Division of Gastroenterology, Sunway Medical Centre, Kuala Lumpur, Malaysia.
J Dig Dis. 2010 Dec;11(6):334-42. doi: 10.1111/j.1751-2980.2010.00466.x.
A proton pump inhibitor (PPI) is often co-prescribed with clopidogrel to reduce the gastrointestinal risk of bleeding ulcers in patients following acute coronary syndrome or a stent implant. However, the safety issue of such practice has been scrutinized after some studies reporting an increased incidence of cardiovascular events and mortality, although there have also been contrary research reports. This has lead to a warning statement from the US Food and Drug Administration cautioning the concomitant use of PPI and clopidogrel. This review examines the evidence of PPI as gastroprotective agent, histamine H(2) antagonists as an alternative therapy, the influence of PPI on the antiplatelet effect of clopidogrel, and the controversies of various studies.
质子泵抑制剂（PPI）常与氯吡格雷联合用于预防急性冠脉综合征或支架植入后的患者发生胃肠道出血性溃疡。然而，一些研究报告称，这种联合使用会增加心血管事件和死亡率，因此这种做法的安全性受到了质疑，尽管也有相反的研究报告。这导致美国食品和药物管理局发出警告，提醒注意同时使用 PPI 和氯吡格雷。本综述考察了 PPI 作为胃保护剂的证据、组胺 H2 拮抗剂作为替代疗法的作用、PPI 对氯吡格雷抗血小板作用的影响，以及各种研究的争议。
