药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2015年
1期
11-14
,共4页
张丽新%樊蓉%任天舒%任刘丽%党大胜%史国兵
張麗新%樊蓉%任天舒%任劉麗%黨大勝%史國兵
장려신%번용%임천서%임류려%당대성%사국병
质子泵抑制剂%泮托拉唑%雷贝拉唑%经皮冠状动脉介入治疗%胃肠出血
質子泵抑製劑%泮託拉唑%雷貝拉唑%經皮冠狀動脈介入治療%胃腸齣血
질자빙억제제%반탁랍서%뢰패랍서%경피관상동맥개입치료%위장출혈
Proton pump inhibitors%Pantoprazole%Rabeprazole%Percutaneous coronary intervention%Gastrointestinal hemorrhage
目的 探讨质子泵抑制剂(PPI)泮托拉唑钠和雷贝拉唑钠预防经皮冠状动脉介入(PCI)术后阿司匹林和氯吡格雷双联抗血小板治疗所致消化道出血的短期疗效和安全性. 方法 收集2014年2-4月在沈阳军区总医院行PCI手术且符合入组条件冠心病患者的病历资料进行回顾性分析.根据用药情况将患者分为泮托拉唑钠组(泮托拉唑钠40 mg加入0.9％氯化钠注射液100 ml中静脉滴注,1次/d)和雷贝拉唑钠组(雷贝拉唑钠10 mg口服,1次/d).2组患者均于PCI术前3d给予阿司匹林、氯吡格雷双联抗血小板治疗.比较2组患者术后2个月内消化道出血和主要心血管不良事件的发生情况以及不良反应发生率. 结果 共84例患者纳入研究,泮托拉唑钠组和雷贝拉唑钠组各42例.泮托拉唑钠组男性23例,女性19例,平均年龄(65±8)岁;雷贝拉唑钠组男性22例,女性20例,平均年龄(66±8)岁.随访期间,2组患者均未发生消化道出血;未出现心肌梗死、再发心绞痛、支架内血栓及再次血运重建等主要心血管不良事件.泮托拉唑钠组和雷贝拉唑钠组消化道不良反应发生率分别为9.5％ (4/42)和11.9％ (5/42).应用PPI前后,2组患者肝酶水平、肾功能及血常规等实验室指标基本在正常范围内.泮托拉唑钠组用药前AST平均水平为(47±28) U/L,高于雷贝拉唑钠组的(24±13) U/L,差异有统计学意义(P =0.020);泮托拉唑钠用药后AST平均水平为(28±15) U/L,明显低于用药前,差异有统计学意义(P =0.026). 结论 PCI术后双联抗血小板治疗的同时加用泮托拉唑钠或雷贝拉唑钠可有效预防消化道出血,且短期内不增加主要心血管不良事件的风险.静脉给予泮托拉唑钠与口服雷贝拉唑钠预防消化道出血的短期疗效和安全性无明显差异.
目的 探討質子泵抑製劑(PPI)泮託拉唑鈉和雷貝拉唑鈉預防經皮冠狀動脈介入(PCI)術後阿司匹林和氯吡格雷雙聯抗血小闆治療所緻消化道齣血的短期療效和安全性. 方法 收集2014年2-4月在瀋暘軍區總醫院行PCI手術且符閤入組條件冠心病患者的病歷資料進行迴顧性分析.根據用藥情況將患者分為泮託拉唑鈉組(泮託拉唑鈉40 mg加入0.9％氯化鈉註射液100 ml中靜脈滴註,1次/d)和雷貝拉唑鈉組(雷貝拉唑鈉10 mg口服,1次/d).2組患者均于PCI術前3d給予阿司匹林、氯吡格雷雙聯抗血小闆治療.比較2組患者術後2箇月內消化道齣血和主要心血管不良事件的髮生情況以及不良反應髮生率. 結果 共84例患者納入研究,泮託拉唑鈉組和雷貝拉唑鈉組各42例.泮託拉唑鈉組男性23例,女性19例,平均年齡(65±8)歲;雷貝拉唑鈉組男性22例,女性20例,平均年齡(66±8)歲.隨訪期間,2組患者均未髮生消化道齣血;未齣現心肌梗死、再髮心絞痛、支架內血栓及再次血運重建等主要心血管不良事件.泮託拉唑鈉組和雷貝拉唑鈉組消化道不良反應髮生率分彆為9.5％ (4/42)和11.9％ (5/42).應用PPI前後,2組患者肝酶水平、腎功能及血常規等實驗室指標基本在正常範圍內.泮託拉唑鈉組用藥前AST平均水平為(47±28) U/L,高于雷貝拉唑鈉組的(24±13) U/L,差異有統計學意義(P =0.020);泮託拉唑鈉用藥後AST平均水平為(28±15) U/L,明顯低于用藥前,差異有統計學意義(P =0.026). 結論 PCI術後雙聯抗血小闆治療的同時加用泮託拉唑鈉或雷貝拉唑鈉可有效預防消化道齣血,且短期內不增加主要心血管不良事件的風險.靜脈給予泮託拉唑鈉與口服雷貝拉唑鈉預防消化道齣血的短期療效和安全性無明顯差異.
