Graham D Y
Department of Medicine, Veteran Administration Medical Center, Houston, Texas.
Scand J Gastroenterol Suppl. 1989;160:46-52. doi: 10.3109/00365528909091735.
This debate addresses whether Campylobacter pylori contributes to the development and maintenance of chronic peptic ulcer disease. C. pylori may be both an aggressive factor and may also impair mucosal defence. C. pylori causes the inevitably ulcer-associated gastritis and duodenitis and eradication of the C. pylori infection is associated with resolution of the inflammation and virtual elimination of the problem of duodenal ulcer relapse. A model is suggested that requires two separate factors to combine to cause chronic duodenal ulcer disease with other environmental factors (e.g. smoking) modifying the interaction between C. pylori and genetic susceptibility. Both genetic susceptibility and C. pylori infection are required to produce duodenal ulcer disease; neither alone is sufficient. C. pylori is the most important factor in the pathogenesis of duodenal ulcer disease because it is the only pathogenetic factor that can be easily reversed by medical therapy.
这场辩论探讨了幽门螺杆菌是否会导致慢性消化性溃疡疾病的发生和持续存在。幽门螺杆菌可能既是一种侵袭性因素，也可能损害黏膜防御功能。幽门螺杆菌会引发不可避免的与溃疡相关的胃炎和十二指肠炎，根除幽门螺杆菌感染与炎症的消退以及十二指肠溃疡复发问题的实际消除相关。有人提出了一个模型，该模型认为需要两个独立的因素相结合，并与其他环境因素（如吸烟）共同作用，来改变幽门螺杆菌与遗传易感性之间的相互作用，从而导致慢性十二指肠溃疡疾病。十二指肠溃疡疾病的发生需要遗传易感性和幽门螺杆菌感染两者共同作用；单独任何一个因素都不足以引发疾病。幽门螺杆菌是十二指肠溃疡疾病发病机制中最重要的因素，因为它是唯一可以通过药物治疗轻易逆转的致病因素。
