摘要
目的:急性冠状动脉综合征(ACS)置入支架患者使用盐酸替罗非班、阿司匹林、氯吡格雷、低分子肝素(四联)时,评价泮托拉唑对消化道的保护作用。方法:选择ACS置入支架治疗的患者266例,随机分入观察组134例,对照组132例,所有患者均服用阿司匹林、氯吡格雷、低分子肝素和盐酸替罗非班。观察组患者静脉注射泮托拉唑40 mg/d 4～5天,之后改为泮托拉唑片剂40 mg/次,2次/天,服用30天。观察两组间30天全因死亡、再次心肌梗死、再次经皮冠状动脉介入治疗(PCI)、再次住院、颅内出血和消化道出血状况。结果:观察组134例患者30天内全因死亡5例、再次心肌梗死4例、再次PCI4例和再次住院8例;对照组132例患者分别为8例、6例、5例和13例,两组相比差异均无统计学意义(P>0.05);两组均无颅内出血发生。观察组消化道大出血0和总消化道出血事件3例,对照组分别为5例和15例,两组比较观察组消化道大出血和总消化道出血事件少于对照组(P<0.05),差异均有统计学意义。结论:ACS置入支架治疗的患者,盐酸替罗非班治疗是安全有效的,未见颅内出血发生。静脉注射和口服泮托拉唑并不增加30天全因死亡、再次心肌梗死、再次PCI和再次住院发生,同时可以减少30天内消化道出血发生率特别是消化道大出血事件的发生,具有良好的消化道保护作用和安全性。
Objective ：To evaluate the efficacy and safety of pantoprazole in patients with acute coronary syndrome（ACS） after percutaneous coronary intervention（PCI） who were treated with tirofihan,aspirin ,elopidogrel and low molecular weight heparin（LMWH）.
Methods：A total of 266 ACS patients who underwent PCI with the combined medications of tirofiban, aspirin, elopidogrel and LMWH were divided into two groups. Pantoprazole group, n = 134, the patients received intravenous pantoprazole 40mg/day for 4 - 5 days, and then continued with oral pantoprazole 40mg twice per day for 30 days, and Control group, n = 132, the patients were not treated with pantoprazole. We compared the all-cause deaths, recurrence of myocardial infarction （ MI ）, revascularization, rehospitalization,intracranial hemorrhage and gastrointestinal bleeding in 30 days for all patients between two groups. Results ：There were no significant differences between Pantoprazole group and Control group in terms of all-cause deaths（5/ 134 vs. 8/132 ）, MI recurrence （ 4/134 vs. 6/132 ）, revascularization （ 4/134 vs. 5/132 ） and re-hospitalization （ 8/134 vs. 13/ 132 ） , P〉0. 05 respectively. No intracranial hemorrhage occurred in neither group, there were less major hemorrhage （0/134 vs. 5/ 132 ）and less gastrointestinal bleeding（ 3/134 vs. 15/132 ）in Pantoprazole group than that in Control group, P〈0. 05 respectively.
Conclusion：Pantoprazole can decrease the gastrointestinal bleeding in patients with ACS who underwent PCI with the combined medications of tirofiban, aspirin, clopidogrel and LMWH.
出处
《中国循环杂志》
CSCD
北大核心
2011年第3期178-181,共4页
Chinese Circulation Journal
