Influence of proton pump inhibitor therapy on intestinal inflammation assessed by fecal calprotectin in pediatric patients

Korean Journal of Pediatrics Pub Date : 2019-07-03 DOI:10.3345/kjp.2019.00115

Su Yeong Kim, Na Mi Lee, S. Yun, S. Chae, I. Lim, E. Choi, D. Yi

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引用次数: 6

Abstract

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.

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粪便钙卫蛋白评价质子泵抑制剂治疗对儿童肠道炎症的影响

背景近年来，出现胃肠道症状的患者数量有所增加。目的探讨质子泵抑制剂(PPI)治疗儿童和青少年肠道炎症的临床表现，并通过粪便钙保护蛋白(FC)水平测定客观评价其疗效。方法连续入组3-18岁出现胃肠道症状且使用或不使用PPI治疗至少1个月的儿童。患者分为PPI组和非PPI组。PPI组按治疗时间和使用的PPI类型进一步细分。收集粪便样本用于基线和治疗后的FC评估，并比较两组之间的临床数据和FC水平。结果51例患者(男孩15例，女孩36例)纳入研究。PPI组37例，非PPI组14例。临床症状无显著差异。FC水平和实验室结果，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PPI治疗前后没有统计学差异。治疗后，与治疗前相比，PPI组FC水平下降至8.1 mg/kg (-575.4 ~ 340.3 mg/kg)，非PPI组FC水平上升至5.6 mg/kg (-460.0 ~ 186.9 mg/kg) (P=0.841)。两组间FC水平升高的患者数量无显著差异(48.6%比64.3%，P=0.363)，与FC水平为bbb50 mg/kg的患者数量相似(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(P=0.811和P=0.502)。结论:虽然我们的目的是通过临床症状和FC测量来证实儿童和青少年使用PPI引起肠道炎症的证据，但没有观察到明显的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Korean Journal of Pediatrics

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.