两种质子泵抑制剂治疗冠心病的临床研究

发布时间：2018-10-05 20:45

【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p H值和血液中各离子(Na~+、K~+、Ca~(2+)、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(P0.05);治疗后,3组患者的血尿酸、K~+(对照组除外)、Ca~(2+)、Cl~-水平均显著下降,尿液p H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Ca~(2+)水平均显著低于对照组,尿液p H值和Na~+水平均显著高于对照组,差异均有统计学意义(P0.05)。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(P0.05),但两组尿液p H值和各离子水平比较,差异均无统计学意义(P0.05)。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(P0.05);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(P0.05)。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p H值和血液中Na~+水平,但同时也会降低Ca~(2+)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 efficacy and safety of two proton pump inhibitors in the treatment of coronary heart disease. Methods: 92 patients with coronary heart disease from June 2015 to May 2016 were selected and divided into rabeprazole group (30 cases), esomeprazole group (32 cases) and control group (30 cases). The patients in the control group were treated with basic treatment regimen, the patients in the rabeprazole group and esomeprazole group were given rabeprazole enteric-coated tablets and esomeprazole magnesium enteric-coated tablets for 20 mg,po,bid. each on the basis of coronary intervention in the control group. The patients in both groups were treated with 30 days as a course of treatment. Before and after treatment, the levels of uric acid, urine pH and Na~ K ~ (2) C ~ (2) C ~ (2 +) were measured, and cardiovascular adverse events, coronary artery adverse events and other adverse events were observed. Results: there was no significant difference in the above indexes between the three groups before and after treatment (P0.05), but the levels of serum uric acid K ~ (2) in the control group were significantly decreased, and the levels of urine pH and Na~ in the blood were significantly increased after treatment, and the results showed that there was no significant difference between the three groups before treatment (P0.05), but the level of serum uric acid (K ~ (2) in the control group was significantly lower than that in the control group. The levels of serum uric acid and Ca~ (2) in rabeprazole group and esomeprazole group were significantly lower than those in control group, and the levels of urine pH and Na~ were significantly higher than those in control group (P0.05). After treatment, the serum uric acid level of rabeprazole group was significantly lower than that of esomeprazole group, the difference was statistically significant (P0.05), but there was no significant difference between the two groups in urine pH value and each ion level (P0.05). The incidence of acute thrombus and joint swelling and pain in rabeprazole group and esomeprazole group were significantly lower than those in control group (P0.05). The difference was not statistically significant (P0.05). Conclusion: rabeprazole and esomeprazole can significantly decrease the level of serum uric acid and the incidence of acute thrombus in patients with coronary heart disease, increase urine pH and Na~ level, but also decrease the level of Ca~ (2). Increase the risk of hypocalcemia or fracture, and will increase the incidence of joint swelling and pain, so in clinical practice should be adjusted according to the specific conditions of patients.
【作者单位】：海南医学院第一附属医院药学部;海南医学院第一附属医院心内科;
【分类号】：R541.4

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