Pathogenesis and pathophysiology of duodenal ulcer.
Pathogenesis and pathophysiology of duodenal ulcer.
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十二指肠溃疡的发病机制和病理生理学。
DOI：
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发表时间：
1984
期刊：
影响因子：
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通讯作者：
Lam Sk
中科院分区：
文献类型：
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作者：
Lam Sk
：大量的流行病学、临床和病理生理学证据表明，十二指肠溃疡的病因是不同的(表8)。十二指肠溃疡药物治疗的最新进展支持了长期以来的观点，即高酸血症是大多数十二指肠溃疡患者的重要生理异常。这也可以表明，高酸度的来源是异质性的。某些特定的生理异常会导致酸度过高，这可能有遗传基础。不同的生理异常，单独或合并，可能导致两个最终的共同途径：异常大量的进食刺激的胃酸分泌和夜间胃酸高分泌。事实上，旨在控制餐后胃酸分泌或夜间胃酸分泌的药物治疗的成功有力地支持了它们的重要性。酸度过高可能是一种暂时现象，并与紧张的生活事件有关。然而，它也可能作为一种持续的异常发生，可能是遗传给十二指肠溃疡患者的。在酸度过高的情况下，粘膜修复可能会受到不利影响。在任何一种情况下，急性溃疡，如与压力有关的溃疡，都会发展成全面的溃疡。如果高酸度消退或通过治疗减轻，就会愈合，从而使正常的粘膜修复得以进行。
: Much epidemiological, clinical, and pathophysiological evidence has accumulated to indicate that the aetiology of duodenal ulcer is heterogeneous (Table 8). Recent advances in the medical therapy of duodenal ulcer support the long held concept that hyperacidity is an important physiological abnormality in the majority of patients with duodenal ulcer. It can also be shown that the origin of hyperacidity is heterogeneous. Certain specific physiological abnormalities that lead to hyperacidity may have a genetic basis. The various physiological abnormalities, alone or in combination, may lead to two final common pathways: abnormally large meal-stimulated acid secretion, and nocturnal acid hypersecretion. Indeed, success of medical therapy aiming at the control of postprandial acid secretion or of nocturnal acid secretion strongly supports their significance. It is possible that hyperacidity occurs as a temporary phenomenon and is associated with stressful life events. However, it is also possible that it occurs as a constant abnormality, bestowed perhaps genetically on the duodenal ulcer patient. In the presence of hyperacidity, mucosal repair may be affected adversely. In either situation, an acute ulcer, such as that associated with stress, is allowed to develop into a full-blown ulcer. Healing takes place if the hyperacidity recedes or is reduced therapeutically, allowing normal mucosal repair to take place.