Lieber C S
Section of Liver Disease and Nutrition, Bronx VA Medical Center, NY 10468-3922, USA.
Digestion. 1997;58(3):203-10. doi: 10.1159/000201445.
Helicobacter pylori has now been propelled into the forefront of gastroenterology, particularly the treatment of gastroduodenal ulcer, whereas its role in gastritis is still widely ignored, although this disease sparked much of the original observations. Forty years ago, it was shown for the first time that antibiotics can eliminate gastric ammonia production in man which suggested that this was due to eradication of bacterial urease activity. It was also found that the gastric juice ammonia concentration correlates with hypo- or anacidity in uremics and with mucosal inflammation in subjects with gastritis. In patients with nonalcoholic and alcoholic gastritis, the histology as well as the symptoms of gastritis were strikingly improved by antibiotic treatment. Beneficial effects of eradication of gastric urease activity and the resulting decreased ammonia production were also shown in patients with hepatic encephalopathy. Broader studies and clinical applications of these earlier findings are now warranted.
幽门螺杆菌现已成为胃肠病学的前沿领域，尤其是在胃十二指肠溃疡的治疗方面，然而其在胃炎中的作用仍被广泛忽视，尽管这种疾病引发了最初的许多观察。四十年前，首次证明抗生素可以消除人体胃部的氨生成，这表明这是由于细菌脲酶活性的根除。还发现胃液氨浓度与尿毒症患者的胃酸过少或无酸以及胃炎患者的黏膜炎症相关。在非酒精性和酒精性胃炎患者中，抗生素治疗显著改善了胃炎的组织学以及症状。根除胃脲酶活性以及由此导致的氨生成减少的有益效果在肝性脑病患者中也得到了证实。现在有必要对这些早期发现进行更广泛的研究和临床应用。
