Wienbeck M, Lübke H J
Medizinische Klinik und Poliklinik, Düsseldorf.
Z Gastroenterol. 1987 Aug;25 Suppl 3:64-8.
The most important causes of peptic ulcers are increased gastric acid secretion, impaired mucosal circulation and damages to the mucosa. In contrast, motility plays only a minor role. The following motility disturbances are discussed in peptic ulcers: 1. Impaired gastric emptying may favor the development of gastric ulceration, if it is grossly delayed, and that of duodenal ulceration, if it is inappropriately accelerated. 2. Disturbances of duodenal motility in the fasted state may disturb bicarbonate secretion and, thus, become theoretically ulcerogenic. 3. Duodenogastric reflux has been discussed as a cause of gastric ulceration for a long time; yet, the proof is still missing. 4. According to own studies gastric ulcer is frequently accompanied by morphological and functional changes in the antrum; the cause-effect relationship, however, has yet to be elucidated.
消化性溃疡最重要的病因是胃酸分泌增加、黏膜循环受损和黏膜损伤。相比之下,动力仅起次要作用。以下是在消化性溃疡中讨论的动力障碍:1. 胃排空受损如果严重延迟可能有利于胃溃疡的发生,如果不适当加速则有利于十二指肠溃疡的发生。2. 空腹状态下十二指肠动力障碍可能会干扰碳酸氢盐分泌,因此从理论上讲会导致溃疡形成。3. 十二指肠-胃反流长期以来一直被认为是胃溃疡的一个病因;然而,仍缺乏证据。4. 根据自身研究,胃溃疡常伴有胃窦部的形态和功能变化;然而,因果关系尚待阐明。