Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan.
J Cardiol. 2009 Aug;54(1):71-5. doi: 10.1016/j.jjcc.2009.04.002. Epub 2009 May 14.
The aim of this study was to examine the effects of gastric medicines on gastroduodenal injury during antiplatelet therapy after coronary intervention.
A total of 501 patients were enrolled and as dual antiplatelet therapy, aspirin and thienopyridine were administered. Patients were divided into four groups: histamine H2-receptor antagonists (H2RA); proton pump inhibitors (PPI); other gastromucosal protective agents (GMP); or nothing (None), and follow-up lasted 8-20 months.
H2RA were prescribed in 212 cases (42%), PPI in 150 (30%), GMP in 56 (11%), and None in 83 (17%). Significant findings by endoscopy were recognized in 18 cases and upper gastrointestinal bleeding requiring hospitalization occurred in 7 patients (1.4%; H2RA in 4, GMP in 2, and None in 1). There were no gastrointestinal injuries in the PPI group. To minimize the effect of selection bias on gastroduodenal lesions, the propensity score analysis for clinical characteristics was used. The results of propensity score matching showed that administration of PPI reduced the incidence of gastrointestinal lesions compared with that of the non-PPI group.
Administration of PPI reduced the incidence of gastrointestinal lesions compared with that of the non-PPI group.
本研究旨在探讨冠状动脉介入治疗后抗血小板治疗期间胃药对胃十二指肠损伤的影响。
共纳入 501 例患者，采用双重抗血小板治疗，即阿司匹林和噻吩吡啶。患者分为四组：组胺 H2 受体拮抗剂（H2RA）；质子泵抑制剂（PPI）；其他胃黏膜保护剂（GMP）；或无治疗（None），随访 8-20 个月。
212 例（42%）患者处方 H2RA，150 例（30%）患者处方 PPI，56 例（11%）患者处方 GMP，83 例（17%）患者未处方任何药物。18 例患者经内镜检查发现明显病变，7 例患者（1.4%；H2RA 组 4 例，GMP 组 2 例，None 组 1 例）发生需住院的上消化道出血。PPI 组无胃肠道损伤。为了最大限度地减少选择偏差对胃十二指肠病变的影响，对临床特征进行了倾向评分分析。倾向评分匹配的结果表明，与非 PPI 组相比，PPI 组胃肠道病变的发生率降低。
与非 PPI 组相比，PPI 组胃肠道病变的发生率降低。
