治疗胃溃疡病患者的胃念珠菌病：是否需要使用抗真菌药物？
Treatment of gastric candidiasis in patients with gastric ulcer disease: are antifungal agents necessary?
机构信息
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
出版信息
Gut Liver. 2009 Mar;3(1):31-4. doi: 10.5009/gnl.2009.3.1.31. Epub 2009 Mar 31.
BACKGROUND/AIMS: The inadequacy of information on the treatment of gastric candidiasis with antifungal agents promoted us to evaluate patients with fungal infections who had gastric ulcers and assess the need for proton-pump inhibitors or antifungal agents.
METHODS
Sixteen patients were included in the study. The criterion for the diagnosis of candidiasis was finding yeast and hyphae in the tissue or an ulcer on histological sections of biopsy samples. Surface fungi were not considered infections.
RESULTS
In all cases with benign ulcers, follow-up endoscopy performed 6 weeks after proton-pump-inhibitor treatment revealed that the ulcer had improved without antifungal medication. However, in patients with malignant ulcers, surgical resection was necessary for a definitive cure. Two patients with lymphoma received combined chemotherapy and a proton-pump inhibitor, which improved their condition.
CONCLUSIONS
The results of this study suggest that benign ulcers with candidiasis can be effectively treated by a proton-pump inhibitor without antifungal medication. However, surgical resection should be considered for malignant ulcers with candidiasis.
背景/目的：抗真菌药物治疗胃念珠菌病的信息不足，促使我们评估患有胃溃疡和真菌感染的患者，并评估是否需要质子泵抑制剂或抗真菌药物。
方法
本研究纳入了 16 名患者。念珠菌病的诊断标准是在组织中发现酵母和菌丝，或活检样本的组织学切片上有溃疡。表面真菌不被认为是感染。
结果
在所有良性溃疡患者中，质子泵抑制剂治疗 6 周后进行的随访内镜检查显示，溃疡在没有抗真菌药物的情况下有所改善。然而，对于恶性溃疡患者，需要手术切除以获得根治。两名患有淋巴瘤的患者接受了联合化疗和质子泵抑制剂治疗，病情得到改善。
结论
本研究结果表明，质子泵抑制剂可有效治疗伴有念珠菌的良性溃疡，而无需抗真菌药物。然而，对于伴有念珠菌的恶性溃疡，应考虑手术切除。
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