Helicobacterpylori virulence factors in duodenal ulceration:A primary cause or a secondary infection causing chronicity  

作　　者：FrankI Tovey Michael Hobsley John Holton 

机构地区：[1]Department of Surgery,University College London,London,United Kingdom [2]Department of Microbiology,University College London,London,United Kingdom

出　　处：《World Journal of Gastroenterology》2006年第1期6-9,共4页世界胃肠病学杂志（英文版）

摘　　要：Reports from countries with a high prevalence of Helicobacter pylori （H pylori） infection do not show a proportionately high prevalence of duodenal ulceration, suggesting the possibility that H pylori cannot be a primary cause of duodenal ulceration. It has been mooted that this discrepancy might be explained by variations in the prevalence of virulence factors in different populations. The aim of this paper is to determine whether the published literature gives support to this possibility. The relevant literature was reviewed and analyzed separately for countries with a high and low prevalence of Hpylori infection and virulence factors. Although virulent strains of Hpylori were significantly more often present in patients with duodenal ulcer than without the disease in countries with a low prevalence of H pylori infection in the population, there was no difference in the prevalence of virulence factors between duodenal ulcer, nonulcer dyspepsia or normal subjects in many countries, where the prevalence of both Hpylori infection and of virulence factors was high. In these countries, the presence of virulence factors was not predictive the clinical outcome. To explain the association between virulence factors and duodenal ulcer in countries where H pylori prevalence is low, only two papers were found that give little support to the usual model proposed, namely that organisms with the virulence factors are more likely than those without them to initiate a duodenal ulcer. We offer an alternative hypothesis that suggests virulence factors are more likely to interfere with the healing of a previously produced ulcer. The presence of virulence factors only correlates with the prevalence of duodenal ulcer in countries where the prevalence of H pylori is low. There is very little evidence that virulence factors initiate duodenal ulceration, but they may be related to failure of the ulcer to heal.感染不看十二指肠的溃疡的成比例地的高流行的来自有 Helicobacter pylori (H pylori ) 的高流行的国家的报告，建议 H pylori 不能是十二指肠的溃疡的一个原发性原因的可能性。这差异可能被变化在不同人口在毒力因素的流行解释，这被提出了。这篇论文的目的是决定出版文学是否支持这可能性。相关文学与 H pylori 感染和毒力因素的高、低的流行为国家独立被考察并且分析。尽管 H pylori 的剧毒的紧张是，更经常显著地与 H pylori 感染的低流行在国家比没有疾病与十二指肠溃疡在病人介绍在人口，在在十二指肠溃疡之间的毒力因素的流行没有差别，非-在许多国家的溃疡消化不良或正常题目，在两 H pylori 感染并且毒力因素的流行高的地方。在这些国家，毒力因素的存在不是预兆的临床的结果。为了在国家解释在毒力因素和十二指肠溃疡之间的协会，在 H pylori 流行是低的的地方，仅仅二份报纸被发现那几乎别把小支持给建议的平常的模型，也就是没有他们，有毒力因素的有机体是比那些更可能的开始十二指肠溃疡。我们提供建议毒力因素是更可能的防碍以前生产的溃疡愈合的一个其他的假设。毒力因素的存在仅仅在 H pylori 的流行是低的国家与十二指肠溃疡的流行相关。有很小的证据，毒力因素开始十二指肠的溃疡，但是他们可能与溃疡的失败有关愈合。

关 键 词：Duodenal ulceration Helicobacter pylorivirulence factors 

分 类 号：R573.1[医药卫生—消化系统]