异烟肼预防食管良性狭窄的实验与应用研究

Experimental and clinical study of isoniazid in prevention of benign stricture of esophagus

目的 探讨异烟肼预防食管良性狭窄的作用。方法 分动物实验及临床应用两部分 ,动物实验采用家犬 2 0只 ,分为 3组 ,按Davis动物模型致伤为深II度食管腐蚀伤 ,采用异烟肼治疗 ;临床应用系对 2 6例食管良性狭窄患者采取扩张术后异烟肼治疗以预防食管再狭窄。结果 动物实验组显示异烟肼具有显著抑制食管腐蚀伤后胶原合成的作用 ,治疗组食管管腔显著大于对照组 (P <0 .0 1) ,食管顺应性明显优于对照组 (P <0 .0 1)。临床病例除 2例失访外其余均获得满意疗效。结论 异烟肼能够防治食管良性狭窄 。

Objective To study the effects of isoniazid on the prevention of benign stricture of the esophagus. Methods The study was divided into 2 parts: In the first of animal experimentation, 20 dogs were divided into group A (normal; n =6), group B (positive control, n =6) and group C (isoniazid treated, n =8). The dogs of group B and C were inflicted with alkali burns of the esophagus and those of group C were treated with isoniazid. 8 weeks later, all the dogs were killed to measure the diameter of the stricture and the compliance and collagen content of the esophagus. In the second part, 26 patients with benign stricture of the esophagus were treated with isoniazid after esophageal dilatation. Results In the dogs inflicted with esophageal burns, isoniazid showed an obvious effect of inhibition on the formation of collagen in the esophagus. The diameter of esophageal stricture was significantly larger and the esophageal complicance markedly better in group C than in group B ( P <0.01). In the clinical study, satisfactory result was obtained in 24 cases and the other 2 dropped out of our follow up. Conclusion Isoniazid can prevent benign stricture of the esophagus and is worthy to be further tried clinically.