rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2003-764rsp-901Research ArticleСтатьиArticlesЛанзап в лечении склеродермического эзофагитаLansap in treatment of esophagitis in patients with systemic sclerosisАлекперовР. Т.AlekperovR T-КаратеевАндрей ЕвгеньевичKarateevA E-ГусеваН. Г.GusevaN G-200315042003412№2 (2003)2527Copyright © Алекперов Р.Т., Каратеев А.Е., Гусева Н.Г., 20032003Алекперов Р.Т., Каратеев А.Е., Гусева Н.Г.Alekperov R.T., Karateev A.E., Guseva N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/901

Цель. Изучить клиническую эффективность препарата ланзап при эзофагите у больных системной склеродермией (ССД). Материалы и методы. 30 больных ССД с клиническими и эндоскопическими признаками эзофагита в течение двух недель принимали ланзап (производство «Dr. Reddy's Laboratoris Ltd.») в суточной дозе 30 мг (15 чел) или 60 мг (15 чел). Бальными ежедневно оценивалась и отмечалась в дневнике выраженность симптомов эзофагита по 10-балльной системе. До начала и в конце исследования проводилась эзофагогастроскопия. Результаты. Клинические симптомы эзофагита до лечения наблюдались у всех больных, в том числе: изжога у 25, боли за грудиной во время и после еды у 18 больных. При эндоскопии во всех случаях были выявлены признаки эзофагита, в том числе эрозивного - у 18 из них. В первый же день приема препарата все пациенты отмечали значительное снижение интенсивности изжоги, которая полностью прошла у 16 на 3-4 и у остальных 9 - на 10-11 дни лечения. К концу лечения на боли за грудиной жаловались только 5. на затрудненное глотание твердой пищи лишь 7 больных из 18. При повторном эндоскопическом исследовании наблюдалось уменьшение выраженности эзофагита во всех случаях. Эрозии эпителизировались у 16 из 18 больных. В двух случаях с множественными эрозиями пищевода наблюдалось уменьшение их количества. Заключение. Ланзап является высокоэффективным средством лечения эзофагита у больных ССД.

Objective. To study the efficacy of Lansap (Lansoprasole) in treatment of esophagitis in pts with systemic sclerosis (SS). Methods. 30 SS pts with clinical manifestations and endoscopic signs of esophagitis received lansap 30 or 60 mg/day during two weeks. All pts had a standard endoscopic examination before and after the treatment. Results. Clinical symptoms of esophagitis were reduced significantly in most pts during the first day of treatment and resolved completely to the eleventh day. Endoscopic examination after two weeks revealed decrease of esophagitis severity in all pts. Esophagial erosions were healed in 16 from 18 pts. Conclusion. Lansap is an effective drug for treatment of reflux esophagitis in pts with SS.

системная склеродермияэзофагитланзапsystemic sclerosisesophagitislansapReferences<div><p>Akesson A., Blom-Bulow В., Scheja A. et al. Long-term evfluation of penicillamine or cyclofenil in systemic sclerosis: results from a two-year randomized study. Scand. J. Rheumatol., 1992, 21. 238-244.</p><p>Basilisco G., Carola F., Vanoli M. et al. Oesophageal acidlearance in patients with systemic sclerosis: effect of body position. Eur. J. Gastroenterol. Hepatol., 1996, 8(3),205- 209.</p><p>Bassotti G., Battaglia E., Debemardi V. et al. Esophageal dysfunction in scleroderma: relationship with disease subsets. Arthr. Rheum., 1997, 40(12), 2252-2259.</p><p>Bestetti A., Carola F„ Conciato L. et al. Esophageal scintigraphy with a semisolid meal to evaluate esophageal dysmotilitv in systemic sclerosis and Ravnaud's phenomenon. J. Nucl. Med., 1999, 40(1), 77-84.'</p><p>Cameron A.J., Malcolm A., Prather C.M., Phillips S.F.Videoendoscopic diagnosis of esophageal motility disor-, ders. Gastrointest. Endosc., 1999, 49(1), 62-69.</p><p>Carro J.J., Salas М., Ward A. Healing and relapse rates in gastroesophageal reflux disease treated with the newer pro- ton-pump inhibitors lansoprazole, rabeprazole, and panto- prazole compared with omeprazole, ranitidine, and placebo: evidence from randomized clinical trials. Clin. Ther., 2001, 23(7), 998-1017.</p><p>Dessein P.H., Joffe B.I., Metz R.M. et al. Autonomic dysfunction in systemic sclerosis: sympathetic overactivity and instability. Am. J. Med., 1992. 