塞来昔布治疗慢性萎缩性胃炎的疗效及安全性  

Efficacy and safety of celecoxib in treatment of chronic atrophic gastritis

作　　者：陈志宏 林万隆 刘清华 

机构地区：[1]上海市闸北区市北医院药剂科,上海200435 [2]上海市闸北区市北医院消化内科,上海200435

出　　处：《世界肿瘤杂志》2006年第2期98-100,103,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：目的初步评价塞来昔布治疗胃癌前疾病-慢性萎缩性胃炎过程中的疗效及副作用。方法胃镜活检经病理证实为慢性萎缩性胃炎的病人78例（男41例，女37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。治疗过程中记录胃黏膜损害、肾功能损害、血清脂蛋白水平变化及心脑血管事件。结果治疗3mo时，塞来昔布组cox-2蛋白表达明显下降（P〈0．05），但两组胃黏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），且胃黏膜萎缩程度有所减轻，但两组间无统计学差异。塞来昔布组治疗前、治疗中及治疗后未发现急性胃黏膜损害及心脑血管事件；治疗前后血清脂蛋白水平及肾功能无明显变化。结论塞来昔布可以明显抑制胃黏膜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。应用塞来昔布治疗慢性萎缩性胃炎安全性良好。Objective To evaluate the efficacy and safety of celecoxib in treatment of human chronic atrophic gastritis. Methods 78 patients （male 41, female 37, M/F= 1.11：1） with chronic atrophic gastritis diagnosed by pathology were randomized into 2 groups： celecoxib group （celecoxib 0.2. qd. Po for 6 months） and control group （no specific treatment）. Patients received endoscopy examination before treatment, 3 months after enrolling and 6 months after enrolling, respectively. Pathologic examination and cox-2 protein expression detected by irnmunohistochemistry 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. In celecoxib group, no acute gastric mucosa lesion and cerebrocardiac incidence were encountered, and there is no significantly difference of sera lipoprotein level and renal function between before and after treatment. Conclusions Celecoxib could down-regulated the expression of cox-2 protein. This research suggested that celecoxib might have therapeutic effect on human chronic atrophic gastritis. Treating chronic atrophic gastritis with celecoxib could be well tolerated.

关 键 词：癌前病变 萎缩性胃炎 塞来昔布 COX-2 

分 类 号：R573.32[医药卫生—消化系统]