Barrett食管的治疗研究及治疗前后bcl-2的表达变化  

The study of treating Barrett's esophagus patients and change of the expression of bcl-2 before and after the treatment

作　　者：夏士涛[1] 王龙[1] 刘坤[1] 李岩[2] 

机构地区：[1]荆门市第一人民医院消化科,湖北荆门448000 [2]华中科技大学同济医学院附属同济医院消化内科

出　　处：《胃肠病学和肝病学杂志》2009年第2期128-130,共3页Chinese Journal of Gastroenterology and Hepatology

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bcl-2的表达改变,探索各种治疗方法产生效果的可能机制。方法经放大胃镜及活检确诊的BE患者240例,随机分为4组。A组:对照组,无任何治疗;B组:药物治疗组:口服奥美拉唑和铝碳酸镁;C组:氩气凝固术(APC)组;D组:氩气凝固术+药物治疗组。各组治疗3个月,观察并记录治疗前后患者的临床表现及内镜下表现,活检取材进行病理学检查,并从mRNA及蛋白水平对治疗前后bcl-2的表达进行检测。结果在缓解临床症状方面,各治疗组均较治疗前有明显改善,与对照组相比具有统计学差异(P<0.05);各治疗组间比较无明显差异(P>0.05)。内镜和病理检查发现,A、B组BE黏膜无明显改变,而C、D组BE黏膜减少或消失。各治疗组bcl-2的表达较对照组均显著降低,差异有显著性(P<0.05),其中D组降低显著。结论APC和药物联合治疗不仅可以改善临床症状,而且能够消除BE黏膜,降低bcl-2的表达,是治疗BE的一种有效实用的方法。bcl-2的表达可作为判定治疗效果的可能指标。Objective To investigate the effect of different treatment on Barrett＇ s esophagus （BE） and to explore the mechanism of therapeutic regimen by detecting the change of the expression of bcl-2 before and after the treatment. Methods Two hundred and forty patients with BE which were diagnosed by endoscopy and biopsy were randomly divided into four groups： A ： control, B ： Omeprazole and Hydrotalcite treatment, C ： Argon plasma coagulation （APC） treatment, D： APC plus Omeprazole and Hydrotalcite treatment. All patients were treated for 3 months. Clinical effect, endoscopy and pathology were detected and the expression of bcl-2 was observed by RT-PCR and Western blot. Results The symptoms of patients in group B, C and D were significantly less than that in A group （P 〈0.05）, but there was no obvious disparity in treatment groups （P 〉 0. 05）. Endoscopy and pathology found that the BE mucous membranes were decreased or eliminated in C and D groups,while no BE mucous membranes changed in A and B groups （P 〈 0.05）. There were striking differences in the expression of bcl-2 between C or D groups and A or B groups. Conclusion APC combined with Omeprazole and Hydrotalcite is an effective, safe and promising therapeutic regimen against BE. bcl-2 may be a good indicator to assess the therapic effect of BE.

关 键 词：BARRETT食管 氩气凝固术 奥美拉唑 铝碳酸镁 BCL-2 

分 类 号：R574[医药卫生—消化系统]