不同药物对反流性食管炎黏膜保护作用的实验研究

目的　用不同药物对混合反流大鼠模型进行干预 ,观察混合反流对大鼠食管黏膜的损伤及西沙比利、萘丁美酮和铝碳酸镁对黏膜的保护作用。方法　健康SD大鼠 16 8只 ,随机分为 4组 :阳性对照组 (Y组 ) ,西沙比利干预组 (P组 ) ,萘丁美酮干预组 (R组 ) ,铝碳酸镁干预组 (D组 )。分别于术后 2 2、2 8、35、4 0周观察食管黏膜的大体和病理变化。结果　术后不同时间Y组的损伤程度均重于其他 3组 (P <0 .0 5 ) ;且Y组Barrett食管 (BE)、重度不典型增生和食管腺癌 (EAC)的发生率均高于其他 3组。P组的损伤程度高于R、D组 (P <0 .0 5 ) ,但BE、重度不典型增生和EAC的发生与R、D组无统计学差异 (P >0 .0 5 )。结论　长期严重的反流性食管炎 (RE)可导致BE、重度不典型增生和EAC ;西沙比利、萘丁美酮和铝碳酸镁对食管黏膜均有一定的保护作用 ,可减少BE、重度不典型增生和EAC的发生 ,但萘丁美酮和铝碳酸镁的效果要优于西沙比利。

Resistance of different drugs to mucosa injury in reflux esophagitis

Objective To observe mixed refl ux contents injury to esophageal mucosa, and compare the effects of cisapride, nab umetone and hydropride resistance to mucosa injury in reflux esophagitis. Methods A total of 168 Sprague-Dawley rats were treated with eso phagoduodenostomy and divided into four groups in random. Group Y: operation + s aline as positive controls, group P: operation + cisapride, group R: operation + nabumetone, group D: operation + hydropride. The lesions of esophageal mucosa w ere observed at weeks 22, 28, 35 and 40 after operation. Results The lesions of esophageal mucosa in group Y were much more severe than tho se of other three groups at different time (P<0.05), and the incidence of Ba rrett's esophagus (BE), severe atypical hyperplasia and esophageal adenocacinom a (EAC) in group Y were higher than others. The lesions in group P were more sev ere than those in groups R and D, with significant differences at different time (P<0.05). Howerve, the incidence of BE, severe atypical hyperplasia and EAC in group P had no significant difference from that of group R and group D (P >0.05). Conclusion Long-term severe reflux esophagitis l ong term can induce BE, severe atypical hyperplasia and EAC. Cisapride, nabumeto ne and hydropride can protect mucosa in reflux esophagitis and reduce the develo pment of BE, severe atypical hyperplasia and EAC, but nabumetone and hydropride are more effective than cisapride.