Arakawa Tetsuo, Higuchi Kazuhide, Fujiwara Yasuhiro, Tominaga Kazunari, Watanabe Toshio, Shiba Masatsugu, Oshitani Nobuhide, Matsumoto Takayuki
Department of Gastroenterology, Osaka City University Graduate Medical School, Osaka.
Intern Med. 2004 Mar;43(3):179-83. doi: 10.2169/internalmedicine.43.179.
Discovery of Helicobacter pylori has changed the life cycle of peptic ulcer disease (PUD). However, PUD does not completely disappear after elimination of H. pylori. Some ulcers recur even after successful eradication of H. pylori in non-users of non-steroidal anti-inflammatory drug (NSAID). In addition, the incidence of H. pylori-negative, non-NSAID PUD (idiopathic PUD) is reported to increase with time. Moreover, H. pylori-positive ulcers are not always H. pylori-induced ulcers because there are two paradoxes of the H. pylori myth: the existence of H. pylori-positive non-recurring ulcer and recurring ulcer after cure of H. pylori infection. Taken together, H. pylori is not the only cause of peptic ulcer disease. Therefore, it is still necessary to seriously consider the pathophysiology and the management of the ulcers, which may exist after elimination of H. pylori.
幽门螺杆菌的发现改变了消化性溃疡疾病（PUD）的病程。然而，根除幽门螺杆菌后，PUD并未完全消失。即使在非甾体抗炎药（NSAID）非使用者中成功根除幽门螺杆菌后，一些溃疡仍会复发。此外，据报道，幽门螺杆菌阴性、非NSAID性PUD（特发性PUD）的发病率随时间增加。此外，幽门螺杆菌阳性溃疡并不总是由幽门螺杆菌引起的溃疡，因为存在幽门螺杆菌理论的两个悖论：幽门螺杆菌阳性不复发溃疡的存在以及幽门螺杆菌感染治愈后溃疡复发。综上所述，幽门螺杆菌不是消化性溃疡疾病的唯一病因。因此，仍有必要认真考虑根除幽门螺杆菌后可能存在的溃疡的病理生理学和治疗方法。
