长期使用质子泵抑制剂所致高胃泌素血症及其对策

Sequelae of hypergastrinemia due to long-term administration of proton pump inhibitors and its management

质子泵抑制剂的应用是酸相关疾病的标准治疗。但是,长期使用对胃食管反流征患者可能存在潜在危害,例如低酸反馈所致的高胃泌素血症,肠嗜银细胞的增殖,潜在的胃部肿瘤诱发作用,停药后的酸反跳,幽门螺杆菌感染者胃泌酸区胃炎发生率增加,高胃泌素血症所致的其它肿瘤等。人们正在研究这些潜在危害,评价长期使用质子泵抑制剂的风险-效益比,并提出对应策略。

Proton pump inhibitor （PPI） is considered as the standard treatment for acid-related disorders. However, its long-term use, especially in patients with gastroesophageal reflux disease, would cause potential risks, such as hypergastrinemia along with reduced gastric acidity, hyperplasia of enterochromaffin cells （ECL）, gastric neoplasms, rebound gastric acid hypersecretion when PPI treatment is stopped, increased oxyntic gastritis in patients with H. pylori infection, and the possible stimulation of growth of non-gastric tumours due to hypergastrinaemia. Each of these trends has led to numerous studies and evaluations on the potential risk-benefit ratio of the long-term use of PPIs, and countermeasures are being proposed for these problems.