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【medical-news】类固醇激素可减轻嗜酸粒细胞性食

Steroids Ease Symptoms of Eosinophilic Esophagitis, but Relapse Common

NEW YORK (Reuters Health) Mar 12 - Eosinophilic esophagitis in pediatric patients responds well to either oral prednisone or swallowed fluticasone, although fluticasone is better tolerated, according to investigators at Indiana University School of Medicine in Indianapolis. However, symptoms return within weeks of stopping treatment in about half of patients.

Eosinophilic esophagitis is characterized by esophageal mucosal biopsy specimens showing at least 15 eosinophils per high-power field and negative findings on esophageal pH probe studies.

Dr. Sandeep K. Gupta and colleagues conducted a prospective trial in which 80 patients between 1 and 16 years of age were randomly assigned to treatment with oral prednisone (1mg/kg twice a day to a maximum total daily dose of 60 mg) or to swallowed fluticasone by metered-dose inhaler (110-220 g per puff, 2 puffs 4 times a day). After 4 weeks, patients were weaned off the medications over the ensuring 8 weeks.

Presenting symptoms included vomiting/regurgitation in about 60%, abdominal pain in 30%, and feeding problems or dysphagia in 19%.

Symptoms had resolved by 4 weeks in all of the patients except one in the fluticasone group, the authors report in the February issue of Clinical Gastroenterology and Hepatology.

Sixteen patients (40%) in the prednisone arm experienced systemic adverse effects, including hyperphagia, weight gain, and cushingoid features, leading three to discontinue treatment. Six patients taking fluticasone experienced esophageal candidal overgrowth without mucosal inflammation.

Despite the good initial response, Dr. Gupta's team reports, "Our results show a strikingly high relapse rate (45% by week 24), suggesting a strong need for the development of maintenance treatment protocols."

Clin Gastroenterol Hepatol 2008;6:165-173.

http://www.medscape.com/viewarticle/571341 试一下

Steroids Ease Symptoms of Eosinophilic Esophagitis, but Relapse Common
类固醇激素可减轻嗜酸粒细胞行食管炎,但复发率较高

NEW YORK (Reuters Health) Mar 12 - Eosinophilic esophagitis in pediatric patients responds well to either oral prednisone or swallowed fluticasone, although fluticasone is better tolerated, according to investigators at Indiana University School of Medicine in Indianapolis. However, symptoms return within weeks of stopping treatment in about half of patients.
纽约(路透社健康)三月十二日---据位于印第安纳波利斯的印第安纳大学医学院的研究者发现,患嗜酸粒细胞性食管炎的儿科病人对口服泼尼松或吞入型氟地松疗效不错,尽管后者的耐受性更好;然而,大约二分之一的患儿在停药后数周内症状复发。

Eosinophilic esophagitis is characterized by esophageal mucosal biopsy specimens showing at least 15 eosinophils per high-power field and negative findings on esophageal pH probe studies.
嗜酸粒细胞性食管炎以食管粘膜活检组织在每高倍视野下至少15个嗜酸性粒细胞为特征,食管PH探针检测无阳性发现。

Dr. Sandeep K. Gupta and colleagues conducted a prospective trial in which 80 patients between 1 and 16 years of age were randomly assigned to treatment with oral prednisone (1mg/kg twice a day to a maximum total daily dose of 60 mg) or to swallowed fluticasone by metered-dose inhaler (110-220 g per puff, 2 puffs 4 times a day). After 4 weeks, patients were weaned off the medications over the ensuring 8 weeks.
Sandeep K. G博士和同事们进行了一项前瞻性研究,在此研究中,将80名1到16岁的患者随机分为口服泼尼松治疗组(1mg/kg,一天两次,每天最大剂量为60mg)和吞咽型氟地松治疗组(采用定量吸入器,110-220/掀,每次2掀,一天4次)。

Presenting symptoms included vomiting/regurgitation in about 60%, abdominal pain in 30%, and feeding problems or dysphagia in 19%.
主要症状包括:大约60%的患儿出现呕吐/反流,30%出现腹痛,19%有喂养或吞咽困难。

Symptoms had resolved by 4 weeks in all of the patients except one in the fluticasone group, the authors report in the February issue of Clinical Gastroenterology and Hepatology.
除氟地松治疗组的一名患儿外,其他患儿的症状均在4周内消失。作者将此结果报道在二月份的《临床肠胃病学与肝脏病学》上。

Sixteen patients (40%) in the prednisone arm experienced systemic adverse effects, including hyperphagia, weight gain, and cushingoid features, leading three to discontinue treatment. Six patients taking fluticasone experienced esophageal candidal overgrowth without mucosal inflammation.
泼尼松组中有16名患儿(40%)出现了全身性不良反应,包括:食量增加、体重增加、库欣样特征,引起3名中断治疗。氟地松组中有6名发生食管念珠菌过度生长,不伴有粘膜炎症。

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作者:admin@医学,生命科学    2011-02-20 05:14
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