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Neuere Erkenntnisse zur Regulation der Magensäuresekretion bei Patienten mit Ulcus duodeni

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Book cover Der Magen

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Zusammenfassung

Die Entstehung des Duodenalulkus wird als Folge eines Ungleichgewichtes zwischen aggressiven und defensiven Faktoren angesehen [1, 2]. Es ist mittlerweile gesichert, daß die Hypersekretion von Magensäure und Pepsinogen eine Schlüsselrolle in der Pathogenese der Ulkusentstehung spielt [1, 2, 3]. Die entscheidende Rolle der Magensäure konnte allerdings nur für eine kleine Untergruppe von Patienten mit Hypergastrinämie oder erhöhter Histaminsekretion bewiesen werden [3, 4]. Auf der anderen Seite unterstützt die eindrucksvolle Wirksamkeit von Medikamenten, die die Säuresekretion vermindern, bei der Heilung des Duodenalulkus die Bedeutung der Säuresekretion im Rahmen der Pathogenese des Ulcus duodeni [5]. Es wurde bereits eine große Anzahl von Studien zur Regulation der Magensäuresekretion durchgeführt, um die Pathogenese des Duodenalulkus aufzuklären. Diese Studien, die Untersuchungen zur Regulation der Magensäure, des Pepsinogens und des Gastrins umfassen, zeigten die wichtige Rolle der Hypersekretion bei vielen Patienten mit Ulcus duodeni. Allerdings weist mehr als die Hälfte der Patienten Normwerte für die oben genannten Parameter auf [3]. Zum Teil auf diesen heterogenen Abnormalitäten der Magensäuresekretion basierend, wurde postuliert, daß das Duodenalulkus eine heterogene Erkrankung darstellt, bei der verschiedene genetische und der Umwelt entstammende Faktoren zum selben Endresultat, d.h. zum Ulkus im Bulbus duodeni, führen [6]. Ein erhöhtes Pepsinogen A im Serum, früher Pepsinogen I genannt, und ein erhöhter Gastrinanstieg nach Testmahlzeit werden als genetische Marker für die duodenale Ulkuskrankheit angesehen [7–11].

Der Dank des Autors gilt Frau J.W. van Spronsen für ihre Hilfe bei der Niederschrift dieses Manuskriptes.

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Authors
  1. C. B. H. W. Lamers
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Editors and Affiliations

  1. Medizinischen Klinik und Poliklinik B, Universität Münster, Albert-Schweitzer-Straße 33, D-48149, Münster, Deutschland

    W. Domschke FACG (Direktor) (Direktor)

  2. Instituts für Physiologie, Universität Kraków, Grzegórzecka 16, PL-31531, Kraków, Polen

    S. J. Konturek (Direktor) (Direktor)

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© 1993 Springer-Verlag Berlin Heidelberg

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Lamers, C.B.H.W. (1993). Neuere Erkenntnisse zur Regulation der Magensäuresekretion bei Patienten mit Ulcus duodeni. In: Domschke, W., Konturek, S.J. (eds) Der Magen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-06526-6_3

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  • DOI: https://doi.org/10.1007/978-3-662-06526-6_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56612-0

  • Online ISBN: 978-3-662-06526-6

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