CHARACTERISTICS OF PEPTIC-ULCER IN SUBJEC TS WITH CONCOMITANT CORONARY HEART-DISEASE

Aim. The study of clinical running of gastric or duodenal ulcer in ass ociated coronary heart disease (CHD). Materials and Methods. 209 CHD p atients with gastric ulcer (CU) or duodenal ulcer (DU) were examined c linically plus histological examination of gastric or duodenal mucosa biopsies was made. Results. In CHD patients CU occurred more frequentl y (56%) than DU. The lesions involved more frequently lesser curvature of the stomach and pyloric part of the stomach. Males developed ulcer s 3.5 times more frequently than females. Ulcers tended to a painless course, without season exacerbations. The disease manifested first wit h gastric bleeding in 52% of the patients. CU and DU ran with frequent recurrences and long-term exacerbations (76% of patients) which coinc ided in time with CHD exacerbations. 68% of patients developed exacerb ations within 10 days after myocardial infarction or aortocoronary byp ass operation. Helicobacter pylori was present as a resolving factor i n arising ulcer in 26% of patients. Microcirculatory disorders, reduce d bloodflow speed in gastric or duodenal mucosa, hypocoagulation syndr ome, dyslipidemia provoked exarbations in 62% of patients. Examination s of biopsies from gastric and duodenal mucosa showed marked dystrophi c changes in the mucosa, ifs connective tissue basis in the vessels in the presence of mild inflammation at ulcer, site. Conclusions. The on set of ulcers and erosions in the mucosa of the gastrointestinal tract in CHD may be dice to circulatory disorders in gastric mucosa. The ma in factors of aggression are hypoxia, hypoxia-induced trophic defects in gastric and duodenal mucosa, circulatory disorders.