非幽门螺杆菌非NSAID药物相关性溃疡

Peptic ulcer disease not related to Helicobacter pylori or non-steroidal antiinflammatory drugs

幽门螺旋杆菌(Hpylori)和非甾体类抗炎药(NSAIDs)已被公认为消化性溃疡的两个最主要的病因.近年来,越来越多的临床证据表明,非H pylori和非NSAID溃疡的发生比例正在逐渐增加.这可能与H pylori感染率的降低以及临床规范的根除H pylori治疗有关,同时也与使用NSAIDs时注意防范其对胃肠道的损害有关.非H pylori和非NSAIDs溃疡病与胃酸分泌变化、胃排空异常、胃黏膜防御机制下降、应激、吸烟、遗传以及其他慢性疾病有关.在治疗上抑制胃酸,保护胃黏膜仍然是主要的手段.对这类溃疡病治疗上应更积极.

Helicobacter pylori infection and non-steroidal anti-inflammatory drugs （NSAIDs） are widely accepted as the most important factors in the pathogenesis of peptic ulcers. However, the proportion of H pylori-negative peptic ulcers without intake of NSAIDs appears to have increased in recent years. The reason is partly related to a decreased prevalence of H pylori among the population and more effective eradication of the bacterium, and it is also related to the defense measures for NSAIDs. The etiological factors involved in peptic ulcer disease not caused by H pylori or NSAIDs include altered acid secretion, abnormal gastric emptying, defective mucosal defense mechanisms, psychological stress, smoking, genetic predisposition and other chronic diseases. The main therapeutic measures include anti-secretory drugs and mucosal protectants.