消化性潰瘍形成的原因英文

1、causes,aggressive factors↑ defensive factors ↓,,peptic ulcer occur,Aggressive Factors,3.Gastric acid and pepsin(胃酸與胃蛋白酶),2. Adverse effects of drugs,such as NSAID,1. Hel

2、icobacter pylori infection(幽門(mén)螺桿菌感染),4.others,1.Helicobacter pylori (H.p),the evidences . the detection rate of H.p in GU is approximately70% -80% . the detection rate of H.p in DU is approximately 90% . Eradication

3、 of H.p would boost the healing of ulcer.How can H.p destroy local mucosal defective/repaired mechanism? 1. colonize the gastric mucosa（胃粘膜）. 2. increased acid secretion,2.NSAID,After H.p infection, NSAID

4、 is the next important cause . Research data show that NSAID use in patients with peptic ulcer and the risk of complications was significantly higher than the general population. By weakening mucosal defense a

5、nd repair functions eventually lead to peptic ulcer.,案例展示,3.Acid and pepsin,The eventual formation of peptic ulcer is due to acid and pepsin digestion of the mucosa itself. Because the biologic ac

6、tivity of pepsin is depended on the pH value. When local pH value elevates to 4, pepsin can’t work well. So we often say that “No acid, no ulcer.”,4. Other risk factors,1) Smoking Smoking is an increased risk of

7、 peptic ulcer. Smoking can affect the healing of ulcer, accelerate ulcer recurrence, and increased complication of ulceration. But the mechanism isn’t clear.,,2)Heredity Patients with peptic ulcer often have

8、 a family history of ulcer.And some studies show that blood group O（O型血人群） have a high risk to developing peptic ulcer .,,3)Stress High stress can stimulate vagus nerve(交感神經(jīng)), which can result in high secretion of ac

9、id .,,4) Abnormal gastroduodenal locomotion胃十二指腸功能異常DU—quick gastric empty → overfull acid load food storageGU—movement obstruction→reflux digestive liqui

10、d 阻滯,,,,1.High acid secretion 2.Aggravating H.p infection 3.Increased bad effect of NSAID,Defensive Factors,,2.Mucosa Barrier（粘膜屏障）,1.Mucus/Bicarbonate Barrier（粘液、碳酸氫鹽屏障）,3.Mucosal Bl

11、ood Flux（胃粘膜血流屏障）,4.Others,1.Mucus/Bicarbonate Barrier,The first line of defense is mucus and bicarbonate secretion(粘液和碳酸氫鹽的分泌). It stabilizes the pH between the lumen and the surface epithelial cells. Mucus

12、 gel( 粘液凝膠)in patients with H.p infection was found to be structurally weak.,2.Mucosa Barrier,The second line of defense is the intrinsic epithelial cell defense（上皮細(xì)胞防御、粘膜屏障） The mucosal surface is a barrier to a

13、cid back diffusion thus maintaining normal intracellular（細(xì)胞內(nèi)） pH.,3.Mucosal Blood Flux,The third line of defense is the rich mucosal blood flow(豐富的粘膜血流屏障). The blood provides a buffer for acid neutralization（中和） as

14、 well as adequate nutrition for the metabolic（代謝） demand to maintain mucosal integrity.,4.Others,Prostaglandin(前列腺素), can reduce the secretion of acid.Feedback regulation of gastric secretion.（胃的分泌的反饋調(diào)節(jié)）,conclusion,whe