Histological esophagitis: clinical and histological response to omeprazole in children.

Histological esophagitis: clinical and histological response to omeprazole in children.
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组织学食管炎:儿童对奥美拉唑的临床和组织学反应。

DOI:
10.1023/a:1026666503642
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发表时间:
1999
影响因子:
3.1
通讯作者:
Mobassaleh,M
Mobassaleh,M
中科院分区:
医学3区
文献类型:
--
作者:
Strauss,RS;Calenda,KA;Dayal,Y;Mobassaleh,M

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许多食管炎患儿在食管镜检查中表现出组织学改变,但没有明显的食管炎证据。奥美拉唑对儿童食管炎组织学愈合的影响尚不清楚。因此,本研究的目的是确定奥美拉唑对儿科患者难治性组织学食管炎的影响。18例有食管炎组织学证据且经H2受体拮抗剂和促动力剂治疗后症状复发的患者前瞻性接受奥美拉唑治疗。通过监测胃内pH值调整剂量,并在奥美拉唑治疗8-12周后重复食管镜检查。2例患者因症状恶化或高胃泌素血症而未完成研究。其余患者中,76%的患者在奥美拉唑治疗后无症状,24%的患者症状明显改善。约40%的患者表现出完全的组织学愈合。3例患者(17%)在接受奥美拉唑治疗时血清胃泌素水平持续升高,这与患者年龄较大和奥美拉唑剂量较高有关;然而,所有升高的胃泌素水平在停药后恢复正常。所有患者在完成一个疗程的奥美拉唑治疗后症状均复发,即使是组织学完全愈合的患者。奥美拉唑对H2受体拮抗剂和促动力剂无效的儿童食管炎有效,但即使在食管炎治愈后,也没有患者能够停止抑酸治疗。
Many children with esophagitis demonstratehistological changes without gross evidence ofesophagitis by esophagoscopy. The effect of omeprazoleon the histological healing of esophagitis in childrenis unknown. Therefore, the aim of this study wasto determine the effect of omeprazole on refractoryhistological esophagitis in pediatric patients. Eighteenpatients with histological evidence of esophagitis and recurrent symptoms despite therapy withH2-receptor antagonists and prokinetic agentswere prospectively treated with omeprazole. Dosing wasadjusted by monitoring intragastric pH, andesophagoscopy was repeated after 8-12 weeks of omeprazoletreatment. Two patients did not complete the study dueto either worsening symptoms or hypergastrinemia. Of theremaining patients, 76% were asymptomatic with omeprazole treatment and 24% reportedimprovement in their symptoms. Approximately 40%demonstrated complete histological healing of theiresophagitis. Three patients (17%) had persistentelevations in serum gastrin levels while on omeprazoletreatment, which was associated with both youngerpatient age and higher omeprazole dosing; however, allelevated gastrin levels returned to normal afterdiscontinuation of the medication. All patients had recurrenceof their symptoms after completing a course ofomeprazole, even patients with complete histologicalhealing. Omeprazole is efficacious in treating children with esophagitis refractory toH2-receptor antagonist and prokinetic agents.However, none of the patients were able to discontinueacid suppressive therapy even after documented healingof their esophagitis.
DOI: 10.1016/0003-9861(86)90427-3
发表时间: 1986
影响因子: 3.9
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