摘要
目的研究不同方法治疗Barrett食管(BE)患者的疗效,并通过检测治疗前后食管中p53、p16的表达改变,探索各种治疗方法产生效果的可能机制。方法BE患者75例,分为4组,(1)对照组(A组):未给予治疗。(2)抑酸药组(B组):口服奥美拉唑20mg,2/d。(3)胆汁吸附剂组(C组):口服铝碳酸镁1000mg,3/d。(4)抑酸药+胆汁吸附剂组(D组):口服奥美拉唑20mg,2/d;铝碳酸镁1000mg,3/d。治疗前、治疗后1个月及3个月后观察临床症状及内镜下表现,取食管黏膜组织标本行病理学检查,采用SABC免疫组化检测p53、p16的表达情况。结果在缓解临床症状方面,各治疗组的症状均较治疗前明显改善,与对照组相比均有统计学差异(P<0.05);各治疗组相比,症状缓解率无明显差异,无统计学差异(P>0.05)。对照组和药物治疗组的BE黏膜均未见明显缩小。各药物治疗组p16的表达无明显差异(P>0.05)。p53在治疗后与对照组相比,除C组外均有降低,有统计学意义(P<0.05)。D组的食管标本中,p53的表达显著降低。结论抑酸药和/或胆汁吸附剂不能使BE逆转,但可消除临床症状,较难改变BE食管p16的表达。抑酸药和/或胆汁吸附剂可改变BE食管p53的表达。
Objective To investigate the effect of different treatment on Barrett＇ s esophagus （BE） and to explore the mechanism of therapeutic regimen by detecting the changes of the expression of p53, p16 in the Barrett＇ s epithelium before and after treatment, four therapeutic regimen were adopted to treat patients of BE in order to select the most effective one. Methods 75 patients with BE were randomly divided into four groups：group A（ control group） ;group B（ Omeprazole 20 mg,bid po） ;group C（ Hydrotalcite 1 000 mg,tid,po） ;group D（ Omeprazole 20mg,bid, po and hydrotalcite 1 000 rag, tid, po）. All patients were treated for three months. Specimens of esophageal tissue were collected and clinical effect was observed by endoscopy before and 1 month ,3 month after treatment. Expression of p53 ,p16 in BE were investigated by immunohistochemistry and the differences were analyzed among groups. Results The symptoms of patients in treatment groups were significantly less than group A after treating（ P 〈 0. 05 ）. There were no significant differences in relieving clinical symptoms in group B, C, D and E （ P 〉 0. 05 ）. BE didn＇t change significantly in group B ,C and D by endoscopy. There was not significant difference in expression of p16 in group A and group B ,C, D （ P 〈 0. 05 ）. There were significant differences in expression of p53 in group B and D compared to group A （ P 〈 0. 05 ）. Conclusion Omeprasole or/and hydrotalcite can＇t eradicate BE,but they can relieve clinical symptoms and affect the expression of p53. They don＇t affect the expressiion of p16.
出处
《临床消化病杂志》
2007年第3期152-154,共3页
Chinese Journal of Clinical Gastroenterology
