｋＥＵ／Ｌ）明显升高，伤后３ｄ达０１１３±００３９，（对照组，ｎ＝１０，００８３±０００７，Ｐ＜００５）；肠内容物中ＩｇＡ含量（μｇ／ｇ）逐渐下降，伤后１ｄ，３ｄ均明显降低，其中３ｄ达３４１５±４０２（对照组为５６２９±１７２０，Ｐ＜００１），为最低点；而后逐渐回升，至伤后１０ｄ已接近对照组水平．烫伤后各时相点肠道细菌的ＩｇＡ包被率均明显降低，伤后３ｄ降至４４３％±６５％（对照组为６３９％±６５％，Ｐ＜００１）．结论烧伤后肠道内ＩｇＡ含量与功能的异常可能是导致内毒素血症和肠源性脓毒症的重要原因之一．     

血清CA125诊断肝癌的价值

目的研究血清ＣＡ１２５对肝癌的诊断价值．方法肝癌患者３２例，男２０例，女１２例，平均年龄４６岁±２５岁；肝硬变３６例，男２７例，女９例，平均年龄４２岁±２３岁；正常对照组４０例．全部受测对象均静脉采血，分离血清，－２０℃贮存备测．采用ＩＲＭＡ法测定血清ＣＡ１２５含量．结果肝癌患者血清ＣＡ１２５含量２１８Ｕ／Ｌ±１３０Ｕ／Ｌ，显著高于肝硬变组和正常对照组（分别为１９Ｕ／Ｌ±１１Ｕ／Ｌ，１０Ｕ／Ｌ±８Ｕ／Ｌ，Ｐ＜００１）．肝硬变组高于正常对照（Ｐ＜００５），但显著低于肝癌组（Ｐ＜００１）．以２６Ｕ／Ｌ为界限值，肝癌阳性检出率为６８７％，其中ＡＦＰ阳性（ＡＦＰ＞４００μｇ／Ｌ）的肝癌中血清ＣＡ１２５的阳性检出率为７６０％，ＡＦＰ阴性（ＡＦＰ＜２０μｇ／Ｌ）的肝癌中血清ＣＡ１２５的阳性检出率为４２９％．结论血清ＣＡ１２５是诊断肝癌较好的肿瘤标记物     

Silent peptic ulcer disease: frequency, factors leading to "silence," and implications regarding the pathogenesis of visceral symptoms

BACKGROUND: Peptic ulcer disease may occur in the absence of dyspeptic symptoms. The pathogenesis of dyspepsia in peptic ulcer disease is unclear. Whether the presence of Helicobacter pylori infection or use of non-steroidal anti-inflammatory drugs affects dyspeptic symptoms in patients with peptic ulcer disease has not been determined. The aim of the study was to determine the frequency and risk factors for peptic ulcer disease in a cohort of asymptomatic, unselected patients undergoing routine screening EGD. METHODS: This was a prospective study of a cohort of Chinese subjects undergoing screening EGD as part of a routine health maintenance program. Routine EGD screening was performed in 6457 consecutive subjects who underwent a self-paid, health evaluation. Those with endoscopy-confirmed peptic ulcer disease were enrolled to assess the risk factors that distinguish asymptomatic patients with peptic ulcer disease from patients with symptoms because of peptic ulcer disease. RESULTS: A total of 704 (10.9%) patients were found to have peptic ulcer disease, of which two thirds (n=496) were asymptomatic. Both uni- and multivariate analysis showed that the asymptomatic patients tended to have a larger body mass index, to be habitual tea drinkers, and to have an ulcer that was less than 1 cm in diameter and in a healing stage. Gender, blood group, history of hypertension and/or diabetes, ulcer location, Helicobacter pylori status, use of non-steroidal anti-inflammatories or sedative medications, habitual coffee drinking, and habits with respect to smoking of tobacco or ingestion of alcohol, had no association with symptoms. CONCLUSIONS: The results of this study suggest that silent peptic ulcer disease is common in Taiwan. Dyspeptic symptoms because of peptic ulcer disease may be influenced by intrinsic (body mass index and ulcer characters) and extrinsic (habitual tea drinking) factors. Non-steroidal anti-inflammatory drug use and Helicobacter pylori status had no significant effect on the symptomatology of peptic ulcer disease. These findings may contribute to the understanding of the pathogenesis in the visceral symptoms of peptic ulcer disease.     

Helicobacter pylori is a risk factor for peptic ulcer disease in cirrhotic patients. A meta-analysis

BACKGROUND : Peptic ulcer disease is highly prevalent in cirrhosis, and ulcer complications are a major cause of morbidity in these patients. Helicobacter pylori infection is considered the chief aetiological factor of ulcer disease. However, in cirrhotic patients the role of H. pylori in the pathogenesis of peptic ulcer remains uncertain. AIM : To evaluate the evidence of the pathogenic role of H. pylori infection in peptic ulcer disease in patients with cirrhosis. MATERIALS AND METHODS : An extensive MEDLINE search of the literature was performed. Studies reporting the prevalence of H. pylori infection in cirrhotic patients with and without ulcers were selected. Meta-analysis was conducted using RevMan 4.0.3. Pooled odds ratios were calculated for each comparison, using a fixed model analysis. RESULTS : The search identified seven studies with a total of 976 patients with cirrhosis (275 cases with ulcer disease and 701 controls). The prevalence of H. pylori infection in patients with peptic ulcer disease was higher than in those without. The pooled odds ratio was 2.70 (95% CI, 1.91-3.82). H. pylori infection was associated more or less equally with duodenal and gastric ulcers. CONCLUSION: H. pylori infection increases the risk of peptic ulcer disease in patients with cirrhosis.     

