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[横断面研究数据显示不同阿司匹林剂型长期治疗稳定性缺血性心脏病且有发生胃病高风险患者的安全性和有效性]

[Safety and efficacy of long-term treatment with different ASA forms in patients with stable IHD and a high risk for development of gastropathy by data from a cross-sectionals study].

作者信息

Nekrasov A A, Timoshchenko E S, Petelina I S, Karpukhina E V

机构信息

Federal State Budgetary Educational Institution of Higher Education, "Nizhny Novgorod State Medical Academy" of the Ministry of Health of the Russian Federation.

State Budgetary Institution of Health Care of Nizhegorodskaya Region, "Municipal Clinical Hospital #5".

出版信息

Kardiologiia. 2017 Mar;57(S3):24-31. doi: 10.18087/cardio.2380.

Abstract

AIM

To study indexes of efficacy, safety and compliance for different ASA forms (Aspirin-Cardio, Cardiomagnyl, Thrombo ASS) used in stable IHD.

MATERIALS AND METHODS

An open, cross-sectional study compared three groups of patients consisting of 200 patients each who had stable IHD and a high risk of gastrointestinal disorders and who received a long-term antiaggregant monotherapy with one of ASA drugs (group 1, Aspirin Cardio; group 2, Thrombo ASS; group 3, Cardiomagnyl). Efficacy, safety and compliance with the treatment were evaluated using standard tests and analogue scales; dyspepsia symptoms were evaluated using a special, additionally developed questionnaire.

RESULTS

The Aspirin-Cardio treatment reduced the mean score of GI symptom severity from the questionnaire (1.4-1.6 times, р=0.001), requirement for proton pump inhibitors (р=0.002) and endoscopy during the ASA treatment the mean score of GI symptom questionnaire >3 predicted non-compliance or insufficient compliance with a diagnostic sensitivity of 58.9 % and specificity of 56.3 % (р=0.002), which makes this value a threshold for considering a modification of the treatment.

CONCLUSION

Aspirin-Cardio is characterized by better safety in respect of GI symptoms and better compliance with the treatment during long-term prophylactic therapy. The proposed questionnaire for evaluation of GI symptoms can be used for specifying indications and modifying the treatment tactics.

摘要

目的

研究用于稳定型缺血性心脏病(IHD)的不同阿司匹林制剂(阿司匹林-心血管、心脉通、血栓心脉宁)的疗效、安全性和依从性指标。

材料与方法

一项开放性横断面研究比较了三组患者,每组200例,均患有稳定型IHD且有高胃肠道疾病风险,接受一种阿司匹林药物的长期抗血小板单药治疗(第1组,阿司匹林-心血管;第2组,血栓心脉宁;第3组,心脉通)。使用标准测试和类似量表评估治疗的疗效、安全性和依从性;使用专门额外编制的问卷评估消化不良症状。

结果

阿司匹林-心血管治疗降低了问卷中胃肠道症状严重程度的平均得分(1.4 - 1.6倍,р = 0.001),降低了阿司匹林治疗期间质子泵抑制剂的使用需求(р = 0.002)以及内镜检查需求。问卷中胃肠道症状平均得分>3预测不依从或依从性不足,诊断敏感性为58.9%,特异性为56.3%(р = 0.002),这使得该值成为考虑调整治疗的阈值。

结论

阿司匹林-心血管在胃肠道症状方面具有更好的安全性,在长期预防性治疗期间具有更好的治疗依从性。所提出的评估胃肠道症状的问卷可用于明确适应症和调整治疗策略。

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