塞来昔布治疗胃黏膜肠化生患者的疗效分析  

Effects of celecoxib on gastric intestinal metaplasia in patients

作　　者：朱晓静 李嵩博 刘洁 朱疆依 刘俊 时永全 ZHU Xiaojing;LI Songbo;LIU Jie;ZHU Jiangyi;LIU Jun;SHI Yongquan(Department of Gastroenterology,Xijing Hospital,Air Force Medical University,Shaanxi Xi'an 710032,China;Department of Air Service,Xijing Hospital,Air Force Medical University,Shaanxi Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院消化内科,陕西西安710032 [2]空军军医大学西京医院空勤科,陕西西安710032

出　　处：《现代肿瘤医学》2023年第19期3615-3621,共7页Journal of Modern Oncology

基　　金：国家自然科学基金项目(编号:82170560)。

摘　　要：目的:评估塞来昔布对胃黏膜肠化生的疗效并分析治疗失败的相关因素。方法:本研究回顾性纳入2019年04月01日至2022年01月01日在我院就诊的223例胃黏膜肠化生患者,均接受塞来昔布胶囊(200 mg/次,1次/天)治疗6个月。通过基于肠化生的胃炎评价系统(operative link on the gastric intestinal metaplasia assessment,OLGIM)和基于胃炎的评价系统(operative link on gastritis assessment,OLGA)的变化评估疗效。采用多因素回归法分析治疗失败的危险因素。结果:塞来昔布治疗肠化生和胃黏膜萎缩的逆转率分别为49.8%(111/223)和45.3%(101/223),分别有50.4%(65/129)和61.4%(43/70)的患者从OLGA高分期和OLGIM高分期逆转到低分期。此外,塞来昔布对OLGA、OLGIM高分期患者的有效率高于低分期患者。多因素分析结果显示,胃黏膜重度炎症(3~4分)与塞来昔布治疗失败有关(OR=3.313,95%CI:1.359~8.076,P<0.05)。结论:塞来昔布可有效逆转胃黏膜的萎缩和肠化生,对于降低患者的胃癌风险具有积极意义。Objective:To assess the effectiveness of celecoxib for gastric intestinal metaplasia(IM)and to analyze factors associated with treatment failure.Methods:A total of 223 patients with gastric IM were retrospectively included in this study at our hospital from Apr.1st 2019 to Jan.1st 2022.All the patients received celecoxib therapy(200 mg/time,once a day)for 6 months.The efficacy was assessed by changes of theoperative link on the gastric intestinal metaplasia assessment(OLGIM)and the operative link on gastritis assessment(OLGA)staging system.Multivariate analysis was performed to analyze risk factors associated with treatment failure.Results:The effective rates for IM and atrophy were 49.8%(111/223)and 45.3%(101/223),respectively.There were 50.4%(65/129)and 61.4%(43/70)of patients with higher OLGA and OLGIM stages reversed to lower stages,respectively.In addition,patients with higher OLGA and OLGIM stages showed a higher IM and atrophy regression rate than those with lower stages.The results of multivariate analysis showed that severe mucosal inflammatory status(inflammation score:3 to 4)was associated with treatment failure of celecoxib(OR=3.313,95%CI:1.359~8.076,P<0.05).Conclusion:Celecoxib could reverse gastric IM and mucosal atrophy,which may further reduce the risk of gastric cancer.

关 键 词：塞来昔布 慢性萎缩性胃炎 肠化生 胃肿瘤 癌变风险 

分 类 号：R730.5[医药卫生—肿瘤]