Fundic gland polyps developing during omeprazole therapy.
Fundic gland polyps developing during omeprazole therapy.
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发表时间：
1997-10
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通讯作者：
H. El-Zimaity;F. W. Jackson;D. Y. Graham
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作者：
H. El-Zimaity;F. W. Jackson;D. Y. Graham
目的：奥美拉唑治疗的副作用包括可逆性高胃泌素血症、肠染色质样增生，并可能加速幽门螺杆菌感染患者胃主体萎缩性胃炎的发生。本报告的目的是描述在奥美拉唑用于巴雷特食管时发生的6例基底腺息肉。方法奥美拉唑20mg /d治疗1 ~ 5年后，3名女性和3名男性出现根底腺息肉。在指标病例中，连续使用奥美拉唑治疗2年后出现了眼底息肉。停用奥美拉唑，但因与h2阻滞剂联合临床疗效不佳，重新使用。结果治疗4年后，出现多个大的盆底息肉。所有病变的组织学表现为特征性的基底腺息肉伴多发囊性扩张。所有患者均无幽门螺杆菌感染。4例血清胃泌素正常，2例略有升高。结论这些病例支持奥美拉唑与非幽门螺杆菌胃炎患者基底腺息肉的发生可能存在因果关系。
OBJECTIVE Side effects of omeprazole therapy include reversible hypergastrinemia, entero chromaffin-like hyperplasia, and possibly acceleration of atrophic gastritis in the gastric corpus in patients with Helicobacter pylori infection. The objective of this report is to describe six cases of fundic gland polyps that developed while omeprazole was being used for Barrett's esophagus. METHODS Three women and three men developed fundic gland polyps after 1-5 yr of omeprazole therapy, 20 mg/day. In the index case, fundal polyps developed after 2 yr of continuous omeprazole therapy. Omeprazole was stopped, but because of poor clinical efficacy with H2-blockers, it was reinstated. RESULTS After 4 yr of therapy, multiple large fundal polyps were present. Histology of all lesions revealed characteristic fundal gland polyps with multiple cystic dilations. None of the patients had H. pylori infection. Serum gastrin was normal in four and slightly increased in two. CONCLUSION These cases support the possible causal relation between the use of omeprazole and the development of fundic gland polyps in patients without H. pylori gastritis.