冠心病患者支架植入术后氯吡格雷与不同质子泵抑制剂联合治疗的疗效比较  

Therapeutic effect of combined clopidogrel and proton pump inhibitors in patients with coronary heart disease after stent implantation

作　　者：蔡军[1] 武强[1] 刘长福[2] 王志国[2] 孙静[1] 

机构地区：[1]解放军总医院南楼临床部,北京100853 [2]解放军总医院心内科,北京100853

出　　处：《军医进修学院学报》2010年第6期535-537,共3页Academic Journal of Pla Postgraduate Medical School

基　　金：全军医药卫生科研基金课题(07BJZ01)~~

摘　　要：目的探讨不同质子泵抑制剂对氯吡格雷抗血小板作用的影响。方法286例在我院实施冠状动脉支架植入术的患者随机分为奥美拉唑40mg/d+氯吡格雷75mg/d组(146例)和泮托拉唑40mg/d+氯吡格雷75mg/d组(140例),连续用药30d,观察主要不良心脑血管事件。结果奥美拉唑组心性死亡、非致死性急性心肌梗死、紧急靶血管血运重建、脑卒中发生率分别为1.37%、2.05%、3.42%、0.68%;泮托拉唑组分别为0.71%、2.85%、2.85%、0.71%,两组无统计学差异(P>0.05)。奥美拉唑组主要不良心脑血管事件、急性亚急性血栓形成发生率分别为7.53%、1.37%,泮托拉唑组分别为7.14%、0.71%,两组亦无统计学差异(P>0.05)。两组出血事件发生率分别为9(6.16%)和9(6.42%),差异无统计学意义(P=0.926)。结论冠心病患者支架植入术后采用氯吡格雷联合奥美拉唑或泮托拉唑治疗的近期疗效相近。Objective To study the effect of different proton pump inhibitors on omeprazole resistant platelets.Methods A total of 286 patients admitted to our hospital after coronary stent implantation were randomly divided into omeprazole（40mg/d）＋ clopidogrel group（n=146）and pantoprazole（40mg/d）＋ clopidogrel（75mg/d）group（n=140）.Adverse cardiac and cerebral vascular events（MACCE）were observed for 30 days.Results The rates of death due to cardiac events,non-fetal acute infarction,acute target vascular supply reconstruction,and cerebral apoplexy were 1.37%,2.05%,3.42%,and 0.68% respectively in omeprazole＋ clopidogrel group,and were 0.71%,2.85%,2.85%,and 0.71% respectively in pantoprazole ＋ clopidogrel group（P0.05）.The rates of adverse cardiac and cerebral events and acute or subacute thrombosis were 7.53% and 1.37% respectively in omeprazole＋ clopidogrel group and were 7.14% and 0.71% respectively in pantoprazole ＋ clopidogrel group（P0.05）.The rates of bleeding were 6.16% and 6.42% respectively in the two groups.Conclusion The short-term therapeutic effects of omeprazole（40mg/d）combined with clopidogrel and pantoprazole combined with clopidogrel are similar in patients with coronary heart disease after coronary stent implantation.

关 键 词：血管成形术 经腔 经皮冠状动脉 氯吡格雷 质子泵抑制剂 

分 类 号：R969.2[医药卫生—药理学]