质子泵抑制剂治疗对通过粪便钙卫蛋白评估的儿科患者肠道炎症的影响。
Influence of proton pump inhibitor therapy on intestinal inflammation assessed by fecal calprotectin in pediatric patients.
作者信息
Kim Su Yeong, Lee Na Mi, Yun Sin Weon, Chae Soo Ahn, Lim In Seok, Choi Eung Sang, Yi Dae Yong
机构信息
Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.
College of Medicine, Chung-Ang University, Seoul, Korea.
出版信息
Korean J Pediatr. 2019 Oct;62(10):400-404. doi: 10.3345/kjp.2019.00115. Epub 2019 Jul 3.
BACKGROUND
An increase in the numbers of patients with gastrointestinal symptoms has recently been observed.
PURPOSE
To investigate the effects of proton pump inhibitor (PPI) therapy on intestinal inflammation in children and adolescents as confirmed by clinical manifestations and objectively assessed by fecal calprotectin (FC) level measurement.
METHODS
Consecutive children (aged 3-18 years) who presented with gastrointestinal symptoms and were treated with or without PPI for at least 1 month were enrolled. Patients were divided into PPI and non-PPI groups. The PPI group was further subdivided by treatment duration and type of PPI used. Stool samples were collected for FC evaluation at baseline and after treatment and clinical data and FC levels were compared between the groups.
RESULTS
Fifty-one patients (15 boys, 36 girls) were enrolled in the study. The PPI group included 37 patients, while the non-PPI group included 14 patients. Clinical symptoms were not significantly different. FC levels and laboratory results, including C-reactive protein levels, white blood cell count, and absolute neutrophil count, were not statistically different before versus after PPI treatment. After treatment, FC levels decreased to 8.1 mg/kg (-575.4 to 340.3 mg/kg) in the PPI group and increased to 5.6 mg/kg (-460.0 to 186.9 mg/kg) in the non-PPI group compared to those before treatment (P=0.841). The number of patients with increased FC levels was not significantly different between the 2 groups (48.6% vs. 64.3%, P=0.363), similar to that observed in patients with an FC level > 50 mg/kg (24.3% and 7.1%, P=0.250). PPI therapy type and duration did not affect the FC levels (P=0.811 and P=0.502, respectively).
CONCLUSION
Although we aimed to confirm the evidence of intestinal inflammation due to PPI use in children and adolescents through clinical symptoms and FC measurement, no significant changes were observed.
背景
最近观察到胃肠道症状患者数量有所增加。
目的
通过临床表现确认并通过粪便钙卫蛋白（FC）水平测量客观评估质子泵抑制剂（PPI）治疗对儿童和青少年肠道炎症的影响。
方法
纳入连续出现胃肠道症状且接受或未接受PPI治疗至少1个月的3至18岁儿童。患者分为PPI组和非PPI组。PPI组根据治疗持续时间和使用的PPI类型进一步细分。在基线和治疗后收集粪便样本进行FC评估，并比较两组的临床数据和FC水平。
结果
51例患者（15名男孩，36名女孩）纳入研究。PPI组包括37例患者，非PPI组包括14例患者。临床症状无显著差异。PPI治疗前后FC水平以及包括C反应蛋白水平、白细胞计数和绝对中性粒细胞计数在内的实验室结果无统计学差异。治疗后，PPI组的FC水平降至8.1mg/kg（-575.4至340.3mg/kg），非PPI组升至5.6mg/kg（-460.0至186.9mg/kg），与治疗前相比（P = 0.841）。两组中FC水平升高的患者数量无显著差异（48.6%对64.3%，P = 0.363），FC水平>50mg/kg的患者中观察到的情况类似（24.3%和7.1%，P = 0.250）。PPI治疗类型和持续时间对FC水平无影响（分别为P = 0.811和P = 0.502）。
结论
尽管我们旨在通过临床症状和FC测量来确认儿童和青少年使用PPI导致肠道炎症的证据，但未观察到显著变化。
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