Kirk R M
Dig Dis Sci. 1981 Feb;26(2):149-54. doi: 10.1007/BF01312235.
It is argued that separation of chronic peptic ulcers into gastric and duodenal may be artificial and confuse the search for common factors in their etiology. Differences are often exaggerated by contrasting the extremes of a continuous distribution of ulcers from high gastric lesser curve to duodenal bulb and beyond. Genetic and epidemiological factors appearing to favor one or the other type of ulcer may act by determining the background cellular changes on which ulcers develop. The extent of the mucosal changes may influence the site of ulceration and incidentally the level of acid secretion. Thus ulcers could be driven distally or drawn proximally across the arbitrary boundary of the pylorus.
有人认为，将慢性消化性溃疡分为胃溃疡和十二指肠溃疡可能是人为的，会干扰对其病因中共同因素的探寻。通过对比从胃小弯高处到十二指肠球部及更远部位溃疡连续分布的两端，差异常常被夸大。看似有利于一种或另一种类型溃疡的遗传和流行病学因素，可能通过决定溃疡发生的背景细胞变化而起作用。黏膜变化的程度可能影响溃疡的部位，并附带影响胃酸分泌水平。因此，溃疡可能被推向远端或被拉向近端，越过幽门这一任意边界。
