不同质子泵抑制剂对预防急性心肌梗死介入术后合并应激性消化道出血的效果分析  

Effect of different proton pump inhibitors on prevention of stress gastrointestinal bleeding after percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：蔡新强 周斌 孔爱民 Cai Xinqiang, Zhou Bing, Kong Aimin(The Traditional Chinese Medicine Hospital of Yiyang County,Yiyang,Jiangxi 33440)

机构地区：[1]弋阳县中医院,江西弋阳334400

出　　处：《基层医学论坛》2018年第26期3642-3643,共2页The Medical Forum

基　　金：江西省卫生计生委科技计划课题(20187304)

摘　　要：目的探讨不同质子泵抑制剂(PPI)对预防急性心肌梗死介入术后并发应激性消化道出血的效果。方法选取我院行经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者164例,随机分为A、B、C和D组,各41例。所有患者予氯吡格雷和阿司匹林抗血小板治疗,在此基础上,A组予奥美拉唑治疗,B组予埃索美拉唑治疗,C组予泮托拉唑治疗,D组不予PPI。比较4组患者应激性消化道出血率及治疗前、后的血小板聚集率。结果 D组的消化道出血率明显高于A、B、C 3组(P<0.05),前3组间比较差异无统计学意义(P>0.05)。4组患者治疗后7 d血小板聚集率明显降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论奥美拉唑、泮托拉唑、埃索美拉唑应用于行PCI的AMI患者临床效果相近,均能明显降低应激性消化道出血发生率,且对血小板聚集效应无明显影响,值得临床推广应用。Objective Investigate the effect of different proton pump inhibitors（PPI）on prevention of stress gastrointestinal bleeding after percutaneous coronary intervention in patients with acute myocardial infarction.Methods164 patients with acute myocardial infarction（AMI） undergoing percutaneous coronary intervention（PCI） in our hospital were randomly divided into A,B,C and D groups,41 cases in each group.All patients were treated with clopidogrel and aspirin for antiplatelet therapy.On this basis,group A was treated with omeprazole,group B was treated with esomeprazole,group C was treated with pantoprazole,and group D was not PPI.The incidence of stress gastrointestinal bleeding and platelet aggregation rate before and after treatment were compared between the 4 groups.Results The gastrointestinal bleeding rate in group D was significantly higher than that in group A,B and C（P0.05）.There was no significant difference between the first 3 groups（P0.05）,and the three groups had no significant difference（P0.05）.The platelet aggregation rate of the 4 groups decreased significantly after treatment（P0.05）,but there was no significant difference between the 4 groups（P0.05）.Conclusion The clinical effect of omeprazole,pantoprazole and Esomeprazole in the patients with PCI AMI can obviously reduce the incidence of stress gastrointestinal bleeding and have no obvious effect on the platelet aggregation effect.It is worthy of clinical application.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 应激性消化道出血 质子泵抑制剂 

分 类 号：R542.22[医药卫生—心血管疾病] R57[医药卫生—内科学]