中文题目幽门螺旋杆菌不是肝硬化合并消化性溃疡之主因.DOC

中文題目：非類固醇藥物造成複雜性消化性潰瘍而與幽門螺旋桿菌殺菌無關 英文題目：Non-steroidal anti-inflammatory drug increase complicated peptic ulcers, irrespective of Helicobacter pylori eradication 作 者：張勝雄1 胡曉雲2,3 服務單位：台北市立聯合醫院陽明院區一般內科、消化內科、內科部1 國立陽明大學公共衛生學科暨研究所2 台北市立聯合醫院教學研究部3 Background: Helicobacter pylori (H. pylori) infection and use of non-steroidal anti-inflammatory drugs (NSAIDs) both confer a 3-fold to 4-fold increase in the risk of peptic ulcer disease. Identification of the roles of NSAID use and H. pylori infection in the pathogenesis of peptic ulcers and recurrent peptic ulcers could, therefore, facilitate the treatment of patients with upper gastrointestinal (UGI) bleeding and avoid progression to life-threatening episodes. H. pylori infection causes gastric epithelial cell damage by way of a toxic-mediated or immune-mediated mechanism. It is also associated with increased tumor necrosis factor-α and Fas/Fas ligand-mediated apoptosis. These factors might contribute to atrophy and ulceration. However, the possible synergistic effects of H. pylori infection and NSAID use on increasing the risk of ulcer complications have yet to be fully elucidated. NSAID is a risk factor of complicated peptic ulcer disease. However, the connection between H. pylori and peptic ulcer complications is somewhat divergent. Our study, therefore, aims to elucidate the combined effects of NSAID use and H. pylori infection in recurrent complicated peptic ulcer disease. In our analyses, we evaluated patients with peptic ulcer disease who had received gastroscopy and H. pylori testing, and grouped the participants into early H. pylori eradication therapy and late H. pylori eradication therapy groups. We selected these patients from the database of the Taiwan National Health Insurance (NHI) bureau, using data from 2000 to 2010. Materials and Methods: All patients with endoscopically diagnosed peptic ulcers were selected as the study cohort. The patients were assigned to an early H. pylori eradication therapy grou