APC治疗前后食管黏膜COX-2的基因表达及意义  

Expression and the significance of COX-2 gene in Barrett′s esophageal mucosa before and after APC

作　　者：贾丽萍[1] 谢文义[2] 向明确[3] 袁晓英[1] 王志宁[1] 陈秀英[1] 鲁厚胜[1] 王丹[1] 沈洲立[1] 杨蕊[1] 

机构地区：[1]重庆市第九人民医院消化科,400700 [2]重庆市第九人民医院心胸外科,400700 [3]重庆市第九人民医院感染科,400700

出　　处：《重庆医学》2013年第31期3740-3743,共4页Chongqing medicine

基　　金：重庆市卫生局资助项目(渝卫科技2008-2-324)

摘　　要：目的研究Barrett食管病例氩离子凝固术(APC)联合药物治疗及单纯药物治疗前、后食管黏膜中环氧化酶-2(COX-2)的基因表达变化。判断Battett食管治疗的临床疗效及可能机制。方法经胃镜及病理诊断的Barrett食管66例,分为3组,A组为阳性对照组(不治疗组),B组为APC联合抑酸剂治疗组,C组为抑酸剂药物治疗组。治疗前、后观察患者症状缓解状况,胃镜下Barrett食管上皮消融情况,取食管黏膜组织标本,采用实时荧光定量聚合酶联反应(PCR)技术检测,Barrett食管黏膜及对照组食管黏膜中COX-2mRNA表达情况,进行组间及治疗前、后比较。结果 B组、C组均可有效地缓解症状,与A组相比差异有统计学意义,B、C组症状缓解率相比差异无统计学意义。A组与C组随访胃镜下Barrett食管上皮未见明显缩小,而B组Barrett食管黏膜消融,代之以淡红色食管黏膜覆盖。胃镜联合药物治疗后COX-2mRNA的表达明显降低至正常食管水平,而C组COX-2mRNA的表达降低,但与治疗前对比差异无统计学意义。结论单纯抑酸治疗与APC联合抑酸剂治疗相比,作用差,APC联合抑酸剂治疗后可以有效地缓解症状,消融Barrett食管上皮,是治疗Barrett食管的一种安全、有效的方法。Objective To research expression changes of COX-2 gene in Barrett＇s esophageal mucosa before and after argon plasma coagulation （APC）operation and to explore itrs clinical curative effect and possible mechanism. Methods 66 barrettrs e- sophageal diagnosed with gastroscope and pathology were randomly divided into normal esophageal group （the negative control group, group A）, the APC with acid suppression therapy group（group B）, Acid antimicrobial drug treatment group（group C）. Oh serve symptom relief condition,barrett esophagus epithelium ablation under gastroscope before and after treatment,esophageal mu- cosa tissue samples was detected by real-time fluorescent quantitative PCR technique. Expression of COX-2 gene in barrettrs esoph- ageal mucosa were compared among groups. Results Compared with group A,both Group B and group C could effectively relieve symptoms （P〈0.05）. Symptom remission rate had no no statistically significant difference in Group B and group C. Barrett esopha- gus epithelium was not significantly narrowed under gastroscope follow-up Group A and group C,while Barrett esophageal mucosal occurred ablation with pink mucous covered in Group B. The expression of Cox-2 mRNA in group B decreased,which was similar to group A. The expression of Cox-2 mRNA in group C also decrease, but there was no significant differences before and after treat ment. Conclusion APC with acid suppression therapy could effectively relieve symptoms,melting Barrett esophagus epithelium,and is of a safe and effective treatment on Barrettes esophagus.

关 键 词：BARRETT食管 环氧化酶2 氩离子凝固术 聚合酶联反应 

分 类 号：R571[医药卫生—消化系统] R735.1[医药卫生—内科学]