奥美拉唑配合内镜下氩离子凝固术治疗Barrett食管疗效及对患者p53蛋白表达的影响

张月晓; 陈健

doi:10.3969/j.issn.1671-038X.2019.08.06

奥美拉唑配合内镜下氩离子凝固术治疗Barrett食管疗效及对患者p53蛋白表达的影响

张月晓,
陈健^,

- 承德医学院附属医院消化内科, 河北承德 067000
基金项目:
2018年承德市科学技术研究与发展计划项目(No:201804A015)

详细信息

作者简介:
张月晓,女,医学硕士,主治医师,研究方向:消化内科疾病诊治

通讯作者: 陈健,E-mail:topp016@163.com

中图分类号: R571

收稿日期: 2019-03-11

Clinical efficacy of endoscopic argon plasma coagulation combined with omeprazole on Barrett’s esophagus and its impact on the expression of p53 protein in patients

ZHANG Yue-xiao,
CHEN Jian^,

- Department of Gastroenterology, Affiliated Hospital of Chengde Medical College, Chengde 067000, China

More Information

Corresponding author: CHEN Jian, E-mail: topp016@163.com

Received Date: 11 March 2019

摘要

摘要: [目的]探讨奥美拉唑配合内镜下氩离子凝固术(APC)治疗Barrett食管(BE)的临床效果。[方法]选取2017年3月~2018年6月我院收治的104例BE患者,利用随机数字表法将其随机分成观察组及对照组,各52例。观察组采取内镜下APC联合奥美拉唑治疗,对照组则单用奥美拉唑治疗,治疗3个月后观察2组疗效。比较2组临床疗效,治疗前后主要症状评分、BE黏膜中p53蛋白表达量变化,药物不良事件发生情况。并统计观察组术后并发症和复发情况。[结果]观察组总有效率为84.62%(44/52),与对照组的61.54%(32/52)比较显著升高(P＜0.05)。2组治疗后各项主要症状(反酸、烧心、胸骨后痛、上腹不适)评分均较治疗前显著降低,且观察组下降更显著(P＜0.05)。与治疗前比较,2组治疗后BE黏膜中p53蛋白表达量均有显著减少(P＜0.05);且观察组降低亦更显著(P＜0.05)。2组药物不良反应均少而轻。52例观察组术后出现1例黏膜下气肿,1例吞咽困难,但经对症处理后均消失,且未发生严重并发症(如出血、溃疡、穿孔等)。观察组术后随访3个月内无复发,随访6个月内仅复发1例,再次行内镜下APC治疗后病灶消失。[结论]奥美拉唑配合内镜下APC治疗BE能有效促进患者临床症状的缓解,下调BE黏膜中p53蛋白表达,疗效确切。
- 内镜下氩离子凝固术 /
- 奥美拉唑 /
- Barrett食管 /
- p53蛋白
Abstract: [Objective]To explore the clinical efficacy of endoscopic argon plasma coagulation(APC)on patients with Barrett's esophagus(BE).[Methods]The subjects of this study,104 BE patients admitted in our hospital from March 2017 to June 2018,were divided into observation group(n=52)and control group(n=52)on the basis of random number table.The observation group was treated with combination of endoscopic APC and omeprazole,while the control group omeprazole only.Clinical efficacy was evaluated after 3 months of treatment.The clinical efficacy,changes of major symptom scores and p53 expression in BE patients' mucous membrane before and after treatment,as well as occurrence of side effect were compared between the two groups.The postoperative complications and recurrence of the observation group were also counted.[Results]The overall effective rate of the observation group was 84.62%(44/52),much higher than 61.54%(32/54)of the control group(P＜0.05).After treatment both groups saw a great decrease in major symptoms scores(sour regurgitation,heartburn,retrosternal pain,epigastric discomfort)as compared with those before the treatment,and the decrease the observation group witnessed were more significant(P＜0.05).After treatment both groups had much less p53 expression than they did before the treatment(P＜0.05),and the decline the observation group saw were more significant(P＜0.05).Both groups seldom saw side effect and those they saw were mild.Among the 52 cases from the observation group,there were 1 case of submucosal emphysema and 1 case of dysphagia,but the symptoms were eliminated with symptomatic treatment,and there were no severe complications like hemorrhage,anabrosis,perforation,etc.No relapse was found for the observation group during the 3 months follow-up visit,and only 1 case of relapse was witnessed during the 6 months follow-up visit which was eliminated by reapplying endoscopic.[Conclusion]In treating BE patients,the combination of endoscopic APC and omeprazole can significantly relieve clinical symptoms in patients and lower p53 expression in their mucous membrane.
- endoscopic argon plasma coagulation /
- omeprazole /
- Barrett's esophagus /
- p53 protein

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