93, 143-150.</p><p>Doan T.T., Wang Q., Griffin J.S, et al. Comparative pharmacokinetics and pharmacodynamics of lartsoprasole oral capsules and suspension in healthy subjects. Am. J. Health Syst. Pharm., 2001. 58(16). 1512-1519.</p><p>Dupas J.L., Houcke P., Samoyeau R. Pantoprazole versus lansoprazole in Franch patients with reflux esophagitis. Gastroenterol. Clin. Biol. 2001, 25(3), 245-250.</p><p>Farup P.G., Juul-Hansen P.H., Rydning A. Does short-term treatment with proton pump inhibitors cause rebound aggravation of symptoms? J. Clin. Gastroenterol., 2001, 33(3), 206-209.</p><p>Hendel L. Hydroxyproline in the oesophageal mucosa of patients with progressive systemic sclerosis during omeprazole-induced healing of reflux oesophagitis. Aliment. Pharmacol- Ther., 1991, 5. 471-480.</p><p>Hendel L„ Hage E„ Hendel J., Stentoft P. Omeprazole in the long-term treatment of severe gastroesophageal reflux disease in patients with systemic sclerosis. Aliment. Pharmacol. Ther., 1992, 6, 565-577.</p><p>Hendel L., Stentoft P., Aggestrup S. The progress of oesophageal involvement in progressive systemic sclerosis during D-penicillamine treatment. Scand. J. Rheumatol., 1989, 18. 149-155.</p><p>LeRoy E.C., Black C.M., Fleischmajer R. et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J. Rheumatol., 1988, 15, 202-205.</p><p>Ipsen P., Egekvist H., Aksglaede K. et al. Oesophageal manometry and video-radiology in patients with systemic sclerosis: a retrospective study of its clinical value. Acta. Derm. Venereol., 2000. 80(2), 130-133.</p><p>Ling T.C., Johnston B.T. Esophageal investigations in connective tissue disease: which tests are most appropriate? J. Clin. Gastroenterol., 2001, 32(1), 33-36.</p><p>Lock G., Zeuner М., Straub R.H. et al. Esophageal manometry in systemic sclerosis: screening procedure or confined to symptomatic patients? Rheumatol. Int. 1997, 17(2), 61-66.</p><p>Marie 1., Dominique S. Levesque H. et al. Esophageal involvement and pulmonary manifestations in systemic sclerosis. Arthr. Rheum., 2001, 45(4), 346-354.</p><p>Russel M.L., Friesen D., Henderson R.D., Hanna W.M. Ultrastructure of the esophagus in scleroderma. Arthr. Rheum., 1982, 25, 1117-1123.</p><p>Silver R.M. Clinical aspects of systemic sclerosis (scleroderma). Ann. Rheum. Dis., 1991, 50 (suppl 4), 854-861.</p><p>Sjogren R.W. Gastrointestinal motility disorders in scleroderma. Arthr. Rheum. 1994, 37(12), 1265-1282.</p><p>Stacher G., Merio R., Budka C. et al. Cardiovascular autonomic function, autoantibodies, and esophageal motor activity in patients with systemic sclerosis and mixed connective tissue disease. J. Rheumatol., 2000. 27(3), 692-697.</p><p>Villadsen G. E., Storkholm J., Zachariae H. et al. Oesophageal pressure-cross-sectional area distributions and secondary peristalsis in relation to subclassification of systemic sclerosis. Neurogastroenterol. Motil., 2001, 13(3), 199-210.</p><p>Weber P., Ganser G., Frosch M. et al. Twenty-four hour intraesophageal pH monitoring in children and adolescents with scleroderma and mixed connective tissue disease. J. Rheumatol. 2000, 27(11), 2692-2695.</p><p>Weston S., Thumshim М., Wiste J., Camilleri M. Clinical and upper gastrointestinal motility features in systemic sclerosis and related disorders. Am. J. Gastroenterol., 1998, 93(7), 1085-1089.</p></div><br /><div><p>Akesson A., Blom-Bulow В., Scheja A. et al. Long-term evfluation of penicillamine or cyclofenil in systemic sclerosis: results from a two-year randomized study. Scand. J. Rheumatol., 1992, 21. 238-244.</p><p>Basilisco G., Carola F., Vanoli M. et al. Oesophageal acidlearance in patients with systemic sclerosis: effect of body position. Eur. J. Gastroenterol. Hepatol., 1996, 8(3),205- 209.</p><p>Bassotti G., Battaglia E., Debemardi V. et al. Esophageal dysfunction in scleroderma: relationship with disease subsets. Arthr. Rheum., 1997, 40(12), 2252-2259.</p><p>Bestetti A., Carola F„ Conciato L. et al. Esophageal scintigraphy with a semisolid meal to evaluate esophageal dysmotilitv in systemic sclerosis and Ravnaud's phenomenon. J. Nucl. Med., 1999, 40(1), 77-84.'