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武汉大学 The causes about Peptic Ulcer 消化性溃疡的形成原因 causes aggressive factors↑ defensive factors ↓ Aggressive Factors 1.Helicobacter pylori (H.p) the evidences . the detection rate of H.p in GU is approximately70% -80% . the detection rate of H.p in DU is approximately 90% . Eradication of H.p would boost the healing of ulcer. How can H.p destroy local mucosal defective/repaired mechanism? 1. colonize the gastric mucosa(胃粘膜). 2. increased acid secretion 2.NSAID After H.p infection, NSAID is the next important cause . Research data show that NSAID use in patients with peptic ulcer and the risk of complications was significantly higher than the general population. By weakening mucosal defense and repair functions eventually lead to peptic ulcer. 案例展示 3.Acid and pepsin The eventual formation of peptic ulcer is due to acid and pepsin digestion of the mucosa itself. Because the biologic activity of pepsin is depended on the pH value. When local pH value elevates to 4, pepsin can’t work well. So we often say that “No acid, no ulcer.” 4. Other risk factors 1) Smoking Smoking is an increased risk of peptic ulcer. Smoking can affect the healing of ulcer, accelerate ulcer recurrence, and increased complication of ulceration. But the mechanism isn’t clear. 2)Heredity Patients with peptic ulcer often have a family history of ulcer.And some studies show that blood group O(O型血人群) have a high risk to developing peptic ulcer . 3)Stress High stress can stimulate vagus nerve(交感神经), which can result in high secretion of acid . 4) Abnormal gastroduodenal locomotion胃十二指肠功能异常 DU—quick gastric empty → overfull acid load food storage GU—movement obstruction→reflux digestive liquid
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