Pashankar Dinesh S, Israel David M
Division of Gastroenterology, British Columbia Children's Hospital, Vancouver, Canada.
J Pediatr Gastroenterol Nutr. 2002 Nov;35(5):658-62. doi: 10.1097/00005176-200211000-00013.
Multiple gastric polyps have been reported to occur in adults receiving omeprazole therapy. There are little published data in children. We report our experience in monitoring the gross and histologic appearance of the stomach in children receiving long-term omeprazole therapy.
This was a retrospective review of the charts of children who received omeprazole for more than 6 months for reflux esophagitis between 1989 and 1998. All patients had repeated endoscopic examinations until healing of the esophagitis was confirmed and then annually thereafter. At endoscopy, gastric mucosal swellings were classified as polyps or nodules based on histology.
Thirty-one children had long-term endoscopic follow-up while receiving omeprazole. Seven of 31 children had gastric polyps and/or nodules, noted between 10 and 48 months (mean = 28 months) of omeprazole therapy. Four had nodules only, one had a sessile hyperplastic polyp, and two had both a polyp (one hyperplastic and one fundic gland polyp) and nodules. All lesions were found in the gastric body. Nodules in four of the six children disappeared spontaneously while the children continued to receive omeprazole. The polyps persisted. There were no dysplastic changes in the gastric mucosa or polyps in any of the patients. There were no significant differences between the 7 children with and the 24 without polyps/nodules with respect to age, gastrin concentrations, or dose and duration of omeprazole therapy.
Gastric polyps and nodules may be found in children receiving long-term omeprazole therapy. The gastric changes in our patients were benign during the mean observation period of 31 months.
据报道，接受奥美拉唑治疗的成年人会出现多发性胃息肉。关于儿童的相关公开数据很少。我们报告了我们在监测接受长期奥美拉唑治疗的儿童胃部大体和组织学表现方面的经验。
这是一项对1989年至1998年间因反流性食管炎接受奥美拉唑治疗超过6个月的儿童病历的回顾性研究。所有患者均反复进行内镜检查，直至食管炎愈合得到确认，此后每年检查一次。在内镜检查时，根据组织学将胃黏膜肿胀分为息肉或结节。
31名儿童在接受奥美拉唑治疗期间接受了长期内镜随访。31名儿童中有7名在奥美拉唑治疗10至48个月（平均28个月）期间出现胃息肉和/或结节。4名仅有结节，1名有无蒂增生性息肉，2名既有息肉（1名增生性息肉和1名胃底腺息肉）又有结节。所有病变均位于胃体部。6名儿童中有4名的结节在继续接受奥美拉唑治疗时自发消失。息肉持续存在。所有患者的胃黏膜或息肉均无发育异常改变。有息肉/结节的7名儿童与无息肉/结节的24名儿童在年龄、胃泌素浓度、奥美拉唑治疗剂量和疗程方面无显著差异。
接受长期奥美拉唑治疗的儿童可能会出现胃息肉和结节。在平均31个月的观察期内，我们患者的胃部改变是良性的。
