消化性溃疡形成的原因-英文课件

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1、ThecausesaboutPepticUlcer消化性溃疡的形成原因武汉大学causesaggressivefactors↑defensivefactors↓pepticulceroccurAggressiveFactors3.Gastricacidandpepsin(胃酸与胃蛋白酶)2.Adverseeffectsofdrugs,suchasNSAID1.Helicobacterpyloriinfection(幽门螺杆菌感染)4.others1.Helicobacterpylori(H.p)theevidences.thedetectionrateofH.pinGUisap

2、proximately70%-80%.thedetectionrateofH.pinDUisapproximately90%.EradicationofH.pwouldboostthehealingofulcer.HowcanH.pdestroylocalmucosaldefective/repairedmechanism?1.colonizethegastricmucosa（胃粘膜）.2.increasedacidsecretion2.NSAIDAfterH.pinfection,NSAIDisthenextimportantcause.Researchdatashowtha

3、tNSAIDuseinpatientswithpepticulcerandtheriskofcomplicationswassignificantlyhigherthanthegeneralpopulation.Byweakeningmucosaldefenseandrepairfunctionseventuallyleadtopepticulcer.案例展示3.AcidandpepsinTheeventualformationofpepticulcerisduetoacidandpepsindigestionofthemucosaitself.Becausethebiolog

4、icactivityofpepsinisdependedonthepHvalue.WhenlocalpHvalueelevatesto4,pepsincan’tworkwell.Soweoftensaythat“Noacid,noulcer.”4.Otherriskfactors1)SmokingSmokingisanincreasedriskofpepticulcer.Smokingcanaffectthehealingofulcer,accelerateulcerrecurrence,andincreasedcomplicationofulceration.Buttheme

5、chanismisn’tclear.2)HeredityPatientswithpepticulceroftenhaveafamilyhistoryofulcer.AndsomestudiesshowthatbloodgroupO（O型血人群）haveahighrisktodevelopingpepticulcer.3)StressHighstresscanstimulatevagusnerve(交感神经),whichcanresultinhighsecretionofacid.4)Abnormalgastroduodenallocomotion胃十二指肠功能异常DU—quic

6、kgastricempty→overfullacidloadfoodstorageGU—movementobstruction→refluxdigestiveliquid阻滞1.Highacidsecretion2.AggravatingH.pinfection3.IncreasedbadeffectofNSAIDDefensiveFactors2.MucosaBarrier（粘膜屏障）1.Mucus/BicarbonateBarrier（粘液、碳酸氢盐屏障）3.MucosalBloodFlux（胃粘膜血流屏障）4.Others1.Mucus/BicarbonateBarrie

7、rThefirstlineofdefenseismucusandbicarbonatesecretion(粘液和碳酸氢盐的分泌).ItstabilizesthepHbetweenthelumenandthesurfaceepithelialcells.Mucusgel(粘液凝胶)inpatientswithH.pinfectionwasfoundtobestructurallyweak.2.MucosaBarrierThesecondlineofdefenseistheintrinsicep