消化性溃疡诊治中的几个问题

消化性溃疡是一种常见病、多发病。目前绝大多数可以内科治愈,但在消化性溃疡的发病机制、分型及抗复发等方面还存在一些问题。本文介绍消化性溃疡的诊治进展。     

Peptic ulcer in the very old patients

OBJECTIVE: To describe the clinical features of peptic ulcer in patients aged 80 years or over. DESIGN: The patient files of 73 ulcer patients were retrospectively analyzed. RESULTS: Peptic ulcer was found in 17% of the gastroscopies made on patients aged 80 years or over. Epigastric pain was the most common symptom (74%). Vomiting and nausea were also common symptoms. 48% of the ulcers were duodenal and 52% gastric. The majority (65%) of ulcers were Helicobacter pylori negative. H.-pylori-positive patients used acetylsalicylic acid more frequently than the H.-pylori-negative (57 vs. 43%) ones. Complications occured in 69% of the patients. Aspirin and nonsteroidal anti-inflammatory drug (NSAID) users had more often complications than the others. CONCLUSIONS: Peptic ulcer is a common clinical finding of gastroscopy in patients aged 80 years or over. Most ulcers are H.-pylori-negative and almost evenly divided between duodenal and gastric ulcers. Most of the elderly patients suffer from epigastric pain. Complications are frequent among the patients, especially in aspirin and NSAIDs users. H.-pylori-infected aspirin users are at increased risk of ulcer disease. Before starting long-term aspirin treatment in elderly patients, eradication of H. -pylori is recommended.     

Epidemiology of peptic ulcer disease

In the United States about four million people have active peptic ulcers and about 350,000 new cases are diagnosed each year. Four times as many duodenal ulcers as gastric ulcers are diagnosed. Approximately 3000 deaths per year in the United States are due to duodenal ulcer and 3000 to gastric ulcer. There has been a marked decrease in reported hospitalization and mortality rates for peptic ulcer in the United States. Changes in criteria for selecting the underlying cause of death might account for some of the apparent decrease in ulcer mortality rates. Hospitalization rates for duodenal ulcers decreased nearly 50 per cent from 1970 to 1978, but hospitalization rates for gastric ulcers did not decrease. Although this decrease in hospitalization rates may reflect a decrease in duodenal ulcer disease incidence, it appears that changes in coding practices, hospitalization criteria, and diagnostic procedures have contributed to the reported declines in peptic ulcer hospitalization and mortality rates. There is no good evidence to support the popular belief that peptic ulcer is most common in the spring and autumn. The most consistent pattern appears to be low ulcer rates in the summer. There is strong evidence that cigarette smoking, regular use of aspirin, and prolonged use of steroids are associated with the development of peptic ulcer. There is some evidence that coffee and aspirin substitutes may affect ulcers, but most studies do not implicate alcohol, food, or psychological stress as causes of ulcer disease. Genetic factors play a role in both duodenal and gastric ulcer. The first-degree relatives of patients with duodenal ulcer have a two- to threefold increase in risk of getting duodenal ulcer and relatives of gastric ulcer patients have a similarly increased risk of getting a gastric ulcer. About half of the patients with duodenal ulcer have elevated plasma pepsinogen I. A small increase in risk of duodenal ulcer is found in persons with blood group O and in subjects who fail to secrete blood group antigens into the saliva. In most Western countries, morbidity from duodenal ulcer is more common than from gastric ulcer, even though deaths from gastric ulcer exceed or equal those from duodenal ulcer. In Japan, both morbidity and mortality are higher for gastric ulcer than for duodenal ulcer.     

Does Helicobacter pylori infection explain all socio-economic differences in peptic ulcer incidence? Genetic and psychosocial markers for incident peptic ulcer disease in a large cohort of Danish adults

