Wayne State University, Detroit, MI, USA.
BMC Pediatr. 2010 Jun 11;10:41. doi: 10.1186/1471-2431-10-41.
Acid suppression with a proton pump inhibitor is standard treatment for gastroesophageal reflux disease and erosive esophagitis in adults and increasingly is becoming first-line therapy for children aged 1-17 years. We evaluated endoscopic healing of erosive esophagitis with esomeprazole in young children with gastroesophageal reflux disease and described esophageal histology.
Children aged 1-11 years with endoscopically or histologically confirmed gastroesophageal reflux disease were randomized to esomeprazole 5 or 10 mg daily (< 20 kg) or 10 or 20 mg daily (> or = 20 kg) for 8 weeks. Patients with erosive esophagitis underwent an endoscopy after 8 weeks to assess healing of erosions.
Of 109 patients, 49% had erosive esophagitis and 51% had histologic evidence of reflux esophagitis without erosive esophagitis. Of the 45 patients who had erosive esophagitis and underwent follow-up endoscopy, 89% experienced erosion resolution. Dilation of intercellular space was reported in 24% of patients with histologic examination.
Esomeprazole (0.2-1.0 mg/kg) effectively heals macroscopic and microscopic erosive esophagitis in this pediatric population with gastroesophageal reflux disease. Dilation of intercellular space may be an important histologic marker of erosive esophagitis in children.
D9614C00097; ClinicalTrials.gov identifier NCT00228527.
质子泵抑制剂抑制胃酸分泌是成人胃食管反流病和糜烂性食管炎的标准治疗方法，并且越来越多地成为 1-17 岁儿童的一线治疗方法。我们评估了埃索美拉唑治疗小儿胃食管反流病的糜烂性食管炎的内镜愈合情况，并描述了食管组织学。
1-11 岁内镜或组织学证实为胃食管反流病的儿童随机分为埃索美拉唑 5 或 10 mg/天（<20 kg）或 10 或 20 mg/天（≥20 kg），疗程 8 周。患有糜烂性食管炎的患者在 8 周后进行内镜检查以评估糜烂愈合情况。
109 例患者中，49%有糜烂性食管炎，51%有组织学证据的反流性食管炎而无糜烂性食管炎。45 例有糜烂性食管炎并进行随访内镜检查的患者中，89%的患者的糜烂得到缓解。组织学检查报告 24%的患者存在细胞间隙扩张。
埃索美拉唑（0.2-1.0mg/kg）可有效治愈小儿胃食管反流病患者的宏观和微观糜烂性食管炎。细胞间隙扩张可能是儿童糜烂性食管炎的重要组织学标志物。
D9614C00097；ClinicalTrials.gov 标识符 NCT00228527。
