替普瑞酮联合法莫替丁防治抗血小板药物所致胃肠道损伤的效果观察

Therapeutic effect of teprenone combined with famotidine on gastrointestinal injury caused by antiplatelet drugs

目的观察替普瑞酮联合法莫替丁防治抗血小板药物所致胃肠损伤的疗效。方法 选取2016年8月至2018年11月化州市人民医院收治的胃肠道损伤患者84例。依据治疗方法分为3组:质子泵抑制剂(PPI)组、H2受体拮抗剂(H2RA)组和联合治疗组,每组28例。所有患者均继续进行抗血小板治疗。PPI组服用泮托拉唑;H2RA组服用法莫替丁;联合治疗组在H2RA组基础上加服替普瑞酮。共治疗6个月。对比3组患者治疗前后各指标变化情况。采用SPSS24.0软件进行数据处理。结果 治疗后,联合治疗组患者的前列腺素E2(PGE2)显著高于PPI组和H2RA组[(83.46±16.83)vs(46.61±14.53)vs(55.67±18.49)ng/L],血栓素B2(TXB2)显著低于PPI组和H2RA组[(139.96±48.69)vs(297.38±44.09)vs(173.82±51.25)pg/L],基础胃酸分泌量高于PPI组、低于H2RA组[(3.86±0.67)vs(2.29±0.56)vs(4.97±0.89)mmol/h],差异具有统计学意义(P<0.05)。治疗后联合治疗组患者胃[(0.76±0.37)vs(3.38±2.11)vs(3.04±1.93)分]和十二指肠[(0.81±0.32)vs(3.19±1.52)vs(2.91±1.49)分]黏膜的改良Lanza量表评分显著低于PPI组与H2RA组(P<0.05)。联合治疗组患者不良反应发生率显著低于PPI组和H2RA组(17.9%vs53.6%vs28.6%,P<0.05)。结论 替普瑞酮联合法莫替丁防治抗血小板药物所致胃肠损伤的疗效显著且不良反应少,值得临床推广应用。

Objective To observe the efficacy of teprenone combined with famotidine in the prevention and treatment of gastro- intestinal injury caused by antiplatelet drugs. Methods A total of 84 patients with gastrointestinal injuries caused by antiplatelet drugs admitted in Huazhou People′s Hospital from August 2016 to November 2018 were enrolled in this study. They were divided into 3 groups ( n =28), that is, proton pump inhibitor group (PPI, pantoprazole), H2 receptor antagonist group (H2RA, famotidine), and combined treatment group (teprenone and famotidine). All patients continued to receive antiplatelet therapy. The related indicators were observed before and in 6 months after treatment, and the results were compared among the 3 groups. SPSS statistics 24.0 was used to perform the statistical analysis. Results After treatment, the combined treatment group had significantly higher prostaglandin E2 level [PGE2,( 83.46±16.83 ) vs (46.61±14.53) vs (55.67±18.49)ng/L], but obviously lower thromboxane B2 [TXB2,(139.96±48.69) vs (297.38±44.09) vs (173.82±51.25)pg/L] when compared with the PPI group and the H2RA group. But the gastric acid secretion in the combined treatment group was higher than the PPI group and lower than the H2RA group [(3.86±0.67) vs (2.29±0.56) vs (4.97±0.89)mmol/h, P <0.05]. What′s more, the modified Lanza scale scores of the gastric and duodenal mucosa in the combined treatment group were significantly lower than those in the PPI group and the H2RA group [(0.76±0.37) vs ( 3.38±2.11 ) vs ( 3.04±1.93 ),(0.81±0.32) vs (3.19±1.52) vs (2.91±1.49), P <0.05]. The incidences of adverse reactions were also significantly lower in the combined treatment group than the other 2 groups (17.9% vs 53.6% vs 28.6%, P <0.05). Conclusion The combination of teprenone and famotidine exerts significant efficacy and has few adverse reactions in the prevention and treatment of gastrointestinal injuries caused by antiplatelet drugs, which is worthy of clinical application.