铝碳酸镁联合艾司奥美拉唑治疗胃溃疡黏膜愈合质量的临床研究  

Mucosal healing quality of hydrotalcite combined with esomeprazole in gastric ulcer

作　　者：杨瑞琦[1] 毛华[1] 黄丽韫[1] 卢敏[1] 靳丹丹[1] Yang Ruiqi Mao Hua Huang Li yun Lu Min Jin Dandan.(Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China)

机构地区：[1]南方医科大学珠江医院消化科,广州510280

出　　处：《中华消化杂志》2017年第1期35-40,共6页Chinese Journal of Digestion

摘　　要：目的 探讨铝碳酸镁联合艾司奥美拉唑治疗胃溃疡黏膜愈合质量。方法 选取于2014年6月至2015年12月就诊并确诊的胃溃疡患者42例，分为联合用药组与单药组，每组21例，分别予艾司奥美拉唑联合铝碳酸镁、单用艾司奥美拉唑，总疗程为8周。选取同期健康体检者21名作为健康对照组。白光内镜下观察胃溃疡愈合情况，在窄带成像术放大内镜下观察溃疡周边黏膜和正常胃黏膜组织的胃小凹和微血管形态变化，分别取两组治疗前后胃溃疡周围黏膜组织和健康对照组胃黏膜组织，分别进行Masson、免疫荧光和免疫组织化学染色、ELISA检测，分析其胶原纤维沉积量和分型、因子Ⅷ和TGF-β1表达水平、羟脯氨酸含量比较采用卡方检验、单因素方差分析、最小显著差异（LSD）法、Dunnett T3法和Kruskal-Wallis检验等。结果 治疗后，联合用药组21例患者中微血管网规则者18例（85.7%），明显高于单药组的12例（57.1%）和健康对照组的10例（47.6%），差异有统计学意义（χ2＝4.200, P＝0.040）。再生黏膜组织学成熟度比较发现，治疗后联合用药组和单药组的胶原蛋白Ⅰ型、Ⅲ型比值，胶原纤维沉积量，因子Ⅷ阳性细胞数、TGF-β1表达水平，羟脯氨酸含量分别为36.05和23.14，269 375.63±171 608.63和137 693.14±98 330.93，34.91±8.40和28.24±6.93，104 498.71±40 487.96和70 757.11±19 323.95，（1 897.80±879.35）和（1 230.57±536.05） μg/L，与健康对照组[36.81，245 696.90±224 687.00, 23.10±8.40, 94 048.04±41 306.55，（1 681.20±423.61） μg/L]比较，3组间比较差异均有统计学意义（H＝7.375，F＝3.465、11.680、5.190、5.160，P均〈0.05）；联合用药组显著高于单药组，差异均有统计学意义（H＝2.416，LSD法；P均〈0.05）。结论 铝碳酸镁联合艾司奥美拉唑治疗胃溃疡可显著改善微血管形态，提高再生黏膜组织成熟度和功能成熟度，黏Objective To explore the mucosal healing quality of hydrotalcite combined with esomeprazole in gastric ulcer.Methods Forty-two patients visiting from June 2014 to December 2015 and diagnosed with gastric ulcer were selected and divided into combination therapy group and single therapy group with 21 patients in each group. The patients of combination therapy group received esomeprazole combined with hydrotalcite, and the patients of single therapy group received esomeprazole alone. The total therapeutic course was eight weeks. At the same period, 21 health check-up participants were enrolled as normal control group. The healing of gastric ulcer was observed under white light endoscopy. The morphological changes of gastric pits and microvessel of mucosal at peripheral mucosa around ulcer and normal gastric mucosal were observed under narrow band imaging magnifying endoscopy. The gastric mucosa tissues of the two groups before and after treatment, and normal gastric mucosa of healthy control group were taken. The amount of deposition and composition of collagen fibers, the expression level of factor Ⅷ, the level of transforming growth factor （TGF）-beta1 and the content of hydroxyproline were analyzed by Masson, immunofluorescent and immunohistochemistry staining as well as enzyme linked immunosorbent assay. Chi square test, one-way analysis of variance （ANOVA）, least significant difference （LSD） method, Dunnett＇s T3 and Kruskal-Wallis test and other method were used for comparison.Results After treatment, 18 patients of combination therapy group （21 patients） had regular microvessel nets （85.7%）, which was significantly more than those of single therapy group （12 cases, 57.1%） and healthy control group （10 cases, 47.6%）, and the differences were statistically significant （χ2 =4.200, P=0.040）. In the comparison of maturity of regenerative mucosa between combination therapy group and single therapy group after treatment, the ration between collagen type Ⅰ and Ⅱ, deposition of c

关 键 词：铝碳酸镁 艾司奥美拉唑 胃溃疡 愈合质量 

分 类 号：R573.1[医药卫生—消化系统]