Gastroenterology Service, Department of Medicine, Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Washington, DC 20307-5001, USA.
Dig Dis Sci. 2009 Dec;54(12):2617-22. doi: 10.1007/s10620-009-0993-z. Epub 2009 Oct 15.
Fundic gland polyps (FGP) have been implicated with long-term proton pump inhibitor (PPI) use.
We attempted to investigate the impact of length and dosage of PPI therapy on the development of FGP.
A retrospective cohort study of all patients who had gastric polyps removed during elective upper endoscopy between March and September 2007 as part of a prior prospective study protocol was carried out. FGP were determined histologically. Prior to endoscopy, all patients completed a questionnaire regarding PPI use and length of therapy (no PPI use, 1-48 months, >48 months). The dosage of PPI was obtained via a thorough chart review of electronic medical records.
Three hundred and eighty-five patients completed upper endoscopy and a questionnaire reporting PPI use (252 [65.4%] patients on PPI). On endoscopy, 55 patients had polyps, with the majority (43/55, 78%) being FGP, resulting in an overall prevalence of 11.1% (43/385). On univariate analysis, FGP were associated with Caucasian race (15 vs. 6%; P=0.009) and chronic PPI therapy (>48 months) (31.9 vs. 7.5%, P<0.001). There was a significant linear-by-linear association between PPI dosage and FGP prevalence (no PPI use, 7.5%; once daily, 10.8%; twice daily 17.4%, P=0.026). On logistic regression, the only independent predictor of FGP was duration of PPI use >48 months (P=0.001, odds ratio [OR] 4.7 [2.0-12.9]).
The only independent predictor of FGP development in our study was duration of PPI therapy greater than 48 months. Increased dosage of therapy did not significantly impact the development of FGP.
胃底腺息肉（FGP）与质子泵抑制剂（PPI）的长期使用有关。
我们试图研究 PPI 治疗的时间和剂量对 FGP 发展的影响。
对 2007 年 3 月至 9 月间进行选择性上消化道内镜检查的所有患者进行了一项回顾性队列研究，这些患者均为之前前瞻性研究方案的一部分。FGP 通过组织学确定。在进行内镜检查之前，所有患者均完成了一份关于 PPI 使用和治疗时间（无 PPI 使用、1-48 个月、>48 个月）的问卷。PPI 的剂量通过电子病历的详细图表审查获得。
385 例患者完成了上消化道内镜检查和报告 PPI 使用情况的问卷（252 例患者服用 PPI）。在内镜检查中，55 例患者有息肉，其中大多数（43/55，78%）为 FGP，总体患病率为 11.1%（43/385）。单因素分析显示，FGP 与白种人种族（15% vs. 6%；P=0.009）和慢性 PPI 治疗（>48 个月）（31.9% vs. 7.5%，P<0.001）相关。PPI 剂量与 FGP 患病率之间存在显著的线性关联（无 PPI 使用、7.5%；每天一次、10.8%；每天两次、17.4%，P=0.026）。在逻辑回归中，FGP 的唯一独立预测因子是 PPI 治疗时间>48 个月（P=0.001，优势比[OR]4.7[2.0-12.9]）。
在我们的研究中，FGP 发展的唯一独立预测因子是 PPI 治疗时间>48 个月。治疗剂量的增加并未显著影响 FGP 的发展。
