慢性萎缩性胃炎治疗初探  

Clinical and experimental research of treatment on chronic atrophic gastritis

作　　者：林万隆 刘清华[2] 马晓明 朱蕾 陈崇稼 

机构地区：[1]上海市闸北区市北医院消化内科,上海200435 [2]上海第二医科大学附属新华医院消化科,上海200092 [3]上海市闸北区市北医院普外科,上海200435 [4]上海市闸北区市北医院病理科,上海200435

出　　处：《世界肿瘤杂志》2006年第1期29-31,F0004,共4页Tumour Journal of the World

基　　金：2003年上海市卫生局青年项目基金资助（编号：044Y37）

摘　　要：目的 探讨塞来昔布对胃癌前疾病——慢性萎缩性胃炎的干预作用。方法 胃镜活检经病理证实为慢性萎缩性胃炎的病人97例（男51例，女46例，男女比例1．11：1）。随机分为两组：塞来昔布组（接受塞来昔布0．2，1次／d，po）和空白对照组（不接受特异性治疗），疗程均为6mo。治疗前，治疗3mo及疗程结束各行胃镜检查1次。活检组织行常规病理检查及免疫组化染色检测COX-2的表达。结果 治疗3mo时，塞来昔布组cox-2蛋白表达明显下降（P〈0．05），但两组胃粘膜萎缩程度无明显差异；疗程结束后，塞来昔布组cox-2蛋白表达明显下降（P〈0．05），且胃粘膜萎缩程度有所减轻，但两组间无统计学差异。结论 塞来昔布可以明显抑制胃粘膜cox-2蛋白的表达，提示对慢性萎缩性胃炎有一定的逆转作用。Objective To evaluate the therapeutic effect of celecoxib on human chronic atrophic gastritis. Methods 97 patients （male 51, female 46, M/F=1.11：1） with chronic atrophic gastritis diagnosed by pathology were randomized into 2 groups： the celecoxib group （celecoxib 0.2. qd. Po for 6 months） and the control group （no specific treatment）. Patients received endoscopy examination before treatment, 3 months and 6 months after enrolling, respectively. Pathologic examination and cox-2 protein expression detected by immunohistochemistry were applied to the biopsy specimen. Results 3 months after enrolling, cox-2 protein expression was significantly down-regulated in celecoxib group （P〈0.05）, but no significantly difference of mucosa atrophy was found between 2 groups. 6 months after enrolling, cox-2 protein expression was significantly down-regulated in celecoxib group （P〈0.05）, while degree of mucosa atrophy was slightly improved in celecoxib group, but without statistical significantly difference. Conclusions Celecoxib could down-regulate the expression of cox-2 protein. This research suggested that celecoxib might have therapeutic effect on human chronic atrophic gastritis.

关 键 词：癌前病变 萎缩性胃炎 塞来昔布 COX-2 慢性萎缩性胃炎 

分 类 号：R573.32[医药卫生—消化系统]