冠心病监护室药物预防急性心肌梗死患者消化道出血效果及成本的评价

Effect of the Preventive Drugs on Gastrointestinal Bleeding in Patients with Acute Myocardial Infarction in Coronary Care Unit and the Cost

目的观察质子泵抑制剂、H2受体拮抗剂或胃黏膜保护剂对急性心肌梗死患者消化道出血非高危人群的消化道出血预防作用,并比较药物单项成本。方法选择急性心肌梗死行急诊经皮冠状动脉介入术后收住冠心病监护室(CCU)患者114例,均接受联合抗血小板治疗和抗凝治疗。将患者随机分为3组分别接受奥美拉唑(静脉滴注80mg/d),法莫替丁(静脉滴注40mg/d)以及吉法酯(口服100mg/d)治疗。观察消化道症状、检测粪便潜血及呕吐物潜血。结果3组患者在CCU期间消化道出血征象的发生率比较,差异无统计学意义(P>0.05),预防消化道出血单项药物费用的比较,差异有统计学意义(P<0.05)。结论胃黏膜保护剂可有效预防急性心肌梗死患者中消化道出血非高危人群的消化道出血并发症。吉法酯单项药物成本最低。

Objective To evaluate the preventive effect of proton pump inhibitor,H2-receptor blocker and the membrane protective agent on gastrointestinal bleeding in non-high-risk patients with acute myocardial infarction,and evaluate the cost of each drug.Methods Totally 114 acute myocardial infarction inpatients in coronary care unit （CCU）,who received antiplatelet and anticoagulant therapy after emergent percutaneous coronary intervention,were randomly divided into three groups：respectively received Omeprazole 80mg intravenous drip once a day,Famotidine 40mg intravenous drip once a day,and Gefarnate 100mg orally once a day.The gastrointestinal symptoms were observed,and fecal and vomit occult blood were tested.Results There was no significant difference in incidence of gastrointestinal bleeding in CCU among the three group （P〈0.05）.However the cost of Gefarnate was lowest among the three （P〈0.01）.Conclusion The membrane protective agent can effectively prevent the gastrointestinal bleeding for non-high-risk patient with acute myocardial infarction,and the cost of Gefarnate was lower.