Eosinophilic Esophagitis: A Review.
Eosinophilic Esophagitis: A Review.
复制标题
DOI：
10.1001/jama.2021.14920
复制
发表时间：
2021-10-05
影响因子：
120.7
通讯作者：
Falk, Gary W.
中科院分区：
文献类型：
--
作者：
Muir, Amanda;Falk, Gary W.
嗜酸性食管炎（EoE）是一种慢性免疫介导的食管炎性疾病，在美国估计约有150，000人受到影响。EoE影响儿童和成人，并导致吞咽困难、食管食物嵌塞和食管狭窄。嗜酸性粒细胞性食管炎定义为食管功能障碍的症状，如呕吐、吞咽困难或进食困难，食管活检显示至少15个嗜酸性粒细胞/高倍视野，不存在与食管嗜酸性粒细胞增多相关的其他疾病，如胃食管反流病或贲门失弛缓症。遗传因素和环境因素，如早期接触抗生素与嗜酸性食管炎有关。目前的治疗方法包括质子泵抑制剂、局部类固醇制剂（如氟替卡松和布地奈德）、氨基酸配方饮食疗法或经验性食物消除和内窥镜扩张。在一项纳入1,051例嗜酸性粒细胞性食管炎患者的观察性研究的系统性综述中，质子泵抑制剂治疗与组织学应答相关，定义为内镜活检时嗜酸性粒细胞< 15，41.7%的患者，而安慰剂治疗与13.3%的应答率相关。在对437例嗜酸性食管炎患者的8项随机试验进行的系统性综述中，局部皮质类固醇治疗与64.9%的患者组织学缓解相关，而安慰剂治疗与13.3%相关。食管狭窄的患者可能需要扩张。治疗反应的客观评估通常需要内窥镜检查和活检。在美国，嗜酸性食管炎影响估计约150，000人，包括儿童和成人。治疗包括质子泵抑制剂，局部类固醇，元素饮食，经验性食物消除，食管扩张保留给有症状的食管狭窄患者。
Eosinophilic esophagitis (EoE) is a chronic immune mediated inflammatory disease of the esophagus, that affects an estimated approximately 150,000 people in the United States. EoE affects both children and adults and causes dysphagia, food impaction of the esophagus, and esophageal strictures. Eosinophilic esophagitis is defined by symptoms of esophageal dysfunction such as vomiting, dysphagia, or feeding difficulties in a patient with an esophageal biopsy demonstrating at least 15 eosinophils/high powered field in the absence of other conditions associated with esophageal eosinophilia such as gastroesophageal reflux disease or achalasia. Genetic factors and environmental factors such as exposure to antibiotics early in life are associated with eosinophilic esophagitis. Current therapies include proton pump inhibitors, topical steroid preparations, such as fluticasone and budesonide, dietary therapy with amino acid formula or empiric food elimination, and endoscopic dilation. In a systematic review of observational studies that included 1,051 patients with eosinophilic esophagitis, proton pump inhibitor therapy was associated with a histologic response, defined as < 15 eosinophils on endoscopic biopsy, in 41.7% of patients, while placebo was associated with a 13.3% response rate. In a systematic review of eight randomized trials of 437 patients with eosinophilic esophagitis, topical corticosteroid treatment was associated with histologic remission in 64.9% of patients, compared to 13.3% for placebo. Patients with esophageal narrowing may require dilation. Objective assessment of therapeutic response typically requires endoscopy with biopsy. Eosinophilic esophagitis affects an estimated approximately 150,000 people in the United States, including children and adults. Treatments consist of proton pump inhibitors, topical steroids, elemental diet, and empiric food elimination, with esophageal dilation reserved for patients with symptomatic esophageal narrowing.
登录
查看更多内容
影响因子：
24.5
作者：
Cheng E;Zhang X;Huo X;Yu C;Zhang Q;Wang DH;Spechler SJ;Souza RF
通讯作者：
Souza RF
影响因子：
7.7
作者：
Dellon ES;Kim HP;Sperry SL;Rybnicek DA;Woosley JT;Shaheen NJ
通讯作者：
Shaheen NJ
DOI：
10.1038/ajg.2013.363
发表时间：
2013-12
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
Dellon ES;Speck O;Woodward K;Gebhart JH;Madanick RD;Levinson S;Fritchie KJ;Woosley JT;Shaheen NJ
通讯作者：
Shaheen NJ
影响因子：
29.4
作者：
Gonsalves, Nirmala;Yang, Guang-Yu;Hirano, Ikuo
通讯作者：
Hirano, Ikuo
影响因子：
9.8
作者：
Ackerman, Steven J.;Kagalwalla, Amir F.;Furuta, Glenn T.
通讯作者：
Furuta, Glenn T.