泮托拉唑降低PCI术后双联抗血小板治疗患者胃肠道出血风险

Pantoprazole reduces risk of gastrointestinal bleeding in patients receiving dual antiplatelet therapy after PCI

目的探讨泮托拉唑对PCI术后双联抗血小板治疗患者胃肠道出血风险及心血管不良事件发生率的影响。方法选取609名2018年10月—2019年6月在郑州大学第一附属医院心内科因急性冠脉综合征住院并行PCI术,术后采取双联抗血小板药物治疗的患者,根据是否联合服用泮托拉唑分为A、B两组。A组为双联抗血小板加泮托拉唑治疗组,B组为双联抗血小板治疗组。搜集并比较两组基线资料,随访1年,记录胃肠道出血及心血管不良事件发生的时间。结果 (1)A、B两组患者基线资料无统计学差异(P>0.05);(2)A组患者胃肠道出血事件的发生率较B组患者低(P<0.05),其中A组患者胃肠道出血事件的发生率为1.48%;B组患者胃肠道出血事件的发生率为5.69%,差异有统计学意义;(3)A、B两组患者心血管不良事件的发生率无统计学差异(P>0.05),A组患者Re-ACS、TVR、心源性死亡事件的发生率分别为7.40%、5.18%、0.00%;B组患者Re-ACS、TVR、心源性死亡事件的发生率分别为9.07%、5.90%、0.21%。结论泮托拉唑能降低PCI术后双联抗血小板治疗患者胃肠道出血风险,且不增加心血管不良事件发生的风险。

Objective To investigate the effect of pantoprazole on gastrointestinal bleeding risk and cardiovascular adverse events in patients with dual antiplatelet therapy after PCI.Methods A total of 609 patients who were admitted to the Department of Cardiology of the First Affiliated Hospital of Zhengzhou University from October 2018 to June 2019 for acute coronary syndrome and underwent PCI and received dual antiplatelet therapy were selected and divided into two groups according to whether they took pantoprazole combined or not. Group A was treated with dual antiplatelet plus pantoprazole, and group B was treated with dual antiplatelet therapy. The baseline data of the two groups are collected and compared. The time of gastrointestinal bleeding and cardiovascular adverse events is recorded during the follow-up of 1 year.Results(1)There is no statistical difference in baseline data between the two groups(P>0.05).(2) The incidence of gastrointestinal bleeding in group A is lower than that in group B(P<0.05). The incidence of gastrointestinal bleeding in group A was 1.48%;The incidence of gastrointestinal bleeding in group B was 5.69%, and the difference was statistically significant.(3) There is no significant difference in the incidence of cardiovascular adverse events between group A and group B(P>0.05). The incidences of Re-ACS, TVR and cardiac death in group A were 7.40%, 5.18% and 0.00% respectively. The incidences of Re-ACS, TVR and cardiac death in group B were 9.07%, 5.90% and 0.21%, respectively.Conclusion Pantoprazole can reduce the risk of gastrointestinal bleeding in patientsreceiving dual antiplatelet therapy after PCI without increasing the risk of cardiovascular adverse events.