泮托拉唑钠与雷贝拉唑钠预防经皮冠状动脉介入术后消化道出血的疗效和安全性比较  

Efficacy and safety of pantoprazole sodium versus rabeprazole sodium in prevention of gastrointestinal hemorrhage after percutaneous coronary intervention

作　　者：张丽新[1] 樊蓉[1] 任天舒[1] 任刘丽 党大胜[1] 史国兵[1] 

机构地区：[1]沈阳军区总医院药学部,110840

出　　处：《药物不良反应杂志》2015年第1期11-14,共4页Adverse Drug Reactions Journal

摘　　要：目的 探讨质子泵抑制剂（PPI）泮托拉唑钠和雷贝拉唑钠预防经皮冠状动脉介入（PCI）术后阿司匹林和氯吡格雷双联抗血小板治疗所致消化道出血的短期疗效和安全性. 方法 收集2014年2-4月在沈阳军区总医院行PCI手术且符合入组条件冠心病患者的病历资料进行回顾性分析.根据用药情况将患者分为泮托拉唑钠组（泮托拉唑钠40 mg加入0.9％氯化钠注射液100 ml中静脉滴注,1次/d）和雷贝拉唑钠组（雷贝拉唑钠10 mg口服,1次/d）.2组患者均于PCI术前3d给予阿司匹林、氯吡格雷双联抗血小板治疗.比较2组患者术后2个月内消化道出血和主要心血管不良事件的发生情况以及不良反应发生率. 结果 共84例患者纳入研究,泮托拉唑钠组和雷贝拉唑钠组各42例.泮托拉唑钠组男性23例,女性19例,平均年龄（65±8）岁;雷贝拉唑钠组男性22例,女性20例,平均年龄（66±8）岁.随访期间,2组患者均未发生消化道出血;未出现心肌梗死、再发心绞痛、支架内血栓及再次血运重建等主要心血管不良事件.泮托拉唑钠组和雷贝拉唑钠组消化道不良反应发生率分别为9.5％ （4/42）和11.9％ （5/42）.应用PPI前后,2组患者肝酶水平、肾功能及血常规等实验室指标基本在正常范围内.泮托拉唑钠组用药前AST平均水平为（47±28） U/L,高于雷贝拉唑钠组的（24±13） U/L,差异有统计学意义（P =0.020）;泮托拉唑钠用药后AST平均水平为（28±15） U/L,明显低于用药前,差异有统计学意义（P =0.026）. 结论 PCI术后双联抗血小板治疗的同时加用泮托拉唑钠或雷贝拉唑钠可有效预防消化道出血,且短期内不增加主要心血管不良事件的风险.静脉给予泮托拉唑钠与口服雷贝拉唑钠预防消化道出血的短期疗效和安全性无明显差异.Objective To explore the short-term efficacy and safety of the proton pump inhibitor （PPI） pantoprazole sodium versus rabeprazole sodium for preventing gastrointestinal hemorrhage after percutaneous coronary intervention （PCI） which used aspirin and clopidogrel dual antiplatelet therapy.Methods The clinical data of patients who were hospitalized in the General Hospital of Shenyang Military Command during February to April 2014 and were diagnosed as coronary heart disease （CHD） and received PCI were collected and analyzed retrospectively.The patients were divided into pantoprazole group （an Ⅳ infusion of pantoprazole sodium 40 mg in 0.9% 100 ml sodium chloride,once daily） and rabeprazole group （oral rabeprazole sodium 10 mg once daily）.Three days before PCI,the two groups received dual antiplatelet therapy with clopidogrel and aspirin.The occurrence of gastrointestinal hemorrhage and major cardiovascular events and incidence of adverse reactions within two months after PCI were compared.Results A total of 84 patients were enrolled in this study,each group had 42 cases.Pantoprazole sodium group comprised 23 males and 19 females with an average age of （65 ±8） years; rabeprazole sodium group comprised 22 males and 20 females with an average age of （66 ± 8） years.During follow-up,none of the two groups of patients developed gastrointestinal hemorrhage,no cardiovascular events including myocardial infarction,recurrent angina,stent thrombosis,revascularization occurred.The incidence of gastrointestinal reaction in the pantoprazole sodium group and rabeprazole sodium group were 9.5% （4/42） and 11.9% （5/42）,respectively.The results of liver function,kidney function and blood routine tests were within normal range in two groups before and after treatment.Before treatment,pantoprazole sodium group serum aspartate aminotransferase [（47 ± 28）U/L] was higher than that of rabeprazole sodium group [（24 ± 13）U/L],the difference was significant （P=0.020）.After treatment,pantopr

关 键 词：质子泵抑制剂 泮托拉唑 雷贝拉唑 经皮冠状动脉介入治疗 胃肠出血 

分 类 号：R57[医药卫生—消化系统]