</p><p>Cameron A.J., Malcolm A., Prather C.M., Phillips S.F.Videoendoscopic diagnosis of esophageal motility disor-, ders. Gastrointest. Endosc., 1999, 49(1), 62-69.</p><p>Carro J.J., Salas М., Ward A. Healing and relapse rates in gastroesophageal reflux disease treated with the newer pro- ton-pump inhibitors lansoprazole, rabeprazole, and panto- prazole compared with omeprazole, ranitidine, and placebo: evidence from randomized clinical trials. Clin. Ther., 2001, 23(7), 998-1017.</p><p>Dessein P.H., Joffe B.I., Metz R.M. et al. Autonomic dysfunction in systemic sclerosis: sympathetic overactivity and instability. Am. J. Med., 1992. 93, 143-150.</p><p>Doan T.T., Wang Q., Griffin J.S, et al. Comparative pharmacokinetics and pharmacodynamics of lartsoprasole oral capsules and suspension in healthy subjects. Am. J. Health Syst. Pharm., 2001. 58(16). 1512-1519.</p><p>Dupas J.L., Houcke P., Samoyeau R. Pantoprazole versus lansoprazole in Franch patients with reflux esophagitis. Gastroenterol. Clin. Biol. 2001, 25(3), 245-250.</p><p>Farup P.G., Juul-Hansen P.H., Rydning A. Does short-term treatment with proton pump inhibitors cause rebound aggravation of symptoms? J. Clin. Gastroenterol., 2001, 33(3), 206-209.</p><p>Hendel L. Hydroxyproline in the oesophageal mucosa of patients with progressive systemic sclerosis during omeprazole-induced healing of reflux oesophagitis. Aliment. Pharmacol- Ther., 1991, 5. 471-480.</p><p>Hendel L„ Hage E„ Hendel J., Stentoft P. Omeprazole in the long-term treatment of severe gastroesophageal reflux disease in patients with systemic sclerosis. Aliment. Pharmacol. Ther., 1992, 6, 565-577.</p><p>Hendel L., Stentoft P., Aggestrup S. The progress of oesophageal involvement in progressive systemic sclerosis during D-penicillamine treatment. Scand. J. Rheumatol., 1989, 18. 149-155.</p><p>LeRoy E.C., Black C.M., Fleischmajer R. et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J. Rheumatol., 1988, 15, 202-205.</p><p>Ipsen P., Egekvist H., Aksglaede K. et al. Oesophageal manometry and video-radiology in patients with systemic sclerosis: a retrospective study of its clinical value. Acta. Derm. Venereol., 2000. 80(2), 130-133.</p><p>Ling T.C., Johnston B.T. Esophageal investigations in connective tissue disease: which tests are most appropriate? J. Clin. Gastroenterol., 2001, 32(1), 33-36.</p><p>Lock G., Zeuner М., Straub R.H. et al. Esophageal manometry in systemic sclerosis: screening procedure or confined to symptomatic patients? Rheumatol. Int. 1997, 17(2), 61-66.</p><p>Marie 1., Dominique S. Levesque H. et al. Esophageal involvement and pulmonary manifestations in systemic sclerosis. Arthr. Rheum., 2001, 45(4), 346-354.</p><p>Russel M.L., Friesen D., Henderson R.D., Hanna W.M. Ultrastructure of the esophagus in scleroderma. Arthr. Rheum., 1982, 25, 1117-1123.</p><p>Silver R.M. Clinical aspects of systemic sclerosis (scleroderma). Ann. Rheum. Dis., 1991, 50 (suppl 4), 854-861.</p><p>Sjogren R.W. Gastrointestinal motility disorders in scleroderma. Arthr. Rheum. 1994, 37(12), 1265-1282.</p><p>Stacher G., Merio R., Budka C. et al. Cardiovascular autonomic function, autoantibodies, and esophageal motor activity in patients with systemic sclerosis and mixed connective tissue disease. J. Rheumatol., 2000. 27(3), 692-697.</p><p>Villadsen G. E., Storkholm J., Zachariae H. et al. Oesophageal pressure-cross-sectional area distributions and secondary peristalsis in relation to subclassification of systemic sclerosis. Neurogastroenterol. Motil., 2001, 13(3), 199-210.</p><p>Weber P., Ganser G., Frosch M. et al. Twenty-four hour intraesophageal pH monitoring in children and adolescents with scleroderma and mixed connective tissue disease. J. Rheumatol. 2000, 27(11), 2692-2695.</p><p>Weston S., Thumshim М., Wiste J., Camilleri M. Clinical and upper gastrointestinal motility features in systemic sclerosis and related disorders. Am. J. Gastroenterol., 1998, 93(7), 1085-1089.</p></div><br />

The authors declare that there are no conflicts of interest present.