PDF(Pubmed)
Abstract：
UNASSIGNED: A key unknown in eosinophilic esophagitis (EoE) is the long-term course of esophageal stenosis. Our aim was to evaluate the course of esophageal strictures using structured serial esophagrams and determine predictors of diameter improvement in patients with EoE.
UNASSIGNED: This was a retrospective study of 78 EoE patients who completed 2 structured esophagrams at an academic tertiary referral center between 2003 and 2021. Maximum and minimum esophageal diameters were measured during esophagram using a standardized protocol to reduce measurement errors.
UNASSIGNED: The median age at first esophagram was 36.2 (12.9-64.3) years; 60.3% of patients were male; 41 patients had active EoE; and 9 were inactive. Of the patients, 39.7% had allergic rhinitis, asthma (32.1%), and atopic dermatitis (7.7%). Medical therapies at second esophagram and esophagogastroduodenoscopy included proton pump inhibitors (39.5%), swallowed topical steroids (31.6%), diet elimination (13.2%), biologic therapies (1.3%), and clinical trial medications (1.3%). Median maximum diameter significantly increased by 1.0 mm (Q1: -1.0 mm, Q3: 3.0 mm) (P = .034), independent of dilation (P = .744). Increase was most profound in patients starting in the lowest maximum diameter group (9-15 mm) with median increase of 3.0 mm. For patients in disease remission at the second esophagram, there was a significant increase in maximum diameter per year compared to active disease at 0.8 mm (Q1: 0.0 mm, Q3: 5.3 mm) and 0.0 mm (Q1: -0.4 mm, Q3: 0.6 mm) respectively (P = .019).
UNASSIGNED: Long-term improvement in esophageal strictures in patients with EoE may occur but is modest and likely occurs over years. Progression also appears to be minimal. Continuous medical treatment may reduce the rate of stricture recurrence and may improve stricture diameter over time.
UNASSIGNED: This was a retrospective study of 78 EoE patients who completed 2 structured esophagrams at an academic tertiary referral center between 2003 and 2021. Maximum and minimum esophageal diameters were measured during esophagram using a standardized protocol to reduce measurement errors.
UNASSIGNED: The median age at first esophagram was 36.2 (12.9-64.3) years; 60.3% of patients were male; 41 patients had active EoE; and 9 were inactive. Of the patients, 39.7% had allergic rhinitis, asthma (32.1%), and atopic dermatitis (7.7%). Medical therapies at second esophagram and esophagogastroduodenoscopy included proton pump inhibitors (39.5%), swallowed topical steroids (31.6%), diet elimination (13.2%), biologic therapies (1.3%), and clinical trial medications (1.3%). Median maximum diameter significantly increased by 1.0 mm (Q1: -1.0 mm, Q3: 3.0 mm) (P = .034), independent of dilation (P = .744). Increase was most profound in patients starting in the lowest maximum diameter group (9-15 mm) with median increase of 3.0 mm. For patients in disease remission at the second esophagram, there was a significant increase in maximum diameter per year compared to active disease at 0.8 mm (Q1: 0.0 mm, Q3: 5.3 mm) and 0.0 mm (Q1: -0.4 mm, Q3: 0.6 mm) respectively (P = .019).
UNASSIGNED: Long-term improvement in esophageal strictures in patients with EoE may occur but is modest and likely occurs over years. Progression also appears to be minimal. Continuous medical treatment may reduce the rate of stricture recurrence and may improve stricture diameter over time.
摘要：
■嗜酸性粒细胞性食管炎（EoE）的一个关键未知因素是食管狭窄的长期病程。我们的目的是使用结构化的连续食管来评估食管狭窄的过程，并确定EoE患者直径改善的预测因素。
■这是一项对78名EoE患者的回顾性研究，这些患者在2003年至2021年之间在学术三级转诊中心完成了2次结构化食道检查。使用标准化方案在食道检查期间测量最大和最小食道直径，以减少测量误差。
■第一次食管的中位年龄为36.2(12.9-64.3)岁；60.3%的患者为男性；41例患者有活动性EoE；9例患者无活动性。在患者中，39.7%有过敏性鼻炎,哮喘（32.1%），和特应性皮炎（7.7％）。第二食道和食管胃十二指肠镜检查的药物治疗包括质子泵抑制剂（39.5%），吞服局部类固醇（31.6％），饮食消除（13.2%），生物疗法（1.3%），和临床试验药物（1.3%）。中值最大直径显着增加了1.0mm（Q1：-1.0mm，Q3:3.0mm)(P=.034),独立于扩张(P=.744)。从最低最大直径组（9-15mm）开始，中位增加3.0mm的患者增加最为明显。对于第二个食道疾病缓解的患者，与0.8mm的活动性疾病相比，每年的最大直径显着增加（Q1：0.0mm，Q3：5.3毫米）和0.0毫米（Q1：-0.4毫米，Q3：0.6毫米）分别（P=.019）。
EoE患者的食管狭窄可能会出现长期改善，但这种改善不大，可能会持续数年。进展似乎也很小。连续的药物治疗可以降低狭窄的复发率，并且可以随着时间的推移改善狭窄的直径。
■这是一项对78名EoE患者的回顾性研究，这些患者在2003年至2021年之间在学术三级转诊中心完成了2次结构化食道检查。使用标准化方案在食道检查期间测量最大和最小食道直径，以减少测量误差。
■第一次食管的中位年龄为36.2(12.9-64.3)岁；60.3%的患者为男性；41例患者有活动性EoE；9例患者无活动性。在患者中，39.7%有过敏性鼻炎,哮喘（32.1%），和特应性皮炎（7.7％）。第二食道和食管胃十二指肠镜检查的药物治疗包括质子泵抑制剂（39.5%），吞服局部类固醇（31.6％），饮食消除（13.2%），生物疗法（1.3%），和临床试验药物（1.3%）。中值最大直径显着增加了1.0mm（Q1：-1.0mm，Q3:3.0mm)(P=.034),独立于扩张(P=.744)。从最低最大直径组（9-15mm）开始，中位增加3.0mm的患者增加最为明显。对于第二个食道疾病缓解的患者，与0.8mm的活动性疾病相比，每年的最大直径显着增加（Q1：0.0mm，Q3：5.3毫米）和0.0毫米（Q1：-0.4毫米，Q3：0.6毫米）分别（P=.019）。
EoE患者的食管狭窄可能会出现长期改善，但这种改善不大，可能会持续数年。进展似乎也很小。连续的药物治疗可以降低狭窄的复发率，并且可以随着时间的推移改善狭窄的直径。
