Thiel H
Z Gastroenterol. 1978 Feb;16(2):73-84.
A review of literature is given concerning the incidence, pathogenesis and clinical relevance of peptic ulcer in chronic liver disease. 1. Today there is no doubt about a highly significant incidence of peptic ulcer in chronic liver diseases, especially in cirrhosis of the liver. Therefore it seems reasonable to use the term "hepatogenic ulcer". 2. Assuming a relation between chronic liver disease and peptic ulceration several theories are discussed with regard to the causality and etiology. Most investigators suppose the diseased liver as "primum movens" in peptic ulceration by means of conditioning different ulcerogenic factors. 3. The clinical finding of increased frequency of peptic ulcer in cirrhotics despite of reduced gastric acid output is no contradiction. It can be explained by relative disturbance of the balance between aggressive and protective mechanism, the latter being diminished. Although a dysfunction of gastric mucus is recently assumed, the specific pathogenetic factor is not clear up to now. 4 Nevertheless, there is no doubt about the clinical relevance of this type of ulcer, given by diagnostic and therapeutic problems and pitfalls.
本文对慢性肝病中消化性溃疡的发病率、发病机制及临床相关性进行了文献综述。1. 如今，慢性肝病尤其是肝硬化中消化性溃疡的高发病率已毋庸置疑。因此，使用“肝源性溃疡”这一术语似乎是合理的。2. 假设慢性肝病与消化性溃疡之间存在关联，针对因果关系和病因学讨论了几种理论。大多数研究者认为，患病的肝脏通过调节不同的致溃疡因素，在消化性溃疡形成中起“首要推动者”的作用。3. 尽管肝硬化患者胃酸分泌减少，但消化性溃疡的发病率却增加，这一临床发现并不矛盾。这可以通过攻击和保护机制之间平衡的相对紊乱来解释，后者有所减弱。尽管最近有人认为胃黏液功能失调，但具体的发病因素至今仍不清楚。4. 然而，鉴于诊断和治疗方面的问题与陷阱，这种类型的溃疡的临床相关性是毋庸置疑的。
