Dagan O, Peled N, Babin P, Silver M, Barker G, Koren G
Department of Radiology, Hospital for Sick Children, Toronto, Ont., Canada.
Dev Pharmacol Ther. 1993;20(1-2):14-9. doi: 10.1159/000457536.
Antral hyperplasia (AH) induced by prostaglandins (PG) has been described by us recently in 5 infants with cyanotic heart disease receiving the drug. The purpose of the present study was to analyze 14 infants diagnosed as having AH either sonographically or pathologically in an attempt to characterize the dose-response characteristics of this adverse drug reaction, its clinical course and its optimal management. Infants with AH exhibiting large gastric aspirates have received a significantly lower cumulative dose (1,633 +/- 1,266 micrograms/kg) than those presented also with a palpable mass (3,458 +/- 1,703 micrograms/kg), (p < 0.01). While in general there is a dose-related clinical toxicity, variability in the location of the hyperplasia can explain cases of no apparent obstruction despite large cumulative doses of PG. In asymptomatic cases the antral hyperplasia, although visualized, it did not result in gastric outlet obstruction. In all cases followed by us to date, discontinuation of the PG has resulted in resolution of the clinical and sonographic findings. Nasojejunal tube was successfully attempted in several cases, preventing surgery in these very-high-risk infants.
我们最近报道了5例接受该药物治疗的患有紫绀型心脏病的婴儿出现了由前列腺素（PG）诱导的胃窦增生（AH）。本研究的目的是分析14例经超声或病理诊断为AH的婴儿，以试图明确这种药物不良反应的剂量反应特征、临床病程及其最佳治疗方法。出现大量胃吸出物的AH婴儿累积剂量（1,633±1,266微克/千克）显著低于同时伴有可触及肿块的婴儿（3,458±1,703微克/千克），（p<0.01）。虽然一般存在剂量相关的临床毒性，但增生部位的变异性可以解释尽管PG累积剂量很大但无明显梗阻的病例。在无症状病例中，胃窦增生虽然可见，但并未导致胃出口梗阻。在我们迄今随访的所有病例中，停用PG后临床和超声检查结果均已消退。在几例病例中成功尝试了鼻空肠管置入，避免了这些高危婴儿进行手术。
