泮托拉唑防治PCI术后消化道损伤及对抗血小板效果影响的临床研究

崔娜娟; 王一可; 崔永亮

doi:10.3969/j.issn.1671-038X.2019.05.15

泮托拉唑防治PCI术后消化道损伤及对抗血小板效果影响的临床研究

- 1. 北京市中西医结合医院呼吸科, 北京 100039;
- 2. 清华大学第一附属医院心脏中心, 北京 100016

详细信息

作者简介:
崔娜娟, 女, 博士, 主治医师, 研究方向:中西医结合消化

通讯作者: 崔永亮, E-mail:shinwalker0909@163.com

中图分类号: R57

收稿日期: 2019-01-24

Clinical study of pantoprazole in preventing and treating gastrointestinal damage and antiplatelet effect after PCI in patients with coronary heart disease

- 1. Department of Respiratory, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China;
- 2. Department of Cardiology, First Hospital of Tsinghua University, Beijing 100016, China

More Information

Corresponding author: CUI Yong-liang, E-mail: shinwalker0909@163.com

Received Date: 24 January 2019

摘要

摘要: [目的]探讨冠心病 (CHD) 介入术后应用泮托拉唑防治消化道损伤的治疗效果及其对抗血小板效果是否存在影响。[方法]入选2015年9月~2017年4月因CHD就诊于清华大学第一附属医院心脏中心并成功完成经皮冠状动脉介入术 (PCI) 的患者232例, 最终纳入符合条件的患者220例。其中男120例, 女100例, 年龄 (63.4±8.6) 岁。根据入院先后顺序随机分为观察组 (n=110) 和对照组 (n=110) 。对照组给予氯吡格雷+阿司匹林双联抗血小板等常规治疗, 观察组在对照组常规治疗基础上加用泮托拉唑口服, 所有患者术后均完善血栓弹力图检测, 随访并记录2组患者术后1年消化道不适或出血、心脑血管不良事件发生情况。[结果]随访显示对照组患者发生消化道不适症状18例, 消化道出血7例, 观察组发生消化道不适症状6例, 无发生消化道出血发生, 观察组消化道不适症状及出血的发生率均明显低于对照组, 分别为5.5 vs.16.4, 0 vs.6.4, 差异均具有统计学意义 (P均<0.05) 。血栓弹力图结果显示对照组AA抑制率 (78.4±21.9) , ADP抑制率 (37.8±25.3) , 观察组AA抑制率 (77.4±22.4) , ADP抑制率 (36.4±24.2) , 观察组与对照组相比较差异无统计学意义 (P均<0.05) 。对照组出现心脑血管不良事件5例, 观察组4例, 2组患者心脑血管不良事件的发生率无统计学意义 (P>0.05) 。[结论]PCI术后在双联抗血小板基础上加用泮托拉唑可以有效降低消化道损伤, 且并不影响抗血小板效果, 未增加心脑血管不良事件的发生率。
- 冠心病 /
- 泮托拉唑 /
- 血栓弹力图 /
- 消化道损伤
Abstract: [Objective] To explore the therapeutic effect of pantoprazole in the prevention and treatment of digestive tract injury after coronary intervention and whether it has an effect on antiplatelet effect.[Methods]Between September 2015 and April 2017, 232 patients who underwent coronary artery disease (CHD) at the Heart Center of the First Affiliated Hospital of Tsinghua University and successfully completed percutaneous coronary intervention (PCI) were enrolled.Finally, 220 eligible patients were included.There were 120 males and 100 females, aged (63.4±8.6) years old.According to the order of admission, they were randomly divided into observation group (n=110) and control group (n=110) .The control group received conventional treatments such as clopidogrel and aspirin.The observation group was given pantoprazole on the basis of the treatment of the control group.All patients improved thrombus elastogram (TEG) test, followed up and recorded the occurrence of gastrointestinal discomfort or bleeding, cardio-cerebrovascular adverse events in the two groups one year after operation.[Results]Follow-up showed that there were 18 cases of digestive tract discomfort, 7 cases of gastrointestinal bleeding in the control group, In the observation group, gastrointestinal discomfort occurred in 6 cases, and no gastrointestinal bleeding occurred, and the incidence of digestive tract discomfort and gastrointestinal bleeding in the observation group were significantly lower than the control group.The difference was statistically significant (P<0.05) for 5.5% vs.16.4%, 0 vs.6.4%.The results of thromboelastography showed that the AA inhibition rate of the control group was (78.4±21.9) %, the ADP inhibition rate was (37.8±25.3) %, the AA inhibition rate of the observation group was (77.4±22.4) %, and the ADP inhibition rate was (36.4±24.2) %.There was no significant difference between the group and the control group (P<0.05) .There were 5 cases of cardiovascular and cerebrovascular adverse events in the control group and 4 cases in the observation group.There was no significant difference in the incidence of cardiovascular and cerebrovascular adverse events between the two groups (P>0.05) .[Conclusion]Application of pantoprazole can reduce the digestive tract injury caused by double antiplatelet therapy after PCI in patients with coronary heart disease, and does not affect the dual antiplatelet effect, and does not increase the incidence of cardiovascular and cerebrovascular adverse events.
- coronary heart disease /
- pantoprazole /
- thromboelastography /
- digestive tract injury

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