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两种质子泵抑制剂治疗冠心病的临床研究
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| 篇名： | 两种质子泵抑制剂治疗冠心病的临床研究 |
| TITLE： | |
| 摘要： | 目的：考察两种质子泵抑制剂治疗冠心病的有效性和安全性。方法：采用回顾性研究法，选取2015年6月－2016年5月在我院就诊的92例冠心病患者资料，按照治疗方案不同分为雷贝拉唑组（30例）、埃索美拉唑组（32例）和对照组（30例）。对照组患者采取基础治疗方案；雷贝拉唑组和埃索美拉唑组患者在对照组基础上于冠状动脉介入治疗前1天给予雷贝拉唑肠溶片和艾司奥美拉唑镁肠溶片各20 mg，po，bid。两用药组患者均以30 d为1个疗程，共治疗2个疗程。治疗前后分别检测两组患者的血尿酸水平、尿液pH值和血液中各离子（Na+、K+、Ca2+、Cl－）水平；观察两组患者治疗期间心血管不良事件、冠脉不良事件以及其他不良事件的发生情况。结果：治疗前，3组患者上述指标比较，差异均无统计学意义（P＞0.05）；治疗后，3组患者的血尿酸、K+（对照组除外）、Ca2+、Cl－水平均显著下降，尿液pH值和血液中Na+水平均显著上升，且雷贝拉唑组和埃索美拉唑组患者的血尿酸和Ca2+水平均显著低于对照组，尿液pH值和Na+水平均显著高于对照组，差异均有统计学意义（P＜0.05）。治疗后，雷贝拉唑组患者的血尿酸水平显著低于埃索美拉唑组，差异有统计学意义（P＜0.05），但两组尿液pH值和各离子水平比较，差异均无统计学意义（P＞0.05）。雷贝拉唑组和埃索美拉唑组患者急性血栓的发生率较对照组显著降低，关节肿痛的发生率较对照组显著升高，差异均有统计学意义（P＜0.05）；3组患者各项冠脉不良事件的发生率比较，差异均无统计学意义（P＞0.05）。结论：雷贝拉唑和埃索美拉唑可以明显降低冠心病患者的血尿酸水平和急性血栓的发生率，提高尿液pH值和血液中Na+水平，但同时也会降低Ca2+水平，增加低钙血症或骨折风险，且会升高关节肿痛的发生率，故在临床实践中应根据患者具体情况调整给药方案。 |
| ABSTRACT： | OBJECTIVE： To investigate the effectiveness and safety of 2 kinds of proton pump inhibitors in the treatment of coronary heart disease （CHD）. METHODS： In retrospective study， a total of 92 patients with CHD were selected from our hospital during Jun. 2015-May 2016， and then divided into rabeprazole group （30 cases）， esomeprazole group （32 cases） and control group （30 cases） according to therapy plan. Control group received basic therapy plan. Rabeprazole group and esomeprazole group were additionally given sodium rabeprazole enteric-coated tablets and Esomeprazole magnesium enteric-coated tablets 20 mg， po， bid， on the basis of control group. A treatment course lasted for 30 d， and both medication groups received 2 courses of treatment. Blood uric acid levels， urine pH values， blood ion levels （Na+， K+， Ca2+， Cl－） were detected before and after treatment. The occurrence of cardiovascular adverse events， coronary adverse events and other adverse events were observed in 2 groups during treatment. RESULTS： Before treatment， there was no statistical significance in above indexes among 3 groups （P＞0.05）. After treatment， the levels of blood uric acid， K+ （except for control group）， Ca2+ and Cl－ were decreased significantly， while urine pH values and blood Na+ levels were increased significantly； the levels of blood uric acid and Ca2+ in rabeprazole group and esomeprazole group were significantly lower than control group， while urine pH value and blood Na+ level were significantly higher than control group， with statistical significance （P＜0.05）. After treatment， the level of blood uric acid in rabeprazole group was significantly lower than esomeprazole group， with statistical significance （P＜0.05）. But there was no statistical significance in urine pH values or ion levels between 2 groups （P＞0.05）. Compared with control group， the incidence of acute thrombosis in rabeprazole group and esomeprazole group were decreased significantly， and the incidence of joint swelling and pain were increased significantly， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of coronary adverse events among 3 groups （P＞0.05）. CONCLUSIONS： Rabeprazole and esomeprazole can significantly reduce the level of blood uric acid and the incidence of acute thrombosis， increase urine pH value and blood Na+ levels， decrease blood Ca2+ level and increase the risk of fracture or hypocalcemia in patients with CHD. Therefore， the dosage regimen should be adjusted according to the specific situation of patients in clinical practice |
| 期刊： | 2017年第28卷第32期 |
| 作者： | 刘煜，任少琳，黄丽云，王军 |
| AUTHORS： | LIU Yu，REN Shaolin，HUANG Liyun，WANG Jun |
| 关键字： | 质子泵抑制剂；雷贝拉唑；埃索美拉唑；痛风；冠心病；骨折 |
| KEYWORDS： | Proton pump inhibitors； Rabeprazole； Esomeprazole； Gout； Coronary heart disease； Fracture |
| 阅读数： | 591 次 |
| 本月下载数： | 1 次 |
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