在食道缩中使用质子抑制剂:系统性审查和元分析
Georges Dimitrov1, Madeleine Aumar2, Alain Duhamel3
1Unit of Pediatric Surgery, Unit of Pediatrics, Competence Centre for Rare Esophageal Diseases, University Hospital Center of Orléans, Orléans, France.
Journal of pediatric gastroenterology and nutrition
|January 23, 2024
概括
预防性质子抑制剂 (PPI) 在儿科食道缩症 (EA) 患者中并不能预防GERD的持续性或降低抗逆流性手术的发生率. PPI可能有助于性和性食道炎,但不能帮助其他EA并发症.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 胃肠道手术 胃肠道手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 胃食道逆流性疾病 (GERD) 在患有食道缩 (EA) 的儿科患者中很常见.
- 质子抑制剂 (PPI) 经常被使用,但它们在EA并发症中的预防作用和有效性仍在争论中.
- 本研究评估了PPI在治疗EA患者的GERD和相关并发症方面的预防性使用和有效性.
研究的目的:
- 评估在被诊断患有EA的儿科患者中PPI的预防性使用.
- 在EA的背景下,评估PPI在管理GERD及其并发症方面的有效性.
- 为了确定PPI是否会影响EA患者抗逆流体手术的发生率.
主要方法:
- 1980年至2022年间发表的研究的系统审查.
- 用随机效应模型比较PPI和没有PPI组的元分析.
- 使用I2指数进行元回归和异质性估计.
主要成果:
- 分析了涉及6044名EA患者的38份报告.
- 在生命的第一年,预防性PPI并没有预防GERD的持续性或减少抗逆流性手术的发生率.
- PPI显示,性食道炎的缓解率为50%,胃食道炎的改善,对其他GERD结局的影响不确定.
- 抗胰岛素抑制剂并没有防止解管狭窄,巴雷特食道或呼吸道并发症.
结论:
- 在EA患者中,PPI对特定的食道炎症状况 (性和eosinophilic食道炎) 有好处.
- 个人防护剂的预防性使用似乎不能防止GERD的持续性或减少ARP的需要.
- 对其他EA相关并发症而言,PPI是无效的,它们在这个人群中的副作用在很大程度上是未知的.
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