抑酸与胃萎缩：分清事实与虚构
Acid suppression and gastric atrophy: sifting fact from fiction.
作者信息
Genta R M
机构信息
Department of Pathology, Medicine, Veterans Affairs Medical Center, Houston, TX, USA.
出版信息
Gut. 1998 Jul;43 Suppl 1(Suppl 1):S35-8. doi: 10.1136/gut.43.2008.s35.
Abstract
Prolonged pharmacological acid suppression is associated with various histological changes in the gastric mucosa, particularly in Helicobacter pylori infected patients. In a number of subjects these changes include a shift in the gastric inflammation from the antrum to the corpus. This finding has been interpreted as gastric atrophy, and the possibility that acid suppression accelerates the progress of lesions that may lead to gastric cancer has been considered. Two recent studies on the relation between treatment with proton pump inhibitors and atrophic gastritis have yielded apparently contradictory results. These studies are reviewed in detail here and some of the possible reasons for the discrepant conclusions are explored. In particular, the way the terms "gastric atrophy" and "atrophic gastritis" are used is examined critically.
摘要
长期药物性抑酸与胃黏膜的各种组织学改变有关，尤其是在幽门螺杆菌感染患者中。在许多受试者中，这些改变包括胃炎症从胃窦向胃体的转移。这一发现被解释为胃萎缩，并且人们已经考虑到抑酸可能加速可能导致胃癌的病变进展。最近两项关于质子泵抑制剂治疗与萎缩性胃炎关系的研究得出了明显矛盾的结果。本文详细回顾了这些研究，并探讨了得出不同结论的一些可能原因。特别是，对“胃萎缩”和“萎缩性胃炎”这两个术语的使用方式进行了批判性审视。
相似文献
1
Acid suppression and gastric atrophy: sifting fact from fiction.抑酸与胃萎缩：分清事实与虚构
Gut. 1998 Jul;43 Suppl 1(Suppl 1):S35-8. doi: 10.1136/gut.43.2008.s35.
2
Histological characteristics of gastric mucosa prior to Helicobacter pylori eradication may predict gastric cancer.幽门螺杆菌根除治疗前胃黏膜的组织学特征可能预测胃癌。
Scand J Gastroenterol. 2013 Nov;48(11):1249-56. doi: 10.3109/00365521.2013.838994. Epub 2013 Sep 30.
3
The Reduction in Gastric Atrophy after Eradication Is Reduced by Treatment with Inhibitors of Gastric Acid Secretion.胃酸分泌抑制剂治疗可减少根除后胃萎缩的减少。
Int J Mol Sci. 2019 Apr 18;20(8):1913. doi: 10.3390/ijms20081913.
4
Comparison of Helicobacter pylori infection and gastric mucosal histological features of gastric ulcer patients with chronic gastritis patients.胃溃疡患者与慢性胃炎患者幽门螺杆菌感染及胃黏膜组织学特征的比较。
World J Gastroenterol. 2005 Feb 21;11(7):976-81. doi: 10.3748/wjg.v11.i7.976.
5
Atrophy, acid suppression and Helicobacter pylori infection: a tale of two studies.萎缩、酸抑制与幽门螺杆菌感染：两项研究的故事
Eur J Gastroenterol Hepatol. 1999 Aug;11 Suppl 2:S29-33; discussion S43-5. doi: 10.1097/00042737-199908002-00006.
6
Interactions between H. pylori infection, gastric acid secretion and anti-secretory therapy.幽门螺杆菌感染、胃酸分泌与抗分泌治疗之间的相互作用。
Br Med Bull. 1998;54(1):121-38. doi: 10.1093/oxfordjournals.bmb.a011663.
7
Helicobacter pylori infection, glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer.幽门螺杆菌感染、浅表性胃炎、胃糜烂、糜烂性胃炎、胃溃疡及早期胃癌中的腺体萎缩和肠化生。
World J Gastroenterol. 2005 Feb 14;11(6):791-6. doi: 10.3748/wjg.v11.i6.791.
8
Synergistic effect of IL-1β and TNF-α polymorphisms on the H. pylori-related gastric pre-malignant condition.白细胞介素-1β和肿瘤坏死因子-α基因多态性对幽门螺杆菌相关胃癌前病变的协同作用。
Hepatogastroenterology. 2012 Nov-Dec;59(120):2416-20. doi: 10.5754/hge10605.
9
Helicobacter pylori gastritis and gastric physiology.幽门螺杆菌胃炎与胃生理学
Gastroenterol Clin North Am. 2000 Sep;29(3):687-703, viii. doi: 10.1016/s0889-8553(05)70138-2.
10
Increase of Helicobacter pylori-associated corpus gastritis during acid suppressive therapy: implications for long-term safety.抑酸治疗期间幽门螺杆菌相关性胃体胃炎的增加：对长期安全性的影响
Am J Gastroenterol. 1995 Sep;90(9):1401-6.
引用本文的文献
1
Age-Related Decline of Gastric Secretion: Facts and Controversies.胃分泌的年龄相关性下降：事实与争议
Biomedicines. 2025 Jun 25;13(7):1546. doi: 10.3390/biomedicines13071546.
