Wirth Hans-Peter
1 GastroZentrumKreuzlingen, Kreuzlingen.
Praxis (Bern 1994). 2016 Jun 8;105(12):693-7. doi: 10.1024/1661-8157/a002367.
Prevalence of H. pylori (HP) is declining, whereas reflux disease and the proportion of non-steroidal antiinflammatory drugs (NSAR) to HP-induced ulcers increase. Eradication heals HP-ulcer disease, interrupts cancerous progression and can improve dyspeptic symptoms. NSAR-ulcers heal under proton pump inhibitor (PPI) therapy but tend to recur after reexposition. Anticoagulants and antiplatlet agents increase the risk additionally. PPI reduces NSAR-ulcer recurrence. Reflux patients with severe inflammation and complications often need long-term therapy. Barrett’s esophagus patients are at risk of esophageal adenocarcinoma.
幽门螺杆菌(HP)的感染率正在下降,而反流性疾病以及非甾体抗炎药(NSAR)所致溃疡在HP诱发溃疡中所占比例增加。根除HP可治愈HP溃疡病,阻断癌变进程,并可改善消化不良症状。NSAR溃疡在质子泵抑制剂(PPI)治疗下可愈合,但再次接触NSAR后往往会复发。抗凝剂和抗血小板药物会进一步增加风险。PPI可降低NSAR溃疡的复发率。患有严重炎症和并发症的反流患者通常需要长期治疗。巴雷特食管患者有患食管腺癌的风险。