The Use of Proton Pump Inhibitors in Children
The Use of Proton Pump Inhibitors in Children
复制标题
质子泵抑制剂在儿童中的使用
DOI：
--
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
B. Gold
中科院分区：
文献类型：
--
作者：
Troy Gibbons;B. Gold
质子泵抑制剂（PPI）属于一组化学相关化合物，其主要功能是抑制胃壁细胞最终共同代谢途径中的酸产生。PPI具有高度的选择性和有效性，几乎没有短期或长期的不良反应。这些药理学特征使得PPI的开发成为过去二十年来酸消化相关疾病管理的最重大进展。有许多已发表的成人研究描述了这些抗分泌剂的药理学、有效性和安全性;然而，在儿科人群中，几乎没有可比性研究，特别是有大量患者入组的多中心研究。在准备这篇文章时，我们的目的是对关于PPI在儿科人群中的临床药理学和使用的文献进行全面综述，并简要回顾了最近的一些文章。通过1990年1月至2001年12月的MEDLINE®/Pubmed®检索确定相关文献。使用以下检索词组合分析这些数据库：质子泵抑制剂、儿童、儿科、胃食管反流病（GERD）、食管炎、肠上皮化生、幽门螺杆菌、奥美拉唑、兰索拉唑、泮托拉唑、雷贝拉唑、埃索美拉唑和安全性。2001年第14届北美儿科胃肠病学、肝病学和营养学会（NASPGHAN）年会和2001年疾病和消化周的摘要也被纳入综述。兰索拉唑用于GERD和相关疾病管理的剂量范围为0.73-1.66 mg/kg/天（最大30 mg/天）。使用奥美拉唑管理GERD的剂量范围为0.3-3.5 mg/kg（最大80 mg/天）。奥美拉唑治疗H. pylori的剂量为0.5-1.5 mg/kg/d，最大剂量为40 mg/d;幽门螺杆菌根除使用的剂量范围为0.6-1.2 mg/kg/天，最大剂量为30 mg/天。几乎没有严重的不良事件报告与使用任何一种药物。H.到目前为止，还没有发表的对照试验足够的权力比较五个市售质子泵抑制剂在儿童中的各种酸性消化道疾病的疗效。研究表明，PPI对GERD和相关疾病的管理非常有效，并且是根除H.幽门。PPI在成人和儿童中具有非常好的耐受性，但需要进行长期耐受性研究，特别是在儿科人群中。迫切需要多中心研究来评价第二代PPI，比较PPI的疗效，并评估这些药物在酸消化性疾病儿童中的发育和遗传药理学的重要性。
Proton pump inhibitors (PPIs) belong to a group of chemically related compounds whose primary function is the inhibition of acid production in the final common metabolic pathway of gastric parietal cells. PPIs are highly selective and effective in their action and have few short- or long-term adverse effects. These pharmacologic features have made the development of PPIs the most significant advancement in the management of acid peptic related disorders in the last two decades. There are numerous published adult studies that describe the pharmacology, efficacy and safety of these anti-secretory agents; however, in the pediatric population, there are very few comparable studies, particularly multicenter studies with significant patient enrollment.In preparing this article, our aim was to perform a comprehensive review of the literature on the clinical pharmacology and use of PPIs in the pediatric population, and to briefly review some recent articles. Relevant literature was identified by performing MEDLINE®/Pubmed® searches from January 1990 to December 2001. Combinations of the following search terms were use to analyze these databases: proton pump inhibitor, children, pediatrics, gastroesophageal reflux disease (GERD), esophagitis, intestinal metaplasia, Helicobacter pylori, omeprazole, lansoprazole, pantoprazole, rabeprazole, esomeprazole, and safety. Abstracts from the 14th annual conference of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) 2001, and the Disease and Digestive Week 2001, were also included in the review.All pediatric studies reviewed were limited to either omeprazole or lansoprazole. The dosage range used for the management of GERD and related disorders with lansoprazole was 0.73–1.66 mg/kg/day (maximum 30 mg/day). The dosage range for GERD management using omeprazole was 0.3–3.5 mg/kg (maximum 80 mg/day). The dosage range for omeprazole used for H. pylori was 0.5–1.5 mg/kg/day, with a maximum dosage of 40 mg/day, and lansoprazole-containing regimens for H. pylori eradication used dosages ranging from 0.6–1.2 mg/kg/day, with a maximum dosage of 30 mg/day. Few severe adverse events were reported with the use of either drug. Eradication rates for H. pylori were 56–87% for lansoprazole-based triple therapy, and 75–94% for omeprazole-based eradication regimens.To date, there are no published controlled trials of sufficient power comparing the efficacy of the five commercially available PPIs in children, for a variety of acid peptic diseases. Studies suggest that PPIs are highly effective for the management of GERD and related disorders, and are a critically needed component of triple therapy to eradicate H. pylori. PPIs have a very good tolerability profile in adults and children, but long-term tolerability studies are needed, particularly in the pediatric population. Multicenter studies are critically needed to evaluate the second-generation PPIs, to compare PPI efficacy to each other, and to assess the importance of developmental and genetic pharmacology of these drugs in children with acid-peptic disease.
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种群和遗传多态性。
DOI：
--
发表时间：
1999
期刊：
Molecular diagnosis : a journal devoted to the understanding of human disease through the clinical application of molecular biology
影响因子：
--
作者：
Weber,WW
通讯作者：
Weber,WW
胃 H,K-ATP 酶的结构。
影响因子：
3
作者：
Sachs,G;Besancon,M;Shin,JM;Mercier,F;Munson,K;Hersey,S
通讯作者：
Hersey,S
影响因子：
29.4
作者：
GRAHAM, DY;LEW, GM;GENTA, RM
通讯作者：
GENTA, RM
夜间哮喘：夜间胃食管反流的作用。
影响因子：
2.8
作者：
Harding,SM
通讯作者：
Harding,SM