Healing of Erosive Esophagitis and Improvement of Symptoms of Gastroesophageal Reflux Disease After Esomeprazole Treatment in Children 12 to 36 Months Old.
Healing of Erosive Esophagitis and Improvement of Symptoms of Gastroesophageal Reflux Disease After Esomeprazole Treatment in Children 12 to 36 Months Old.
复制标题
12至36个月大的儿童接受埃索美拉唑治疗后糜烂性食管炎的治愈和胃食管反流病的症状改善。
DOI：
10.1097/mpg.0b013e3181ddcf11
复制
发表时间：
2015
影响因子：
2.9
通讯作者：
Illueca,Marta
中科院分区：
文献类型：
--
作者：
Tolia,Vasundkara;Gilger,MarkA;Barker,PeterN;Illueca,Marta
目的本研究的目的是评估在年龄12至36个月的内镜或组织学证实的胃食管反流病（GERD）儿童中，每日一次埃索美拉唑对糜烂性食管炎愈合和症状改善的影响。在1 - 11岁经内镜或组织学证实的GERD患者中进行的剂量分层双盲研究。儿童随机接受埃索美拉唑5或10毫克，每天一次。患者在基线时接受内镜检查和粘膜活检（如需要）。基线时患有糜烂性食管炎（使用洛杉矶分类系统分级）的患者在最终研究访视时接受随访内镜检查，以评估糜烂性食管炎的愈合情况。研究者在基线和每2周使用医师全球Assessment.Results31 GERD症状的严重程度进行评分的109名主要研究患者的年龄12至36个月被纳入事后分析。基线时，15例患者（48.4%）患有糜烂性食管炎，接受了随访内镜检查，并在埃索美拉唑治疗8周后愈合。在19例基线医生总体评估症状评分为中度至重度的患者中，84.2%的患者在最终访视时评分较低。埃索美拉唑治疗后，GERD症状从基线到最终访视显著改善结论埃索美拉唑5 mg或10 mg可成功治疗1岁以下儿童的糜烂性食管炎和GERD症状。洛杉矶分级系统可用于12 - 36个月儿童糜烂性食管炎的分级。
ObjectivesThe aim of the study was to evaluate erosive esophagitis healing and symptom improvement with once‐daily esomeprazole in children ages 12 to 36 months with endoscopically or histologically proven gastroesophageal reflux disease (GERD).Patients and MethodsData from children ages 12 to 36 months were included in a post‐hoc analysis of an 8‐week, multicenter, randomized, and double‐blind by dose strata study of patients ages 1 to 11 years with endoscopically or histologically confirmed GERD. Children were randomized to receive esomeprazole 5 or 10 mg once daily. Patients underwent endoscopy and, if required, mucosal biopsy at baseline. Patients who had erosive esophagitis (graded using the Los Angeles classification system) at baseline underwent a follow‐up endoscopy at final study visit to assess healing of erosive esophagitis. Investigators scored severity of GERD symptoms at baseline and every 2 weeks using the Physician Global Assessment.ResultsThirty‐one of 109 primary study patients ages 12 to 36 months were included in the post hoc analysis. At baseline, 15 patients (48.4%) had erosive esophagitis, underwent follow‐up endoscopy, and were healed after 8 weeks of esomeprazole treatment. Of the 19 patients with moderate‐to‐severe baseline Physician Global Assessment symptom scores, 84.2% had lower scores by the final visit. Following esomeprazole treatment, GERD symptoms were significantly improved from baseline to final visit (P≤ 0.0018).ConclusionsEsomeprazole 5 or 10 mg may be used to successfully treat erosive esophagitis and symptoms of GERD in children as young as 1 year.Moreover, although not yet validated in pediatric patients, the Los Angeles classification system was useful in grading erosive esophagitis in children ages 12 to 36 months.