Siple J F, Joseph C L, Pagel K J, Leigh S
Pharmacy Service, Veterans Affairs Medical Center (119-V), Portland, OR 97207, USA.
Ann Pharmacother. 1997 Nov;31(11):1311-4. doi: 10.1177/106002809703101107.
To describe a patient with gastrointestinal (GI) bleeding caused by arteriovenous malformations (AVMs) that was treated with estrogen therapy.
A 70-year-old white man was diagnosed with multiple AVMs in the cecum, duodenum, and stomach. Pharmacologic management included the use of ferrous sulfate; however, the patient continued to have recurrent bleeding that required multiple transfusions and endoscopic cauterization. Therapy was initiated with ethinyl estradiol 0.05 mg po qd; no further transfusions have been required for 10 months.
It is estimated that AVMs of the GI tract account for 1-8% of upper GI bleeding episodes and up to 6% of lower GI bleeding episodes. Hormonal agents have been reported to decrease bleeding in patients with both hereditary and acquired AVMs.
The role of estrogen therapy in treating AVMs of the GI tract is unclear and supported by only one clinical study.
描述一名因动静脉畸形（AVM）导致胃肠道（GI）出血并接受雌激素治疗的患者。
一名70岁白人男性被诊断出在盲肠、十二指肠和胃中有多处动静脉畸形。药物治疗包括使用硫酸亚铁；然而，患者持续反复出血，需要多次输血和内镜烧灼治疗。开始使用乙炔雌二醇0.05毫克口服，每日一次；10个月来无需进一步输血。
据估计，胃肠道动静脉畸形占上消化道出血事件的1 - 8%，占下消化道出血事件的比例高达6%。据报道，激素药物可减少遗传性和后天性动静脉畸形患者的出血。
雌激素治疗在胃肠道动静脉畸形治疗中的作用尚不清楚，仅有一项临床研究提供支持。
