幽门螺杆菌感染与非甾体抗炎药相互关系的研究进展

Research progress of the relationship between helicobacter pylori infection and non-steroidal anti-inflammatory drugs

幽门螺杆菌感染和非甾体抗炎药被认为是引起消化道黏膜损伤的两个重要致病因素,临床上两者常同时存在,但对于两者之间的相互关系仍未探明。目前部分研究认为,幽门螺杆菌和非甾体抗炎药在某些情况下存在相互拮抗作用,其机制可能为幽门螺杆菌可通过上调胃黏膜COX-2 mRNA的表达,促进前列腺素的合成,增强胃黏膜的修复能力,而非甾体抗炎药却可抑制前列腺素的合成,诱导胃黏膜发生急性损伤;但亦有部分研究表明,两者可通过诱导多种相似炎症因子发挥协同致病作用;同时还有研究报道两者之间关联性并不显著。总之,两者的相互关系非常复杂,仍需大量多中心大样本的实验进一步研究。

Helicobacter pylori infection and non-steroidal anti-inflammatory drugs are considered as the two important pathogenic factors that cause gastrointestinal mucosal injury.Both of them often exist concurrently in clinic,but the relationship between them is not clear yet.At present,some studies have suggested that they have antagonistic effects in some cases.The mechanism may be that Helicobacter pylori can enhance gastric mucosal repair capacity by up-regulating the COX-2 m RNA’s expression and promoting the synthesis of prostaglandins.But non-steroidal anti-inflammatory drugs can inhibit the synthesis of prostaglandins,which induces acute gastric mucosal injury.Other studies have showed that the two factors can play a synergistic pathogenic role by inducing the body to produce a variety of similar inflammatory factors.In addition,there are still some studies indicating that the two factors have no significant correlation.In short,the relationship between them is very complex,and still needs a large number of multi-center large-sample experiments to further study.