CAJ | 학술논문

目的:探讨不同剂量辛伐他汀对Barrett食管患者食管癌的预防效果.方法:选取2004年1月-2009年1月期间收治的Barrett食管患者228例,按照随机数字表法分为A组、B组和C组,每组76例.所有患者均接受PPI治疗,A组和B组在PPI治疗的基础上分别加用辛伐他汀20 mg/d和40 mg/d,疗程为9个月,所有患者均获得为期5年的随访.统计分析三组Barrett食管疗效、食管癌发生情况和并发症发生情况.结果:A组、B组和C组治疗前后治疗效果为显著、好转和无效的患者比例及治疗有效率比较差异均无统计学意义(P>0.05).C组食管癌的发生率为13.16%,高于A组的6.58%和B组的5.26%,差异均有统计学意义(P<0.05).A组和B组食管癌的发生率比较差异无统计学意义(P>0.05).A组和C组慢性咳嗽、基底层细胞增生等并发症的发生率和总并发症发生率比较差异均无统计学意义(P>0.05),B组肝功能异常和肌肉并发症的发生率及总并发症发生率均明显高于A组和C组,差异有统计学意义(P<0.05).结论:PPI治疗的基础上每日加用20 mg辛伐他汀用于治疗Barrett食管有效预防患者食管癌的发生且不会增加其并发症发生的风险,可作为预防食管癌发生辅助用药之一.
목적:탐토불동제량신벌타정대Barrett식관환자식관암적예방효과.방법:선취2004년1월-2009년1월기간수치적Barrett식관환자228례,안조수궤수자표법분위A조、B조화C조,매조76례.소유환자균접수PPI치료,A조화B조재PPI치료적기출상분별가용신벌타정20 mg/d화40 mg/d,료정위9개월,소유환자균획득위기5년적수방.통계분석삼조Barrett식관료효、식관암발생정황화병발증발생정황.결과:A조、B조화C조치료전후치료효과위현저、호전화무효적환자비례급치료유효솔비교차이균무통계학의의(P>0.05).C조식관암적발생솔위13.16%,고우A조적6.58%화B조적5.26%,차이균유통계학의의(P<0.05).A조화B조식관암적발생솔비교차이무통계학의의(P>0.05).A조화C조만성해수、기저층세포증생등병발증적발생솔화총병발증발생솔비교차이균무통계학의의(P>0.05),B조간공능이상화기육병발증적발생솔급총병발증발생솔균명현고우A조화C조,차이유통계학의의(P<0.05).결론:PPI치료적기출상매일가용20 mg신벌타정용우치료Barrett식관유효예방환자식관암적발생차불회증가기병발증발생적풍험,가작위예방식관암발생보조용약지일.
Objective:To explore the prevention effect of different doses of Simvastatin on esophagus cancer of Barrett's esophagus patients. Method:228 patients with Barrett's esophagus from January our hospital from January, 2004 to January, 2009 were divided into group A and group B and group C by digital random method, 76 cases in each group. All patients were treated with proton pump inhibitors(PPI), and on the basis of PPI therapy, group A and group B combined with Simvastatin 20 mg/d and 40 mg/d respectively. All the patients received 5 years follow up. The treatment time was 9 months. Barrett's esophagus cure effect, Barrett esophagus occurrence and complications occurrence of three groups were statistical analyzed.Result:Patients rate with significant, good, normal and bad curative effect and total treatment efficient in 3 groups had no statistical significance (P>0.05). Esophagus cancer incidence of group C was 13.16%, which werehigher than the6.58% of group A and 5.26% of group B, and the difference was statistically significant (P<0.05). The esophagus cancer incidence of group A and group B had no statistical significant difference (P>0.05). the incidence of chronic cough, base layer cell hyperplasia and other complications and total complications incidence of group A and group C had no statistical significant difference (P>0.05), while the incidence of abnormal liver function and muscle related disease and total complication incidence of group B were higher than that of group A and group C, and the difference was statistically significant (P<0.05).Conclusion:20 mg Simvastatin used in the treatment of Barrett's esophagus can effectively prevent the happening of esophagus cancer without increasing the risk of complications, thus 20 mg Simvastatin can be used as one of auxiliary medication to prevent esophagus cancer.