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既往非瓣膜性心房颤动合并急性心肌梗死患者住院期间抗栓治疗研究 被引量:3
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作者 赵明磊 毕齐 《中国卒中杂志》 2017年第2期124-130,共7页
目的回顾性调查既往非瓣膜性心房颤动(non-valvular atrial fibrillation,NVAF)合并急性心肌梗死(acute myocardial infarction,AMI)患者抗栓治疗实际应用情况,并分析住院期间双抗治疗(阿司匹林联合氯吡格雷或替格瑞洛)基础上肠外抗凝... 目的回顾性调查既往非瓣膜性心房颤动(non-valvular atrial fibrillation,NVAF)合并急性心肌梗死(acute myocardial infarction,AMI)患者抗栓治疗实际应用情况,并分析住院期间双抗治疗(阿司匹林联合氯吡格雷或替格瑞洛)基础上肠外抗凝的抗栓疗效。方法纳入首都医科大学附属北京安贞医院2010年1月-2015年12月因AMI住院且出院诊断为AMI和NVAF患者143例,其中NVAF病程≥1个月,统计抗栓治疗实际应用情况,将住院期间使用双抗治疗和肠外抗凝联合双抗治疗患者分为双抗组(33例)和三抗组(102例),比较两组间出血性事件[采用出血学术研究会(Bleeding Academic Research Consortium,BARC)出血定义]和缺血性事件(缺血性卒中、急性冠脉综合征再发和外周动脉栓塞)发生。结果 1143例入选患者仅12.6%(18/143例)入院前使用华法林抗凝治疗。住院期间,71.3%(102/143例)患者使用肠外抗凝联合双抗,部分患者未使用任何抗凝治疗,双抗占23.1%(33/143例),单抗(阿司匹林或氯吡格雷或替格瑞洛)占2.1%(3/143例)。患者出院带药中,超过2/3患者使用双抗治疗,比例占76.9%(103/134例),华法林联合双抗比例仅占4.5%(6/134例)。2住院期间双抗组相较于三抗组总出血性事件(BARC 2~5)、重大出血事件(BARC 3,5)和轻微出血事件(BARC2)发生率低(3.0%vs 7.8%,0 vs 1.0%,3.0%vs 6.9%),而缺血性事件、缺血性卒中、外周动脉栓塞的发生率高(6.1%vs 3.9%,6.1%vs 1.0%,3.0%vs 0),但两组间差异均无显著性(P>0.05)。结论本研究结果提示既往NVAF合并AMI患者住院期间部分患者未使用任何抗凝治疗,双抗基础上肠外抗凝治疗并未显著降低栓塞事件和增加出血事件,该类患者二级预防三重抗栓治疗比例很低。 展开更多
关键词 非瓣膜性心房颤动 急性心肌梗死 抗栓治疗 抗栓治疗
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Omeprazole-based triple therapy with low-versus high-dose of clarithromycin plus amoxicillin for H pylori eradication in Iranian population 被引量:3
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作者 Ali Asghar Keshavarz Homayoon Bashiri Mahtab Rahbar 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第6期930-933,共4页
AIM: To investigate the efficacy and tolerability of H pylori eradication in an omeprazole-based triple therapy with high-and low-dose of clarithromycin and amoxicillin. METHODS: One hundred and sixty H pylori positiv... AIM: To investigate the efficacy and tolerability of H pylori eradication in an omeprazole-based triple therapy with high-and low-dose of clarithromycin and amoxicillin. METHODS: One hundred and sixty H pylori positive patients were randomly assigned to two groups based on the following 2 wk investigation; (1) group A or low-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 250 mg b.i.d and amoxicillin 500 mg b.i.d; and (2) group B or high-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 500 mg b.i.d and amoxicillin 1000 mg b.i.d. During the study H pylori status was assessed by histology and rapid urease test prior and by 13C-urea breath test 6 wk after the therapy. Standard questionnaires were administered to determine the compliance to treatment and possible adverse events of therapy. Data were subject to χ2 to compare the eradication rates in the two groups. The significant level of 95% (P ≤ 0.05) was considered statistically different. RESULTS: We found that the per-protocol eradication rate was 88% (68/77) in group A, and 89% (67/75) in group B. The intension-to-treat eradication rate was 85% (68/80) in group A and 83.75% (67/80) in group B. Overall adverse events were 26% in group A and 31% in group B. The adverse events were generally mild in nature and tolerated well in both groups with a compliance of 98% in group A vs 96% in group B. CONCLUSION: The omeprazole-based low dose regimen of clarithromycin and amoxicillin for two weeks in H pylori eradication is as effective as high dose regimen in Iranian population. 展开更多
关键词 伊朗人群 幽门螺杆菌根除术 三重治疗 奥美拉唑 克拉霉素 药物剂量 阿莫西林
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