摘要
目的:盐酸替罗非班、阿司匹林、氯吡格雷、低分子肝素(四联)联合使用治疗急性冠脉综合征(ACS)患者时,评价静脉注射泮托拉唑对消化道保护的疗效和安全性。方法:选择住院ACS患者296例,随机分为试药组184例,对照组112例,所有患者均服用阿司匹林、氯吡格雷、低分子肝素和使用2～3 d盐酸替罗非班。在此基础上试药组患者静脉输注泮托拉唑40 mg/d,4～5 d,再服用泮托拉唑片剂40 mg/次,2次/d,连服8 d。结果:试药组8 d内全因死亡、顽固性心绞痛、再次心肌梗死、急诊经皮冠状动脉介入治疗(PCI)数较对照组显著减少(P<0.05);试药组与对照组比较消化道出血发生率(2.2%vs.12.5%)、TIMI小出血发生率(1.6%vs.6.2%)和TIMI较小出血发生率(0.5%vs.5.4%)明显降低(P<0.05)。结论:在四联抗栓治疗ACS患者时,静脉注射和口服泮托拉唑可以减少8 d内消化道出血发生率,从而减少了8 d内患者死亡、顽固性心绞痛、再次心肌梗死、急诊PCI数,具有良好的消化道保护作用和安全性。
To evaluate the efficacy and safety of protecting the alimentary canal with pantoprazole when using the quadruple therapy： aspirin, clopidogrel, low molecular weight heparin （LMWH） and tirofiban hydrochloride in acute coronary syndrome （ACS）. METHODS： Two hundred and ninety-six selected hospitalized patients with ACS were divided into observation group （n = 184） and control group （n = 112）. Aspirin, clopidogrel, LMWH and 2- 3 clays of tirofiban were administered to all patients. On this basis, pantoprazole 40 mg i. v. was first administered by drip phleboclysis for 4 - 5 days and then changed to tablets （40 mg twice daily） for 8 days in the observation group. RESULTS： Occurrence of 8-day all-cause death, refractory angina pectoris, relapse myocardial infarction and emergency percutaneous coronary intervention （PCI） in the observation group was lower than that in the control group （P 〈 0.05 ）. The number of total hemorrhages, mild hemorrhages and midrange hemorrhages in the control group was higher than in the observation group （P 〈 0.05）. CONCLUSION： Intravenous injection and oral administration of pantoprazole decreased the 8-day rate of alimentary tract hemorrhage when using the quadruple anti-thrombosis therapy for ACS, thus decreasing the number of all-cause death for 8 days, intractable angina pectoris, intractable angina, relapse myocardial infarction and emergency PCI.
出处
《心脏杂志》
CAS
2012年第3期366-369,共4页
Chinese Heart Journal
