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根据是否服用非甾体抗炎药(NSAIDs)可将幽门螺杆菌(H.pylori)阴性消化性溃疡(PU)分为NSAIDs相关PU和非H.pylori、非NSAIDs相关PU。NSAIDs相关PU病程较短,常无典型的腹痛,近50%为无痛性,症状与实际病变相关性差,内镜下常表现为多发溃疡,溃疡直径较小,多集中于胃窦部。对NSAIDs相关PU的治疗仍有争议,对高危人群和非高危人群应采用不同的治疗策略。非H.pylori、非NSAIDs相关PU发生的机制复杂,可能与高胃酸分泌、基础疾病致黏膜防御机制受损、少见病原体感染、某些药物以及其他因素如吸烟、心理因素、应激、饮食习惯等有关。由于发病因素较多且无法明确,非H.pylori、非NSAIDs相关PU的治疗效果常较差。
H. pylori-negative peptic ulcer (PU) can be divided into NSAIDs-associated PUs and non-H. pylori, non-NSAIDs-related PUs depending on whether they are taking NSAIDs. NSAIDs related PU duration is shorter, often without typical abdominal pain, nearly 50% is painless, the correlation between the symptoms and the actual lesion is poor, endoscopic often showed multiple ulcers, ulcer diameter smaller, mostly concentrated in the antrum. The treatment of NSAIDs related PU is still controversial, and different treatment strategies should be adopted for high-risk and non-high-risk groups. Non-H. pylori and non-NSAIDs related PUs are complicated by mechanisms that may be associated with high gastric acid secretion, impaired mucosal defense mechanisms underlying underlying diseases, rare pathogen infections, certain medications and other factors such as smoking, psychological factors, stress, dietary habits And so on. Due to the high incidence of factors and can not be clear, non-H. pylori, non-NSAIDs related PU treatment is often poor.