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目的研究分析双联抗血小板加质子泵抑制剂泮托拉唑对急性心肌梗死患者预后的影响。方法选择2014年4月—2017年3月接受经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的急性心肌梗死患者98例,随机分为对照组与观察组,各49例。对照组给予阿司匹林和氯吡格雷进行双联抗血小板治疗,观察组在对照组基础上加用泮托拉唑进行联合治疗。比较两组消化道异常反应、消化道出血情况及主要心脑血管不良事件。计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组消化道不良反应发生率为4.08%,低于对照组的26.52%,差异有统计学意义(P<0.05)。两组心源性死亡、再发心肌梗死、心力衰竭和短暂性脑缺血发作等主要心脑血管不良事件发生率均较低,比较差异无统计学意义(均P>0.05)。结论质子泵抑制剂泮托拉唑可有效降低PCI术后因抗血小板治疗所造成的消化道不良反应发生率。
Objective To study the effect of dual antiplatelet plus proton pump inhibitor pantoprazole on the prognosis of patients with acute myocardial infarction. Methods From April 2014 to March 2017, 98 patients with acute myocardial infarction who underwent percutaneous coronary intervention (PCI) were randomly divided into control group and observation group, with 49 cases in each. The control group was given aspirin and clopidogrel for dual antiplatelet therapy. The observation group was treated with the combination of pantoprazole on the basis of the control group. Gastrointestinal abnormalities, gastrointestinal bleeding and major cardiovascular events were compared between the two groups. Count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The incidence of gastrointestinal adverse reactions in the observation group was 4.08%, which was lower than that in the control group (26.52%), the difference was statistically significant (P <0.05). The incidence of major cardiovascular and cerebrovascular adverse events such as cardiac death, recurrent myocardial infarction, heart failure and transient ischemic attack were lower in both groups, with no significant difference (all P> 0.05). Conclusion Proton pump inhibitor pantoprazole can effectively reduce the incidence of adverse reactions of gastrointestinal tract caused by antiplatelet therapy after PCI.