2
Rebound Acid Hypersecretion after Withdrawal of Long-Term Proton Pump Inhibitor (PPI) Treatment-Are PPIs Addictive?长期质子泵抑制剂（PPI）治疗停药后出现的酸反跳性分泌过多——PPI 会上瘾吗？
Int J Mol Sci. 2024 May 17;25(10):5459. doi: 10.3390/ijms25105459.
3
Identification of New Pathogenic Variants of Hereditary Diffuse Gastric Cancer.遗传性弥漫性胃癌的新型致病性变异体的鉴定。
Cancer Res Treat. 2024 Oct;56(4):1126-1135. doi: 10.4143/crt.2024.328. Epub 2024 Apr 11.
4
Prediction of future gastric cancer risk using a machine learning algorithm and comprehensive medical check-up data: A case-control study.基于机器学习算法和综合体检数据预测未来胃癌风险：一项病例对照研究。
Sci Rep. 2019 Aug 27;9(1):12384. doi: 10.1038/s41598-019-48769-y.
5
A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit.一项成功的基于药剂师的质量改进措施，以减少学术性医学重症监护病房中不适当的应激性溃疡预防用药
Inquiry. 2018 Jan-Dec;55:46958018759116. doi: 10.1177/0046958018759116.
6
Gastric cancer in women: A regional health-center seven year retrospective study.女性胃癌：一项地区医疗中心的七年回顾性研究。
World J Gastroenterol. 2015 Jul 7;21(25):7805-13. doi: 10.3748/wjg.v21.i25.7805.
7
Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial.长期使用奥美拉唑治疗的反流性食管炎患者幽门螺杆菌感染的治愈可逆转胃炎且不会加重反流性疾病：一项随机对照试验的结果
Gut. 2004 Jan;53(1):12-20. doi: 10.1136/gut.53.1.12.
8
Gastroesophageal reflux and Helicobacter pylori: a review.胃食管反流与幽门螺杆菌：综述
World J Gastroenterol. 2000 Jun;6(3):311-314. doi: 10.3748/wjg.v6.i3.311.
9
Effect of Helicobacter pylori eradication on chronic gastritis during omeprazole therapy.奥美拉唑治疗期间幽门螺杆菌根除对慢性胃炎的影响。
Gut. 2000 May;46(5):615-21. doi: 10.1136/gut.46.5.615.
本文引用的文献
1
Parietal cell protrusions in gastric ulcer disease.胃溃疡疾病中的壁细胞突起。
Hum Pathol. 1997 Oct;28(10):1126-30. doi: 10.1016/s0046-8177(97)90249-5.
2
Gastric corpus IL-8 concentration and neutrophil infiltration in duodenal ulcer patients.十二指肠溃疡患者胃体白细胞介素-8浓度及中性粒细胞浸润情况
Aliment Pharmacol Ther. 1997 Aug;11(4):793-800. doi: 10.1046/j.1365-2036.1997.00218.x.
3
Gastric mucosa during treatment with lansoprazole: Helicobacter pylori is a risk factor for argyrophil cell hyperplasia.使用兰索拉唑治疗期间的胃黏膜：幽门螺杆菌是嗜银细胞增生的一个危险因素。
Gastroenterology. 1997 Mar;112(3):707-17. doi: 10.1053/gast.1997.v112.pm9041231.
4
Current European concepts in the management of Helicobacter pylori infection--the Maastricht Consensus Report. The European Helicobacter Pylori Study Group (EHPSG).当前欧洲幽门螺杆菌感染管理理念——马斯特里赫特共识报告。欧洲幽门螺杆菌研究小组（EHPSG）。
Eur J Gastroenterol Hepatol. 1997 Jan;9(1):1-2. doi: 10.1097/00042737-199701000-00002.
5
Omeprazole produces parietal cell hypertrophy and hyperplasia in humans.奥美拉唑可导致人体壁细胞肥大和增生。
Dig Dis Sci. 1996 Oct;41(10):2039-47. doi: 10.1007/BF02093608.
6
Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994.胃炎的分类与分级。更新后的悉尼系统。1994年于休斯顿召开的胃炎组织病理学国际研讨会。
Am J Surg Pathol. 1996 Oct;20(10):1161-81. doi: 10.1097/00000478-199610000-00001.
7
Effect of proton pump inhibitors on the detection of Helicobacter pylori in gastric biopsies.质子泵抑制剂对胃活检中幽门螺杆菌检测的影响。
Aliment Pharmacol Ther. 1996 Jun;10(3):289-93. doi: 10.1111/j.0953-0673.1996.00289.x.
8
Helicobacter pylori and gastric cancer.幽门螺杆菌与胃癌
Scand J Gastroenterol Suppl. 1996;215:48-51.
9
Recognizing atrophy: another step toward a classification of gastritis.认识萎缩：迈向胃炎分类的又一步。
Am J Surg Pathol. 1996;20 Suppl 1:S23-30. doi: 10.1097/00000478-199600001-00004.
10
Helicobacter pylori in the stomach--a paradox unmasked.胃中的幽门螺杆菌——一个被揭开的悖论。
N Engl J Med. 1996 Jul 25;335(4):278-80. doi: 10.1056/NEJM199607253350411.
Zotero 插件