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使用替罗非班时泮托拉唑对非ST段抬高型急性冠脉综合征患者消化道保护作用的评(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第3期
页码:
366-369
栏目:
临床研究
出版日期:
2012-06-25

文章信息/Info

Title:
Evaluation of the efficacy and safety of pantoprazole with tirofiban in protecting the alimentary canal of non-ST elevation acute coronary syndrome
作者:
帕尔哈提1; 李 岚1; 赵勤英2; 姜述斌1; 张宝简1; 毛拉提1; 马 俊1
(1.新疆医科大学附属中医医院心脏中心，新疆 乌鲁木齐 830000；2.新疆民政康复医院，新疆 乌鲁木齐 830094)
Author(s):
PA Er-ha-ti1;  LI Lan1;  ZHAO Qin-ying2;  JIANG Shu-bin1;  ZHANG Bao-jian1;  MAO La-ti1;  MA Jun1
(1.Center of Cardiology, Fourth Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, Xinjiang, China; 2.Civil Administration Rehabilitation Hospital of Xinjiang, Urumuqi 830094, Xinjiang, China)
关键词:
泮托拉唑; 替罗非班; 急性冠脉综合征
Keywords:
pantoprazole;  tirofiban;  acute coronary syndrome
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:盐酸替罗非班、阿司匹林、氯吡格雷、低分子肝素（四联）联合使用治疗急性冠脉综合征(ACS)患者时，评价静脉注射泮托拉唑对消化道保护的疗效和安全性。方法： 选择住院ACS患者296例，随机分为试药组184例，对照组112例，所有患者均服用阿司匹林、氯吡格雷、低分子肝素和使用2～3 d盐酸替罗非班。在此基础上试药组患者静脉输注泮托拉唑40 mg/d，4~5 d，再服用泮托拉唑片剂40 mg/次，2次/d，连服8 d。结果： 试药组8 d内全因死亡、顽固性心绞痛、再次心肌梗死、急诊经皮冠状动脉介入治疗(PCI)数较对照组显著减少（P<0.05）；试药组与对照组比较消化道出血发生率（2.2% vs. 12.5%）、TIMI小出血发生率(1.6% vs. 6.2%)和TIMI较小出血发生率(0.5% vs. 5.4%)明显降低（P<0.05）。结论： 在四联抗栓治疗ACS患者时，静脉注射和口服泮托拉唑可以减少8 d内消化道出血发生率，从而减少了8 d内患者死亡、顽固性心绞痛、再次心肌梗死、急诊PCI数，具有良好的消化道保护作用和安全性。
Abstract:
AIM:To evaluate the efficacy and safety of protecting the alimentary canal with pantoprazole when using the quadruple therapy: aspirin, clopidogrel, low molecular weight heparin (LMWH) and tirofiban hydrochloride in acute coronary syndrome (ACS). METHODS: Two hundred and ninety-six selected hospitalized patients with ACS were divided into observation group (n=184) and control group (n=112). Aspirin, clopidogrel, LMWH and 2-3 days of tirofiban were administered to all patients. On this basis, pantoprazole 40 mg i.v. was first administered by drip phleboclysis for 4-5 days and then changed to tablets (40 mg twice daily) for 8 days in the observation group. RESULTS: Occurrence of 8-day all-cause death, refractory angina pectoris, relapse myocardial infarction and emergency percutaneous coronary intervention (PCI) in the observation group was lower than that in the control group (P<0.05). The number of total hemorrhages, mild hemorrhages and midrange hemorrhages in the control group was higher than in the observation group (P<0.05). CONCLUSION: Intravenous injection and oral administration of pantoprazole decreased the 8-day rate of alimentary tract hemorrhage when using the quadruple anti-thrombosis therapy for ACS, thus decreasing the number of all-cause death for 8 days, intractable angina pectoris, intractable angina, relapse myocardial infarction and emergency PCI.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2011-06-27.通讯作者：姜述斌，主任医师，主要从事心血管危重症抢救研究 Email：13565852840@139.com 作者简介：帕尔哈提，主任医师 Email：peht324@sina.cn
更新日期/Last Update: 2012-05-02