奥美拉唑联合氢氯比格雷治疗急性心肌梗死的效益与风险  

Benefit-risk assessment of omeprazole combined with clopidogrel bisulfate in the treatment of acute myocardial infarction

作　　者：管慧琴 龙云 张玉 郎捷[4] GUAN Huiqin;LONG Yun;ZHANG Yu;LANG Jie(Department of Pharmacy,Shanghai 5th Rehabilitation Hospital,Shanghai 201620,China;Department of Medical Administration,Health Committee of Songjiang District,Shanghai,Shanghai 201620,China;Shanghai Songjiang Center for Disease Control and Prevention,Shanghai 201620,China;Department of Pharmacy,Tangshan People s Hospital,Tangshan 063000,China)

机构地区：[1]上海市第五康复医院药剂科,上海201620 [2]上海市松江区卫生健康委员会基层卫生健康科,上海201620 [3]上海市松江区疾病预防控制中心信息科,上海201620 [4]唐山市人民医院药剂科,唐山063000

出　　处：《西北药学杂志》2022年第6期138-141,共4页Northwest Pharmaceutical Journal

基　　金：河北省卫生和计划生育委员会科研基金项目(编号:201836000Y020)。

摘　　要：目的探究奥美拉唑联合硫酸氢氯比格雷治疗急性心肌梗死(AMI)的效益及风险。方法选择就诊的AMI患者120例,按照随机数字表法均分为观察组和对照组,每组60例。对照组采用硫酸氢氯比格雷治疗,观察组采用奥美拉唑联合硫酸氢氯比格雷治疗。比较2组治疗前后的心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心输出量(CO)和左心室收缩末期内径(LVESD)],比较2组治疗前及治疗3、7 d的前列腺素E_(2)(PGE_(2)),并观察2组治疗期间不良反应发生清况。随访1年,记录临床终点事件及其他不良事件发生情况。结果治疗后,观察组与对照组患者的总有效率分别为93.33%、91.67%,差异无统计学意义;治疗后,2组患者LVEF和CO水平均高于治疗前,LVESD和LVEDD水平均低于治疗前(P<0.05);治疗后2组心功能各指标比较,差异无统计学意义;治疗3、7 d后,观察组患者的PGE_(2)高于治疗前,且均高于对照组(P<0.05);对照组治疗前及治疗3、7 d后,PGE_(2)水平无明显变化,差异无统计学意义;治疗后,2组患者的不良心脏事件(MACE)、30 d内再入院、腹泻和穿刺部位出血发生率比较,差异无统计学意义;观察组胃肠终点事件发生率低于对照组,院内获得性肺炎发生率高于对照组(P<0.05);2组不良反应发生率比较,差异无统计学意义。结论奥美拉唑联合硫酸氢氯比格雷治疗AMI具有较好的效果,能提高患者PGE_(2)水平,保护胃黏膜,降低胃肠终点事件发生率,且不会增加MACE、30 d内再入院的发生率,具有一定安全性。Objective To assess the benefits and risks of omeprazole combined with clopidogrel bisulfate in the treatment of acute myocardial infarction(AMI).Methods A total of 120 AMI patients were enrolled and divided into observation group and control group according to random number table method,60 cases in each group.The control group were treated with clopidogrel bisulfate,while the observation group were treated with omeprazole and clopidogrel bisulfate.The clinical curative effect after treatment,the cardiac function[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),cardiac output(CO)and left ventricular end systolic diameter(LVESD)]before and after treatment,and the level of prostaglandin E_(2)(PGE_(2))before treatment,3 days and 7 days after treatment were compared between the 2 groups.The occurrence of adverse reactions during treatment was observed.After 1 year of follow-up,the occurrence of clinical endpoint events and the other adverse events were recorded.Results After treatment,the difference in total response rate between observation group and control group was not statistically significant(93.33%vs.91.67%)(P>0.05).After treatment,the levels of LVEF and CO were increased,while the levels of LVESD and LVEDD were decreased in both groups(P<0.05).After treatment,there was no significant difference in cardiac function indexes between the 2 groups(P>0.05).After 3 days and 7 days treatment,the PGE_(2) was all higher than that before treatment in observation group,higher than that in control group(P<0.05).Before treatment,after 3 days and 7 days treatment,there was no significant change in PGE_(2) level in control group(P>0.05).After treatment,the difference in incidence of Major Adverse Cardiovascular Events(MACE),re-admission within 30 days,diarrhea or bleeding at puncture sites between the 2 groups was not statistically significant(P>0.05).The incidence of gastrointestinal endpoint events in observation group was lower than that in control group,while the incidence of hospit

关 键 词：奥美拉唑 硫酸氢氯比格雷 急性心肌梗死 疗效 

分 类 号：R972[医药卫生—药品]