목적 탐토질자빙억제제(PPI)반탁랍서납화뢰패랍서납예방경피관상동맥개입(PCI)술후아사필림화록필격뢰쌍련항혈소판치료소치소화도출혈적단기료효화안전성. 방법 수집2014년2-4월재침양군구총의원행PCI수술차부합입조조건관심병환자적병력자료진행회고성분석.근거용약정황장환자분위반탁랍서납조(반탁랍서납40 mg가입0.9％록화납주사액100 ml중정맥적주,1차/d)화뢰패랍서납조(뢰패랍서납10 mg구복,1차/d).2조환자균우PCI술전3d급여아사필림、록필격뢰쌍련항혈소판치료.비교2조환자술후2개월내소화도출혈화주요심혈관불량사건적발생정황이급불량반응발생솔. 결과 공84례환자납입연구,반탁랍서납조화뢰패랍서납조각42례.반탁랍서납조남성23례,녀성19례,평균년령(65±8)세;뢰패랍서납조남성22례,녀성20례,평균년령(66±8)세.수방기간,2조환자균미발생소화도출혈;미출현심기경사、재발심교통、지가내혈전급재차혈운중건등주요심혈관불량사건.반탁랍서납조화뢰패랍서납조소화도불량반응발생솔분별위9.5％ (4/42)화11.9％ (5/42).응용PPI전후,2조환자간매수평、신공능급혈상규등실험실지표기본재정상범위내.반탁랍서납조용약전AST평균수평위(47±28) U/L,고우뢰패랍서납조적(24±13) U/L,차이유통계학의의(P =0.020);반탁랍서납용약후AST평균수평위(28±15) U/L,명현저우용약전,차이유통계학의의(P =0.026). 결론 PCI술후쌍련항혈소판치료적동시가용반탁랍서납혹뢰패랍서납가유효예방소화도출혈,차단기내불증가주요심혈관불량사건적풍험.정맥급여반탁랍서납여구복뢰패랍서납예방소화도출혈적단기료효화안전성무명현차이.
Objective To explore the short-term efficacy and safety of the proton pump inhibitor (PPI) pantoprazole sodium versus rabeprazole sodium for preventing gastrointestinal hemorrhage after percutaneous coronary intervention (PCI) which used aspirin and clopidogrel dual antiplatelet therapy.Methods The clinical data of patients who were hospitalized in the General Hospital of Shenyang Military Command during February to April 2014 and were diagnosed as coronary heart disease (CHD) and received PCI were collected and analyzed retrospectively.The patients were divided into pantoprazole group (an Ⅳ infusion of pantoprazole sodium 40 mg in 0.9％ 100 ml sodium chloride,once daily) and rabeprazole group (oral rabeprazole sodium 10 mg once daily).Three days before PCI,the two groups received dual antiplatelet therapy with clopidogrel and aspirin.The occurrence of gastrointestinal hemorrhage and major cardiovascular events and incidence of adverse reactions within two months after PCI were compared.Results A total of 84 patients were enrolled in this study,each group had 42 cases.Pantoprazole sodium group comprised 23 males and 19 females with an average age of (65 ±8) years; rabeprazole sodium group comprised 22 males and 20 females with an average age of (66 ± 8) years.During follow-up,none of the two groups of patients developed gastrointestinal hemorrhage,no cardiovascular events including myocardial infarction,recurrent angina,stent thrombosis,revascularization occurred.The incidence of gastrointestinal reaction in the pantoprazole sodium group and rabeprazole sodium group were 9.5％ (4/42) and 11.9％ (5/42),respectively.The results of liver function,kidney function and blood routine tests were within normal range in two groups before and after treatment.Before treatment,pantoprazole sodium group serum aspartate aminotransferase [(47 ± 28)U/L] was higher than that of rabeprazole sodium group [(24 ± 13)U/L],the difference was significant (P=0.020).After treatment,pantoprazole sodium group serum aspartate aminotransferase (28 ± 15) U/L was significantly lower than that before treatment (P =0.026).Conclusions In patients underwent PCI and dual antiplatelet therapy,combined treatment with pantoprazole sodium or rabeprazole sodium may be effective in preventing gastrointestinal hemorrhage and do not increase the risk of cardiovascular events within short time.There was no significant difference in efficacy and safety for preventing gastrointestinal hemorrhage in short-term between intravenous pantoprazole sodium and oral rabeprazole sodium.
