奥美拉唑和氯吡格雷对颈动脉支架内血栓形成的临床研究

Clinical study of clopidogrel with or without omeprazole in the in-stent restenosis

目的观察服用质子泵抑制剂奥美拉唑后对颈动脉支架置入术后患者支架内血栓形成的影响。方法选取行颈动脉支架置入术的67例患者,术前行幽门螺杆菌检测。其中28例支架置入术后,幽门螺杆菌阳性者、既往有消化性溃疡病史和胃大部切除的患者,在服用氯吡格雷和阿司匹林的同时,加用奥美拉唑6个月;39例支架置入术后,幽门螺杆菌阴性的患者仅服用氯吡格雷和阿司匹林,在术后3、6个月应用经颅多普勒超声复查置入支架的血管的血流情况。结果支架置入术后3、6个月复查经颅多普勒超声,显示服用与未服用奥美拉唑的患者在平均血流速度和波动指数差异无统计学意义(P>0.05)。结论氯吡格雷和奥美拉唑联用,不会影响血管支架置入术后的支架内血栓形成。

Objective To investigate clopidogrel with or without omeprazole in the in - stent restenosis. Methods A prospec- tive study was performed of 67 patients with unilateral severe stenosis of the carotid artery that underwent carotid angioplasty with stenting （CAS）. Helicobacter pylori （Hp） was detected before underwent CAS. Patients who had Hp, peptic ulcer and gastric remnant, took clopi- dogrel,aspirin and omeprazole. Transcranial Doppler （TCD） was confirmed the in - stent restenosis after underwent CAS at 3 and 6 months. Results There was no significant difference in TCD in the two groups （ P 〈 0.05 ）. Conclusion There is no apparent in - stent restenosis between clopidogrel and omeprazole.