Herek Ozkan, Karabul Murat, Yenisey Ciğdem, Erkuş Muhan
Department of Pediatric Surgery, Faculty of Medicine, Pamukkale University, 20100, Denizli, Turkey.
Pediatr Surg Int. 2010 Jul;26(7):721-7. doi: 10.1007/s00383-010-2618-1. Epub 2010 May 18.
The aim of this study was to investigate the efficacy of ibuprofen on the healing of esophagus and the prevention of stricture development after esophageal caustic injuries in rats.
Rats were divided into three groups as: group 1(sham), group 2(esophageal burn injury), group 3(injury + ibuprofen). In groups 2 and 3, a standard esophageal burn injury was created by applying 10% NaOH solution to distal esophagus of about 3 cm. To rats in the sham group, isotonic solution was given instead of NaOH. Ibuprofen (90 mg/kg/day) was given via oral route to group 3 rats. Normal saline as placebo was given via the same route to rats in groups 1 and 2. 28 days later, all the live rats were killed. The distal esophageal segments of all rats were removed and divided into two equal parts for biochemical and histopathologic examination. In the tissue samples, biochemically hydroxyproline and histopathologically collagen content and stenosis indices were evaluated for efficacy of treatment.
The hydroxyproline level (microg/mg wet tissue) in the groups was 1.54 +/- 0.08, 4.82 +/- 0.60, and 3.28 +/- 0.27, respectively. The hydroxyproline level increased significantly in group 2 compared with group 1 (P < 0.01). Although the hydroxyproline level was significantly increased in group 3 compared with group 1, it decreased significantly in group 3 compared with group 2 (P < 0.05) by treatment of ibuprofen. In group 3, the collagen content score (1.50 +/- 0.26) was significantly lower than in group 2 (2.62 +/- 0.37) (P < 0.05). The stenosis index was found as 0.37 +/- 0.02 in group 1, 0.84 +/- 0.02 in group 2, and 0.67 +/- 0.03 in group 3. The stenosis index in group 2 was significantly higher than group 1 and group 3 (P < 0.01). Although the stenosis index was significantly higher than in group 1, a significant decrease in stenosis index was found in group 3 compared with group 2, by ibuprofen treatment (P < 0.01).
Based on these results, we concluded that the treatment with ibuprofen in acute phase esophageal burn injury has beneficial effects on healing of esophagus and may decrease the stricture formation. For these reasons, ibuprofen may effectively be used in the acute phase treatment of caustic esophagus injury and after esophageal dilatation procedures.
本研究旨在探讨布洛芬对大鼠食管腐蚀性损伤后食管愈合及狭窄形成预防的疗效。
将大鼠分为三组:第1组(假手术组)、第2组(食管烧伤组)、第3组(损伤+布洛芬组)。在第2组和第3组中,通过向约3 cm的食管远端涂抹10%氢氧化钠溶液造成标准的食管烧伤。给假手术组大鼠给予等渗溶液而非氢氧化钠。第3组大鼠经口给予布洛芬(90 mg/kg/天)。第1组和第2组大鼠经相同途径给予生理盐水作为安慰剂。28天后,处死所有存活大鼠。取出所有大鼠的食管远端节段并分成两等份进行生化和组织病理学检查。在组织样本中,评估生化指标羟脯氨酸、组织病理学指标胶原蛋白含量和狭窄指数以判断治疗效果。
三组中羟脯氨酸水平(μg/mg湿组织)分别为1.54±0.08、4.82±0.60和3.28±0.27。第2组的羟脯氨酸水平与第1组相比显著升高(P<0.01)。虽然第3组的羟脯氨酸水平与第1组相比显著升高,但经布洛芬治疗后,第3组与第2组相比显著降低(P<0.05)。第3组的胶原蛋白含量评分(1.50±0.26)显著低于第2组(2.62±0.37)(P<0.05)。狭窄指数在第1组为0.37±0.02,第2组为0.84±0.02,第3组为0.67±0.03。第2组的狭窄指数显著高于第1组和第3组(P<0.01)。虽然第3组的狭窄指数显著高于第1组,但经布洛芬治疗后,第3组与第2组相比狭窄指数显著降低(P<0.01)。
基于这些结果,我们得出结论,急性期食管烧伤损伤用布洛芬治疗对食管愈合有有益作用,并可能减少狭窄形成。因此,布洛芬可有效用于腐蚀性食管损伤的急性期治疗及食管扩张术后。