老年冠心病患者经皮冠状动脉介入治疗术后应用雷贝拉唑的安全性分析

Safety of Rabeprazole in Elderly Coronary Heart Disease Patients Treated by Percutaneous Coronary Intervention

目的分析老年冠心病患者经皮冠状动脉介入治疗(PCI)术后应用雷贝拉唑的安全性。方法选取2011年3月—2012年11月在安庆市第一人民医院心血管内科住院的老年冠心病患者120例(年龄≥60岁),随机分为对照组和雷贝拉唑组,每组60例。两组患者均接受PCI,并于术前、术后口服阿司匹林、氯吡格雷及冠心病治疗药物,雷贝拉唑组患者在PCI术后口服雷贝拉唑钠肠溶胶囊,20 mg/d。观察两组患者上消化道不良反应发生情况,PCI术后3、6个月大便隐血试验阳性率,PCI术后6个月、1年主要复合终点发生情况。结果两组患者均获得随访,无一例失访,无一例死亡。雷贝拉唑组患者上消化道不良反应发生率,PCI术后3、6个月大便隐血试验阳性率均低于对照组(P<0.01);两组患者PCI术后6个月、1年主要复合终点发生率比较,差异无统计学意义(P>0.05)。结论雷贝拉唑有助于减少老年冠心病患者PCI术后上消化道不良反应、消化道出血的发生,且不增加其不良临床结局的发生风险,安全性较高。

Objective To analyze the safety of rabeprazole in elderly coronary heart disease patients treated by pereu- taneous coronary intervention （PCI）. Methods From March 2011 to November 2012, 120 coronary heart disease patients aged over 60 years old were selected in the Department of Cardiology, the First People＇s Hospital of Anqing, and they were randomly divided into control group and rabeprazole group, 60 cases in each. Both groups underwent PCI and given aspirin, clopidogrel, coronary heart disease drug therapy before and after PCI, rabeprazole group received extra rabeprazole sodium enteric - coated capsules after PCI, 20 mg per night. The incidence of upper gastrointestinal adverse reactions, positive rate of fecal occult blood testing three months and six months after PC/, incidence of composite endpoint six months and one year after PC/between the two groups were compared. Results All of the patients were followed - up, and no one died. The incidence of upper gastrointestinal adverse reactions, positive rate of fecal occult blood testing three months and six months after PCI of rabeprazole group were lower than those of control group （P 〈0. 01 ） ; no significant differences was found of incidence of composite endpoint six months and one year after PCI between the tWO groups （P 〉 0. 05）. Conclusion Rabeprazole is helpful to reduce the incidence of upper gastrointestinal adverse reactions and alimentary tract hemorrhage in elderly coronary heart disease patients treated by PCI, with- out increasing the incidence of adverse clinical outcome, and is safe.