摘要
AIM To determine the preventive effect and safetyof proton pump inhibitors （PPIs） in low-dose aspirin（LDA）-associated gastrointestinal （GI） ulcers andbleeding.METHODS： We searched MEDLINE, EMBASE and theCochrane Controlled Trials Register from inception toDecember 2013, and checked conference abstracts ofrandomized controlled trials （RCTs） on the effect ofPPIs in reducing adverse GI events （hemorrhage, ulcer,perforation, or obstruction） in patients taking LDA.The preventive effects of PPIs were compared with thecontrol group [taking placebo, a cytoprotective agent,or an H2 receptor antagonist （H2RA）] in LDA-associatedupper GI injuries. The meta-analysis was performedusing RevMan 5.1 software.RESULTS： We evaluated 8780 participants in 10 RCTs.The meta-analysis showed that PPIs decreased the riskof LDA-associated upper GI ulcers （OR = 0.16; 95%CI：0.12-0.23） and bleeding （OR = 0.27; 95%CI： 0.16-0.43）compared with control. For patients treated with dualanti-platelet therapy of LDA and clopidogrel, PPIs wereable to prevent the LDA-associated GI bleeding （OR =0.36; 95%CI： 0.15-0.87） without increasing the riskof major adverse cardiovascular events （MACE） （OR =1.00; 95%CI： 0.76-1.31）. PPIs were superior to H2RAin prevention of LDA-associated GI ulcers （OR = 0.12;95%CI： 0.02-0.65） and bleeding （OR = 0.32; 95%CI：0.13-0.79）.CONCLUSION： PPIs are effective in preventing LDAassociatedupper GI ulcers and bleeding. Concomitantuse of PPI, LDA and clopidogrel did not increase therisk of MACE.
