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上消化道粘膜的完整性取决于侵袭因素(Ag-gressive factors)和防御因素(Defensive factors)之间的平衡。多年来,消化性溃疡的治疗仅着重于消除侵袭因素,即通过减少胃酸分泌(如H_2受体拮抗剂、毒蕈碱受体拮抗剂)或中和已分泌的酸(制酸剂)或阻止酸接触溃疡面(如硫糖铝)而促使溃疡愈合。仅仅近几年来“强化”粘膜防御才被作为消化性溃疡治疗的新途径。例如,前列腺素E被认为是实施细胞保护的主要因子,其合成类似品已被用于预防和治疗消化性溃疡。其他药物如生胃酮,铋剂也被认为能增强粘膜的防御能力。在合理设计旨在增强粘膜防御的治疗方案之前,有必要了解:胃肠粘膜怎样抵御损伤?一旦发生损伤,粘膜通过何种机制修复并限制损伤的发展?
The integrity of the upper gastrointestinal mucosa depends on the balance between Ag-gressive factors and Defensive factors. Over the years, the treatment of peptic ulcer has focused on the elimination of invasive factors, either by reducing gastric acid secretion (such as H 2 receptor antagonists, muscarinic receptor antagonists) or neutralizing secreted acids (antacids) or preventing Acid contact ulcer surface (such as sucralfate) and promote ulcer healing. Only in recent years to “strengthen” mucosal defense was only as a new way of treatment of peptic ulcer. For example, prostaglandin E is considered to be a major factor in the implementation of cytoprotection, and its synthetic analogs have been used to prevent and treat peptic ulcer disease. Other drugs such as endosulfan and bismuth are also thought to enhance mucosal defense. Before rationally designing a treatment plan to enhance mucosal defenses, it is necessary to understand: How does the gastrointestinal mucosa resist damage? In what ways does the mucosa repair and limit the development of damage in the event of injury?