Hunt R H
Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.
Scand J Gastroenterol Suppl. 1993;196:12-6. doi: 10.3109/00365529309098335.
Helicobacter pylori infection causes inflammation of the gastric and duodenal mucosae, which results in a disturbance of the regulatory mechanisms for gastrin, gastric acid and pepsin secretion. Acid secretion may be decreased, normal or increased, depending on the stage of infection, although the meal-stimulated gastrin response is invariably elevated. The exact mechanisms involved are not known but may be due to the release of cytokines in response to bacterial toxins. H. pylori colonization is reduced by effective acid suppression with proton pump inhibitors, although it is not eradicated. In combination with amoxycillin, omeprazole, up to 40 mg twice daily, eradicated the organism in up to 82% of cases. This synergistic effect may be due to a direct effect of omeprazole on the organism, the protection of amoxycillin from acid degradation, or enhancement of host defence mechanisms accompanying acid suppression.
幽门螺杆菌感染会导致胃和十二指肠黏膜发炎，进而扰乱胃泌素、胃酸和胃蛋白酶分泌的调节机制。根据感染阶段的不同，胃酸分泌可能会减少、正常或增加，不过进食刺激后的胃泌素反应总是会升高。其中的确切机制尚不清楚，但可能是由于细菌毒素引发细胞因子释放所致。质子泵抑制剂有效抑制胃酸可减少幽门螺杆菌定植，不过无法将其根除。与阿莫西林联合使用时，每日两次、每次40毫克的奥美拉唑可在高达82%的病例中根除该病菌。这种协同效应可能是由于奥美拉唑对病菌的直接作用、保护阿莫西林不被胃酸降解，或是伴随胃酸抑制增强宿主防御机制所致。
