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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。
PURPOSE: To evaluate the efficacy and safety of intravenous injection of pantoprazole in the protection of gastrointestinal tract in patients with acute coronary syndrome (ACS) when used in combination with tirofiban hydrochloride, aspirin, clopidogrel, and low molecular weight heparin (quadruple) Sex. Methods: A total of 296 hospitalized patients with ACS were randomly divided into trial group (n = 184) and control group (n = 112). All patients were given aspirin, clopidogrel, low molecular weight heparin and tirofiban for 2 ~ 3 days. On this basis, the patients in the test group received intravenous pantoprazole 40 mg / d for 4-5 days, then pantoprazole 40 mg / time for 2 times / d for 8 days. Results: The numbers of all-cause death, intractable angina pectoris, re-myocardial infarction and emergency percutaneous coronary intervention (PCI) in the experimental group were significantly lower than those in the control group within 8 days (P <0.05) The incidence of hemorrhage (2.2% vs. 12.5%) was significantly lower in patients with TIMI (1.6% vs.6.2%) and TIMI (0.5% vs.5.4%) (P <0.05). Conclusions: Intravenous and oral pantoprazole can reduce the incidence of gastrointestinal bleeding within 8 days in patients treated with quadruple antithrombotic therapy, thereby reducing the risk of death, refractory angina, recurrent myocardial infarction, and emergency PCI within 8 days Number, with good gastrointestinal protection and safety.