Gastric Hyperplastic Polyps Can Shrink After Discontinuation of Proton Pump Inhibitors: A Case Series Compared With Continuation of Proton Pump Inhibitors
Gastric Hyperplastic Polyps Can Shrink After Discontinuation of Proton Pump Inhibitors: A Case Series Compared With Continuation of Proton Pump Inhibitors
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停止使用质子泵抑制剂后胃增生性息肉会缩小：一系列病例与继续使用质子泵抑制剂进行比较
DOI：
10.1097/mcg.0000000000001577
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Seno H.
中科院分区：
文献类型：
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作者：
Nikaido M;Miyamoto S;Utsumi T;Shimizu T;Nakanishi Y;Kumagai K;Teramura M;Setoyama T;Seno H.
背景：据报道，长期使用PPI会增加GHP的发生率，GHP有时会出血并导致贫血。我们经历了一个病人的复发出血GHP与长期使用PPIS.Study停止后消失：这项研究是回顾性地在京都大学医院。组织学证实的GHP患者，服用PPI> 6个月，2年内接受过重复内镜检查。息肉缩小定义为息肉消失或最大息肉长径减少> 50%。结果：6例停用PPI的患者与17例继续使用PPI的患者进行了比较。PPI停药组（5/6，83%）的息肉缩小率显著高于PPI继续治疗组（0/17，0%）（P< 0.001）。在PPI停药组的2例患者中，息肉最终完全消失。结论：这些研究结果表明，停止PPI可以缩小使用PPIs的患者的GHP。长期使用质子泵抑制剂（PPIs），往往需要胃食管反流病（GERD）和巴雷特食管的患者，并防止出血的人服用非甾体抗炎药。1一些指南还建议在双重抗血小板治疗或阿司匹林和抗凝剂联合治疗期间预防性使用PPI。2-4最近开发的钾竞争性酸阻滞剂（P-CAB）比PPI更能抑制胃酸分泌，已被用于治疗亚洲的GERD。虽然PPI已知几乎没有显著的不良反应，但人们对其长期使用的安全性表示担忧。一、五、六
Background:Long-term use of PPIs has been reported to increase the incidence of GHPs, which sometimes bleed and cause anemia. We experienced a patient whose recurrent hemorrhagic GHPs associated with long-term use of PPIs had disappeared after discontinuation of PPIs.Study:This study was conducted retrospectively at Kyoto University Hospital. Patients with histologically confirmed GHPs who had been taking PPIs for> 6 months and who had undergone a repeat endoscopy within 2 years were included. Polyp shrinkage was defined as the disappearance of polyps or a reduction of> 50% in the long diameter of the largest polyp.Results:Six patients who discontinued PPIs were compared with 17 patients who continued PPIs. Polyp shrinkage was significantly more frequent in the PPI-discontinuation group (5/6, 83%) than in the PPI continuation group (0/17, 0%)(P< 0.001). In 2 patients in the PPI-discontinuation group, the polyps completely disappeared finally.Conclusion:These findings suggest that discontinuation of PPIs can shrink GHPs in patients using PPIs.Long-term use of proton pump inhibitors (PPIs) is often required for patients with gastroesophageal reflux disease (GERD) and Barrett’s esophagus, and to prevent bleeding in people taking nonsteroidal anti-inflammatory drugs. 1 Several guidelines also recommend the prophylactic use of PPIs during dual antiplatelet therapy or combined aspirin and anticoagulant therapy. 2–4 Recently developed potassium-competitive acid blockers (P-CABs), which suppress acid secretion more strongly than PPIs, have been indicated for treatment of GERD in Asia. Although PPIs are known to have few significant adverse effects, there are concerns about the safety of their long-term use. 1, 5, 6