汉族急性冠状动脉综合征患者使用质子泵抑制药对阿司匹林联合替格瑞洛抗血小板作用的影响  

Study on the interaction between proton pump inhibitor and ticagrelor in acute coronary syndrome population of Han people

作　　者：袁冬冬[1] 郭丽萍[1] 王高彪 向倩[2] 谢秋芬[2] 崔一民[2] YUAN Dong-dong;GUO Li-ping;WANG Gao-biao;XIANG Qian;XIE Qiu-fen;CUI Yi-min(Department of Pharmacy,Zhengzhou Seventh People's Hospital,Zhengzhou 450001,Henan Province,China;Department of Pharmacy,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]郑州市第七人民医院药学部,河南郑州450001 [2]北京大学第一医院药剂科,北京100034

出　　处：《中国临床药理学杂志》2020年第9期1051-1053,1061,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家重点研发计划精准医学研究重点专项课题基金资助项目(2016YFC0904900);郑州市科技局常州四药临床药学科研基金资助项目(CZSYJJ15006)。

摘　　要：目的探讨汉族急性冠状动脉综合征(ACS)患者使用质子泵抑制药(PPI)对阿司匹林联合替格瑞洛抗血小板作用的影响。方法将90例汉族ACS患者在给予阿司匹林联合替格瑞洛的基础上,根据使用不同PPI类药物分为奥美拉唑组18例、兰索拉唑组18例、泮托拉唑组18例、雷贝拉唑组18例和对照组(未联合使用PPI类药物)18例。用Verifynow法测定血小板反应单位(PRU),并比较不同组别间的差异。随访6个月,记录6个月内主要不良心脏事件(MACE)、出血事件和药物不良反应的发生情况。结果对照组、奥美拉唑组、兰索拉唑组、泮托拉唑组和雷贝拉唑组的平均PRU分别为(38.52±38.77),(18.09±18.90),(28.62±19.06),(30.35±40.86)和(18.50±20.50),其中奥美拉唑组与对照组比较,差异有统计学意义(P<0.05)。随访6个月,主要不良心脏事件(MACE)发生6例,出血事件发生33例,药物不良反应发生27例,各组的发生率均无显著差异。结论奥美拉唑组与对照组的PRU有显著性差异,但长期随访结果显示该差异无临床意义,因此PPI类药物对阿司匹林联合替格瑞洛抗血小板药效无临床意义上的相互作用。Objective To investigate the effect of proton pump inhibitor(PPI)on the antiplatelet effect of aspirin combined with ticagrelor in patients with acute coronary syndrome(ACS)in Han nationality.Methods Ninety ACS patients in Han nationality were divided into five groups by different proton pump inhibitor,omeprazole group(n=18 cases),lansoprazole group(n=18 cases),pantoprazole group(n=18 cases),rabeprazole group(n=18 cases)and control group(n=18 cases).All the groups on the basis of aspirin and ticafrelor.Using the method of verifynow to determine platelet response units(PRU)and found that wearther the different groups have the statistical differences.The patients were followed up for 6 months and the adverse cardiac events(MACE),bleeding events,and adverse drug reactions were recorded.Results The average PRU of the control group,omeprazole group,lansoprazole group,pantoprazole group and rabeprazole group were(38.52±38.77),(18.09±18.90),(28.62±19.06),(30.35±40.86)and(18.50±20.50),in which the omeprazole group was significantly different from the control group(P<0.05).The major adverse cardiac events were 6 cases.The bleeding events were 33 cases.The adverse drug reactions were 27 cases,and there were no statistical difference in the incidence between the groups.Conclusion There is a significant difference in PRU between the omeprazole group and the control group,but there is no clinical significance in the results of long-term follow-up.Therefore,there is no clinically significant interaction between PPI drugs and anti-platelet efficacy of aspirin plus ticagrelor.

关 键 词：质子泵抑制药 替格瑞洛 抗血小板药物 汉族 急性冠状动脉综合征 

分 类 号：R972[医药卫生—药品]