Itoh K
Second Department of Internal Medicine, National Defense Medical College.
Nihon Rinsho. 1998 Sep;56(9):2391-5.
It is well known that uremic patients frequently exhibit hemorrhagic lesions of the digestive tract and the recent introduction and progression of the hemodialysis treatment has changed the frequency of occurrence of a variety of gastrointestinal diseases. We have paid much attention on the upper digestive tract lesions of patients undergoing hemodialysis for chronic renal failure and have found that these lesions are predominantly mucosal hemorrhage of the stomach and gastroduodenal ulcers are rare. We have investigated the mechanism of onset of gastric hemorrhagic mucosal lesions focusing on blood flow, oxygen supply and infection of Helicobacter pylori. We conclude that not the blood flow but oxygen supply seems to play an important role and oxygen radicals produced at hemodialysis also may participate in the pathogenesis of mucosal hemorrhage. On the other hand, Helicobacter pylori does not seem to be important, because its infection rate is low among the patients investigated.
众所周知,尿毒症患者常出现消化道出血性病变,而血液透析治疗的新近应用和发展改变了各种胃肠道疾病的发生频率。我们一直高度关注慢性肾衰竭血液透析患者的上消化道病变,发现这些病变主要是胃黏膜出血,胃十二指肠溃疡罕见。我们着重从血流、氧供应和幽门螺杆菌感染方面研究了胃出血性黏膜病变的发病机制。我们得出结论,似乎不是血流而是氧供应起重要作用,血液透析时产生的氧自由基也可能参与黏膜出血的发病过程。另一方面,幽门螺杆菌似乎并不重要,因为在所研究的患者中其感染率较低。