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中华消化病与影像杂志(电子版)

中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (04) : 232 -235. doi: 10.3877/cma.j.issn.2095-2015.2023.04.009

论著

小剂量塞来昔布对结直肠腺瘤术后复发的影响
梁飞飞, 梁海, 陆兴俊, 李小庆, 赵太云†()   
  1. 236800　安徽省，亳州市人民医院消化内科
    236800　安徽省，亳州市人民医院药学部
    230032　合肥，安徽医科大学
  • 收稿日期:2023-04-03 出版日期:2023-08-01
  • 通信作者: 赵太云
  • 基金资助:
    安徽省重点研究与开发计划项目(2022e07020066)

Effect of low-dose celecoxib on postoperative recurrence of colorectal adenomas

Feifei Liang, Hai Liang, Xingjun Lu, Xiaoqing Li, Taiyun Zhao†()   

  1. Department of Gastroenterology, Bozhou People′s Hospital, Bozhou 236800, China
    Department of Pharmacy, Bozhou People′s Hospital, Bozhou 236800, China
    Anhui Medical University, Hefei 230032, China
  • Received:2023-04-03 Published:2023-08-01
  • Corresponding author: Taiyun Zhao
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梁飞飞, 梁海, 陆兴俊, 李小庆, 赵太云. 小剂量塞来昔布对结直肠腺瘤术后复发的影响[J]. 中华消化病与影像杂志(电子版), 2023, 13(04): 232-235.

Feifei Liang, Hai Liang, Xingjun Lu, Xiaoqing Li, Taiyun Zhao. Effect of low-dose celecoxib on postoperative recurrence of colorectal adenomas[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 232-235.

目的

探讨小剂量塞来昔布对结直肠腺瘤手术治疗后复发的影响。

方法

纳入2020年1月1日至2022年3月1日亳州市人民医院消化科因结直肠息肉入院者，行内镜下息肉切除术且病理检查为腺瘤性息肉213例，随机分为观察组108例，对照组105例，观察组给予小剂量塞来昔布200 mg/次，每日一次，对照组给予同等剂量安慰剂。两组均经6个月和1年随访，统计两组复发率及不良反应(消化道出血、胃十二指肠溃疡、死亡)发生率。

结果

6个月后观察组腺瘤复发率(2/108)低于对照组(8/105), 1年后观察组复发率(9/108)仍低于对照组(23/105)，差异均有统计学意义(P<0.05)。随访6个月观察组不良反应发生率(2/108)略高于对照组(0/105)，差异无统计学意义(P>0.05)，1年后观察组不良反应发生率(8/108)高于对照组(2/105)，差异有统计学意义(P<0.05)。

结论

口服小剂量塞来昔布能有效预防结直肠腺瘤的发生，但随着用药时间延长，会增加不良反应发生率。

关键词: 塞来昔布, 大肠腺瘤, 复发
Objective

To investigate the effect of low-dose celecoxib on postoperative recurrence of colorectal adenomas.

Methods

A total of 213 patients admitted to the Department of Gastroenterology of Bozhou People′s Hospital from January 1, 2020 to March 1, 2022 due to colon polyps underwent endoscopic polypectomy with postoperative pathological manifestations of adenomatous polyps were included, and were randomly divided into observation group (108 cases) and control group (105 cases). The observation group was given low-dose celecoxib 200 mg, once a day. The control group was given the same dose placebo. Both groups were followed up for half of 1 year and 1 year. The recurrence rates and the incidences of adverse reactions (gastrointestinal bleeding, gastroduodenal ulcer and death) of the two groups were analyzed.

Results

Half a year later, the recurrence rate of adenoma in the observation group (2/108) was lower than that in the control group (8/105); One year later, the recurrence rate of adenoma in the observation group (9/108) was still lower than that in the control group (23/105), with statistically significant differences (P<0.05). The incidence of adverse reactions in the observation group (2/108) was slightly higher than that in the control group (0/105) after six months of follow-up, without a statistically significant difference (P>0.05). The incidence of adverse reactions in the observation group (8/108) was higher than that in the control group (2/105) after one year of follow-up, with a statistically significant difference (P<0.05).

Conclusion

Oral low-dose celecoxib can effectively prevent the occurrence of colorectal adenomas, but the incidence of adverse reactions will increase with prolonged oral administration.

Key words: Celecoxib, Colorectal adenomas, Recurrence
表1 纳入研究患者一般资料
组别 例数 性别(例) 年龄(岁) 吸烟史(例)# 饮酒史(例)& 身高(cm) 体重(kg)
男 女
观察组 108 62 46 49.3±2.2 24 42 164±6.5 63±8.50
对照组 105 58 47 48.9±2.4 27 39 165±6.0 64±8.72
χ2/t   0.102   1.27 0.357 0.181 1.17 0.85
P   0.75   0.21 0.55 0.67 0.25 0.4
组别 例数 体重指数(kg/m2) 高血压病史(例) 糖尿病病史(例) 口服二甲双胍 注射胰岛素 脑梗死病史(例)
观察组 108 23.1±2.5 25 18 12 6 4
对照组 105 22.8±2.4 28 16 10 6 7
χ2/t   0.89 0.353 0.081 0.145 0.002 0.95
P   0.38 0.55 0.78 0.7 0.96 0.33
表2 2组患者随访期间复发和不良反应情况比较[例(%)]
组别 例数 治疗6个月 治疗1年
复发率 不良反应 复发率 不良反应
观察组 108 2(1.9) 2(1.9) 9(8.3) 8(7.4)
对照组 105 8(7.6) 0 23(21.9) 2(1.9)
χ2   3.96 1.96 7.68 4.49
P   0.047 0.16 0.006 0.034
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