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肾移植受者中组胺受体拮抗剂与质子泵抑制剂预防胃肠道溃疡的比较

A Comparison of Histamine Receptor Antagonists Versus Proton Pump Inhibitor Gastrointestinal Ulcer Prophylaxis in Kidney Transplant Recipients.

作者信息

Rouse Ginger E, Hardinger Karen, Tsapepas Demetra, Tichy Eric M

机构信息

1 Medical ICU, Department of Pharmacy, Yale-New Haven Hospital, New Haven, CT, USA.

2 Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, USA.

出版信息

Prog Transplant. 2017 Mar;27(1):4-9. doi: 10.1177/1526924816669725. Epub 2016 Sep 21.

Abstract

INTRODUCTION

There are several different agents that can be used for gastrointestinal (GI) ulcer prophylaxis in posttransplant recipients, such as histamine-2 receptor antagonists (H2RA) or proton pump inhibitors (PPIs).

RESEARCH QUESTION

This study was conducted to compare the incidence of adverse kidney events in transplant recipients who received prophylaxis with H2RAs or PPIs.

DESIGN

This retrospective study included all kidney transplant recipients from 3 transplant centers who were transplanted in 2009 through 2011. The primary objective was to compare the incidence of adverse events posttransplant, defined as the incidence of pneumonia, Clostridium difficile, hip fractures, GI bleeding, cytomegalovirus, organ rejection, and bacteremia.

RESULTS

A total of 211 patients were included in the study; of which 35 were included in the PPI group and 176 were included in the H2RA group. There were no significant differences between groups in regard to incidence of GI bleeding events or other adverse events.

DISCUSSION

These findings suggest there is a low incidence of GI ulcers and upper GI bleeding events after kidney transplantation with the use of H2RAs or PPIs. Additionally, there are similar rates of adverse events when comparing H2RAs versus PPIs for GI ulcer prophylaxis.

摘要

引言

有几种不同的药物可用于移植后受者的胃肠道(GI)溃疡预防,如组胺-2受体拮抗剂(H2RA)或质子泵抑制剂(PPI)。

研究问题

本研究旨在比较接受H2RA或PPI预防的移植受者中不良肾脏事件的发生率。

设计

这项回顾性研究纳入了2009年至2011年在3个移植中心接受移植的所有肾移植受者。主要目的是比较移植后不良事件的发生率,定义为肺炎、艰难梭菌、髋部骨折、胃肠道出血、巨细胞病毒、器官排斥和菌血症的发生率。

结果

共有211名患者纳入研究;其中35名纳入PPI组,176名纳入H2RA组。两组在胃肠道出血事件或其他不良事件的发生率方面没有显著差异。

讨论

这些发现表明,肾移植后使用H2RA或PPI时,胃肠道溃疡和上消化道出血事件的发生率较低。此外,在比较H2RA与PPI预防胃肠道溃疡时,不良事件的发生率相似。

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