Elta G H
Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0362.
Rev Infect Dis. 1991 Jul-Aug;13 Suppl 8:S696-9. doi: 10.1093/clinids/13.supplement_8.s696.
The relationship between endoscopically diagnosed gastroduodenitis, histologically confirmed gastritis, and symptoms of dyspepsia remains unclear. Marked histologically confirmed inflammation of gastric mucosa often occurs in a stomach that appears normal by endoscopy. Both histologically confirmed and endoscopically diagnosed gastritis are commonly blamed as causes of nonulcer dyspepsia (NUD), although neither disease has been convincingly shown to cause NUD. Helicobacter pylori infection of gastric mucosa is a common cause of histologically confirmed inflammation. It is unclear whether this infection with H. pylori and the resultant gastric mucosal inflammation cause symptoms since inflamed mucosae are also common in asymptomatic controls. The reported increased prevalence of H. pylori in patients with NUD compared with controls suggests a possible causative role in at least a subset of patients with NUD. In addition, three controlled studies of treatment with bismuth demonstrated a significant trend toward improvement of symptoms after clearance of H. pylori. However, two studies of therapy with bismuth failed to demonstrate improvement of symptoms. Further study of patients with NUD is needed to clarify this possible association.
内镜诊断的胃十二指肠炎症、组织学确诊的胃炎与消化不良症状之间的关系仍不明确。组织学确诊的胃黏膜明显炎症常发生在内镜检查显示正常的胃中。组织学确诊的胃炎和内镜诊断的胃炎通常都被认为是非溃疡性消化不良（NUD）的病因，尽管这两种疾病均未被确凿证明会导致NUD。胃黏膜幽门螺杆菌感染是组织学确诊炎症的常见原因。目前尚不清楚幽门螺杆菌感染及由此导致的胃黏膜炎症是否会引起症状，因为无症状对照者中也常见黏膜炎症。与对照组相比，NUD患者中幽门螺杆菌患病率升高的报道提示其在至少一部分NUD患者中可能具有致病作用。此外，三项铋剂治疗对照研究表明，幽门螺杆菌清除后症状改善有显著趋势。然而，两项铋剂治疗研究未能证明症状改善。需要对NUD患者进行进一步研究以阐明这种可能的关联。
