中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
22期
3413-3416
,共4页
谢彬%孙光裕%丁云岗%曾培灿%刘小翠
謝彬%孫光裕%丁雲崗%曾培燦%劉小翠
사빈%손광유%정운강%증배찬%류소취
泮托拉唑%双联抗血小板%消化道损伤%心血管事件%缺血性脑卒中
泮託拉唑%雙聯抗血小闆%消化道損傷%心血管事件%缺血性腦卒中
반탁랍서%쌍련항혈소판%소화도손상%심혈관사건%결혈성뇌졸중
Pantoprazole%Double antiplatelet drug%Digestive tract damage%Cardiovascular system incidence%Ischemic stroke
目的：研究双联抗血小板联合泮托拉唑治疗缺血性脑卒中患者是否能明显减少消化道损伤及是否增加心血管不良事件发生率。方法筛取270例确诊“缺血性脑卒中”患者，随机分为两组，入组病例均连续应用阿司匹林＋氯吡格雷双联抗血小板治疗90 d，联合治疗组为接受泮托拉唑40 mg 口服联合治疗（137例），常规治疗组不接受任何保护胃黏膜药物治疗（133例）。比较两组出现消化道损伤症状及心血管不良事件发生率。结果两组各有1例失访、随访90 d，联合治疗组（136例）出现消化不良症状26例（19．11％）；大便潜血试验阳性11例（8．08％）；排黑便4例（2．94％）；呕血0例。常规治疗组（132例）出现消化不良症状41例（31．06％）；大便 OBT（＋）23例（17．42％）；排黑便19例（14．39％）；呕血4例（3．00％）。两组各指标差异均有统计学意义（χ2＝6．66、4．56、11．20和4．18，均 P ＜0．05）。联合治疗组出现心悸胸闷等症状5例（3．68％）、心电图确诊心肌缺血4例（2．94％），心肌梗死及因心血管病死亡均为0例；常规治疗组出现心悸胸闷等症状4例（3．03％）、心电图确诊心肌缺血3例（2．27％）、心肌梗死及因心血管病死亡均为0例。两组各指标差异均无统计学意义（χ2＝0．086和0．125，均 P ＞0．05）。结论泮托拉唑对减少双联抗血小板治疗的缺血性脑卒中患者继发消化道损害发生率具有积极临床意义；其应用未增加患者心血管不良事件的发生率。
目的：研究雙聯抗血小闆聯閤泮託拉唑治療缺血性腦卒中患者是否能明顯減少消化道損傷及是否增加心血管不良事件髮生率。方法篩取270例確診“缺血性腦卒中”患者，隨機分為兩組，入組病例均連續應用阿司匹林＋氯吡格雷雙聯抗血小闆治療90 d，聯閤治療組為接受泮託拉唑40 mg 口服聯閤治療（137例），常規治療組不接受任何保護胃黏膜藥物治療（133例）。比較兩組齣現消化道損傷癥狀及心血管不良事件髮生率。結果兩組各有1例失訪、隨訪90 d，聯閤治療組（136例）齣現消化不良癥狀26例（19．11％）；大便潛血試驗暘性11例（8．08％）；排黑便4例（2．94％）；嘔血0例。常規治療組（132例）齣現消化不良癥狀41例（31．06％）；大便 OBT（＋）23例（17．42％）；排黑便19例（14．39％）；嘔血4例（3．00％）。兩組各指標差異均有統計學意義（χ2＝6．66、4．56、11．20和4．18，均 P ＜0．05）。聯閤治療組齣現心悸胸悶等癥狀5例（3．68％）、心電圖確診心肌缺血4例（2．94％），心肌梗死及因心血管病死亡均為0例；常規治療組齣現心悸胸悶等癥狀4例（3．03％）、心電圖確診心肌缺血3例（2．27％）、心肌梗死及因心血管病死亡均為0例。兩組各指標差異均無統計學意義（χ2＝0．086和0．125，均 P ＞0．05）。結論泮託拉唑對減少雙聯抗血小闆治療的缺血性腦卒中患者繼髮消化道損害髮生率具有積極臨床意義；其應用未增加患者心血管不良事件的髮生率。
목적：연구쌍련항혈소판연합반탁랍서치료결혈성뇌졸중환자시부능명현감소소화도손상급시부증가심혈관불량사건발생솔。방법사취270례학진“결혈성뇌졸중”환자，수궤분위량조，입조병례균련속응용아사필림＋록필격뢰쌍련항혈소판치료90 d，연합치료조위접수반탁랍서40 mg 구복연합치료（137례），상규치료조불접수임하보호위점막약물치료（133례）。비교량조출현소화도손상증상급심혈관불량사건발생솔。결과량조각유1례실방、수방90 d，연합치료조（136례）출현소화불량증상26례（19．11％）；대편잠혈시험양성11례（8．08％）；배흑편4례（2．94％）；구혈0례。상규치료조（132례）출현소화불량증상41례（31．06％）；대편 OBT（＋）23례（17．42％）；배흑편19례（14．39％）；구혈4례（3．00％）。량조각지표차이균유통계학의의（χ2＝6．66、4．56、11．20화4．18，균 P ＜0．05）。연합치료조출현심계흉민등증상5례（3．68％）、심전도학진심기결혈4례（2．94％），심기경사급인심혈관병사망균위0례；상규치료조출현심계흉민등증상4례（3．03％）、심전도학진심기결혈3례（2．27％）、심기경사급인심혈관병사망균위0례。량조각지표차이균무통계학의의（χ2＝0．086화0．125，균 P ＞0．05）。결론반탁랍서대감소쌍련항혈소판치료적결혈성뇌졸중환자계발소화도손해발생솔구유적겁림상의의；기응용미증가환자심혈관불량사건적발생솔。
Objective To research whether double antiplatelet drug combined with pantoprazole can reduce digestive tract damage,or aggravate cardiovascular system side effect.Methods 270 patients diagnosed as ischemic stroke received double antiplatelet drug were randomly divided into two groups.The treatment group received panto-prazole,the control group did not took any gastric drug.The side effect of the digestive and cardiovascular system was observed.Results 268 patients were followed up for 90 days,and digestive system side effect of the treatment group (136 cases)included indigestion in 26 cases(19.11%),stool occult blood(+)in 11 cases(8.08%),melena in 8 cases(5.89%),hematemesis in 0 case,and the control group (132 cases)included indigestion in 42 cases (31.82%),stool occult blood(+)in 23 cases(17.42%),melena in 19 cases(14.39%),hematemesis in 4 cases. There were significant differences between the two groups(χ2 =6.66,4.56,11.2 and 4.18,all P <0.05).Cardiovas-cular system side effect of the treatment group included palpitation or chest distress or chest pain in 4 cases (3.68%),myocardial ischemia diagnosed by electrocardiogram in 4 cases(2.94%),myocardial infarction and died of cardiovascular disease in 0 case,and the control group included palpitation or chest distress or chest pain in 4 cases (3.00%),myocardial ischemia diagnosed by electrocardiogram in 3 cases(2.27%),myocardial infarction and died of cardiovascular disease in 0 case.There were no statistical differences between the two groups(χ2 =6.66 and 4.56, both P >0.05 ).Conclusion Double antiplatelet drug combined with pantoprazole had a positive significance in reducing the digestive tract damage of ischemic stroke patients,and didn't increase the incidence of cardiovascular sys-tem side effect.
