PDF(Pubmed)
Abstract：
This systematic review was conducted with the objective of understanding the efficacy and safety of proton pump inhibitors (PPIs) in the pediatric population. We used PubMed to identify randomized controlled trials (RCTs) published between 1 June 2010 and 30 June 2023, performed in patients from birth to 18 years old with gastroesophageal reflux disease (GERD) who received treatment with any PPI. This literature search yielded 76 articles and 13 of these met the inclusion criteria. For infants, PPIs were equal to placebos in reducing GERD symptoms in four articles. In one article, the numbers of GER episodes and esophageal acid exposures were lower in infants who received PPIs in the left lateral position, but there was generally no significant improvement in symptoms. In another publication, the combination of PPIs and feeding modifications (FMs) was not more effective than PPIs alone. For children and adolescents, PPIs were effective in improving symptoms and achieving endoscopic healing, which was subsequently maintained. To conclude, PPIs are not effective in reducing the symptoms related to GERD in infants but are effective in older children, where histological remission can be seen. Generally, PPIs are well tolerated, but it is important to remember the possible adverse events (AEs), especially if PPIs are used for an extended period.
摘要：
本系统评价旨在了解质子泵抑制剂（PPI）在儿科人群中的疗效和安全性。我们使用PubMed来确定2010年6月1日至2023年6月30日之间发表的随机对照试验（RCT），这些试验在出生至18岁的胃食管反流病（GERD）患者中进行，这些患者接受了任何PPI治疗。这次文献检索产生了76篇文章，其中13篇符合纳入标准。对于婴儿，在四篇文章中，PPI在减轻GERD症状方面等同于安慰剂。在一篇文章中，在左侧卧位接受PPI的婴儿中，GER发作次数和食管酸暴露次数较低，但症状一般没有明显改善。在另一份出版物中，PPI和喂养修饰(FMs)联合使用并不比单独使用PPI更有效.对于儿童和青少年，PPI在改善症状和实现内窥镜愈合方面有效，随后被维持。最后，PPI不能有效减轻婴儿GERD相关症状，但对年龄较大的儿童有效。可以看到组织学缓解。一般来说,PPI耐受性良好，但重要的是要记住可能的不良事件（AE），特别是如果PPI的使用期限延长。
