不同质子泵抑制剂对阿司匹林抗血小板作用的影响

Effects of different proton pump inhibitors on antiplatelet effect of aspirin

目的探讨稳定型心绞痛患者在服用阿司匹林及质子泵抑制剂(PPI)时,抑酸药物对阿司匹林抗血小板聚集作用的影响。方法选取90例稳定型心绞痛患者,随机分为四组,对照组:服用阿司匹林+安慰剂;奥美拉唑组:服用阿司匹林+奥美拉唑片;兰索拉唑组:服用阿司匹林+兰索拉唑片;泮托拉唑组:服用阿司匹林+泮托拉唑片。四组患者在给药前1天、服药后30天分别测定血小板聚集率,同时记录各组患者的不良反应。结果四组患者治疗前血小板聚集率无明显差异(P>0.05),应用阿司匹林治疗后血小板聚集率均显著降低,差异有统计学意义(P<0.01)。服药30天后质子泵抑制剂组与对照组相比较血小板聚集率无明显差异(P>0.05)。结论奥美拉唑、兰索拉唑及泮托拉唑对阿司匹林的抗血小板作用均无明显影响。

Objective To investigate the effects of acid suppressive drugs on the anti platelet aggregation effect of aspirin and proton pump inhibitor（PPI） in patients with stable angina pectoris.Methods 90 cases of patients with stable angina pectoris were randomly divided into four groups： the control group of 21 patients taking placebo once daily Aspirin Enteric-coated Tablets 100 mg ＋.Omeprazole group 25 cases,taking Aspirin Entericcoated Tablets 100 mg ＋ Omeprazole Enteric-coated Tablets 20 mg,once a day.Lansoprazole group 22 cases,taking Aspirin Enteric-coated Tablets 100 mg ＋ Lansoprazole Tablets 30 mg,once a day.Pantoprazole group 22 cases,taking Aspirin Enteric-coated Tablets 100mg＋ pantoprazole tablets 40 mg,once a day.Platelet aggregation rate was determined 1 day before and 30 days after treatment,and adverse reactions were recorded at the same time in the four groups.Results There was no significant difference in platelet aggregation rate（P〈0.05）between the four groups before and after treatment.The rate of platelet aggregation was significantly decreased after aspirin therapy,and the difference was statistically significant（P〈0.01）.There was no significant difference in platelet aggregation rate（P〉0.05） between the proton pump inhibitor group and the control group after 30 days.Conclusions There were no obvious effects of antiplatelet effect of omeprazole,lansoprazole and pantoprazole on aspirin.