BACKGROUND: Peptic ulcer epidemiology has changed considerably within the past century. The aim of this study was to assess the 11-year cumulative incidence of peptic ulcer disease and examine the relationship between ulcer incidence and psychosocial and genetic factors. METHODS: A random sample of 2416 Danish adults with no history of peptic ulcer disease residing in Copenhagen County, Denmark, attended a population-based prospective cohort study in 1983 and 1994. All participants reported whether they had had an ulcer diagnosed within the observation period. Information on socio-economic factors, family history of peptic ulcer disease (PUD) and lifestyle practices was obtained from a questionnaire. Lewis blood group antigens were assessed from blood samples and Helicobacter pylori infection status was determined with an in-house IgG ELISA. RESULTS: The overall 11-year cumulative incidence proportion of PUD was 2.9% (95% CI (2.2; 3.6)), i.e. 1.6% (95% CI (1.1; 2.1)) for duodenal ulcer, and 1.3% (95% CI (0.8; 1.7)) for gastric ulcer. Poor socio-economic status increased the risk of PUD independently of H. pylori infection (odds ratio 2.7, 95% CI (1.1; 6.1)) and accounted for 17% of all ulcer cases. High physical activity at work increased the risk of PUD in people infected with H. pylori (odds ratio 2.6, 95% CI (0.8; 8.0)). Family history of PUD or Lewis blood group antigens did not relate to ulcer incidence. CONCLUSIONS: Poor socio-economic status is an important risk factor for PUD that exerts its effect independently of H. pylori infection. Strenuous work may increase the risk of PUD in people with H. pylori infection. Genetic factors do not influence the risk of PUD in Danish adults.     

Peptic ulcer and its course in cirrhosis: an endoscopic and clinical prospective study

The epidemilogical and clinical characteristics of peptic ulcer were studied in 324 of 368 consecutive patients with cirrhosis of the liver during a mean period of 1.2 (±0.61) years. Peptic ulcer prevalence rates in patients with cirrhosis were as follows: point prevalence 11.7%, period prevalence 15.1%, and lifetime prevalence 24.2%. The annual incidence rate observed in 140 patients with cirrhosis undergoing endoscopic follow up was 4.3%.Ulcers were asymptomatic in more than 70% of patients. The peptic ulcer complication rate at entry was 20% in the whole group and 40% in those who had not a previous diagnosis of peptic ulcerwhen admitted to the study. Peptic ulcer was more frequent among HBsAg+ cirrhotics (p=0.05). Patients with more severely decompensated cirrhosis also had a higher frequency of asymptomatic ulcers (p=0.04), gastric ulcers (p=0.01) and asymptomatic gastic ulcers (p=0.005). After diagnosis, during endoscopic follow up, gastric ulcer in patients with cirrhosis tended to heal slowly and recurred with higher frequency than in controls without cirrhosis (p=0.04). Seventy-nine per cent of peptic ulcer recurrences were asymptomatic in patients with cirrhosis. There were no complications during the follow-up period: this could be due to the regular timing of endoscopy, which permitted early detection and treatment of the recurrences, thus preventing further complications.     

非甾体类抗炎药相关性胃十二指肠黏膜损害临床调查分析

目的 探讨非甾体类抗炎药(NSAID)相关性胃十二指肠黏膜损害的发生情况及其危险因素.方法 收集心血管科与风湿免疫科门诊中184例长期服用NSAID的患者作为研究对象.记录患者的一般资料,对患者的消化不良症状进行评分,胃镜下行黏膜损伤评分,留取标本行幽门螺杆菌(Hp)检测,并行统计分析.结果 在184例长期服用NSAID患者中共发现消化性溃疡63例(34.2%),其中胃溃疡22例、十二指肠溃疡34例、复合性溃疡7例.在其余121例无溃疡患者中,57例胃黏膜存在3处或3处以上糜烂灶.Logistic多因素回归分析发现,Hp感染是长期服用NSAID人群发生消化性溃疡的重要危险因素(OR=13.86,95%CI:6.53～29.43).低剂量阿司匹林与其他NSAlD导致胃十二指肠黏膜损伤的发生率相似(OR=0.45,95%CI:0.16～1.28).结论 长期服用NSAID者胃十二指肠黏膜易受损,Hp感染是重要的危险因素.低剂量阿司匹林致胃肠道损伤的发生率与其他NSAID相似.     

Bleeding peptic ulcer: characteristics and outcomes in Newcastle, NSW

Background: Peptic ulcer disease risk factors have changed, as has the impact of treatment on morbidity and mortality. Recent data on clinical presentation and outcome are sparse in Australia. Aim: To determine the characteristics and outcome of patients presenting with a bleeding peptic ulcer to a tertiary referral centre. Methods: We evaluated patients diagnosed with peptic ulcer bleeding between 2004 and 2008 at a tertiary referral hospital. Variables assessed included demographic data, comorbidities, medication use and Rockall score. Outcomes of interest were the time to endoscopy, peptic ulcer treatment, transfusion requirements, urgent surgery and survival. Results: Peptic ulcers were confirmed in 265 patients (55% male), of which 145 were gastric and 119 duodenal. The mean age was 71 years. On admission 38% of patients had haemodynamic instability and 92% had one or more comorbidity. Consumption of ulcerogenic medications at the time of admission was frequent (non‐steroidal anti‐inflammatory drugs (NSAIDs) 22%, aspirin 41%, clopidogrel or warfarin 10%) and proton pump inhibitors infrequent (15%). A gastroenterologist managed all patients according to their usual practice. Only a minority of patients received over three units of packed red cells. Few patients were referred for surgery (3%) or died (3%), but both events were significantly higher for the duodenal ulcer group. Conclusion: The characteristics and outcomes in patients with peptic ulcer bleeding have changed. Peptic ulcer disease remains a public health problem with modifiable risk factors, such as Helicobacter pylori infection and NSAIDs, which should be targeted to reduce the burden of illness.