Zhao Jing, Fan Yihong, Ye Wu, Feng Wen, Hu Yue, Cai Lijun, Lu Bin
Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou 310006, China.
Key Laboratory of Digestive Pathophysiology of Zhejiang Province, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Gastroenterol Res Pract. 2019 Jun 18;2019:6532876. doi: 10.1155/2019/6532876. eCollection 2019.
Aspirin usage is associated with increased risk of gastrointestinal bleeding. The present study explored the potential of teprenone, an antiulcerative, in preventing aspirin-related gastric mucosal injuries.
280 patients with coronary diseases, naïve to aspirin medication, were admitted between 2011 and 2013 at the First Affiliated Hospital of Zhejiang Chinese Medical University and randomized into two groups ( = 140). The aspirin group received aspirin enteric-coated tablets 100 mg/day, while the aspirin+teprenone group received teprenone 50 mg 3 times/day along with aspirin. The patients were recorded for gastrointestinal symptoms and gastric mucosal injuries during a follow-up period of 12 months with 3-month intervals.
During the 3-month follow-up, no significant difference was observed in the incidence rate of gastrointestinal symptoms between the two groups ( = 0.498). However, the incidence rate of gastrointestinal symptoms was significantly lower in the aspirin+teprenone group than in the aspirin group during the follow-ups at 6 months ( = 0.036) and 12 months ( = 0.036). The incidence rate of gastric mucosal injuries in the aspirin group was significantly increased at 12 months compared to that at 3 months ( = 0.016). The incidence rates at 12 months and cumulative for the entire follow-up period in the aspirin+teprenone group were both significantly lower than those of the aspirin group ( = 0.049 and = 0.001, respectively).
Long-term use of low-dose aspirin causes varying degrees of gastric mucosal damages and gastrointestinal symptoms; the severity will increase within a certain range with the extension of medication duration. Teprenone mitigates the gastrointestinal symptoms caused by low-dose aspirin, lowering both the incidence and severity of gastric mucosal injuries and exerting a positive protective effect.
阿司匹林的使用与胃肠道出血风险增加有关。本研究探讨了抗溃疡药物替普瑞酮预防阿司匹林相关胃黏膜损伤的潜力。
2011年至2013年期间，浙江中医药大学附属第一医院收治了280例未服用过阿司匹林的冠心病患者，并将其随机分为两组（每组 = 140例）。阿司匹林组患者每天服用100毫克阿司匹林肠溶片，而阿司匹林+替普瑞酮组患者除服用阿司匹林外，还每天3次、每次50毫克服用替普瑞酮。在为期12个月、每隔3个月的随访期内，记录患者的胃肠道症状和胃黏膜损伤情况。
在3个月的随访期内，两组胃肠道症状的发生率无显著差异（ = 0.498）。然而，在6个月（ = 0.036）和12个月（ = 0.036）的随访中，阿司匹林+替普瑞酮组胃肠道症状的发生率显著低于阿司匹林组。与3个月时相比，阿司匹林组在12个月时胃黏膜损伤的发生率显著增加（ = 0.016）。阿司匹林+替普瑞酮组在12个月时以及整个随访期的累积发生率均显著低于阿司匹林组（分别为 = 0.049和 = 0.001）。
长期使用低剂量阿司匹林会导致不同程度的胃黏膜损伤和胃肠道症状；随着用药时间的延长，在一定范围内严重程度会增加。替普瑞酮可减轻低剂量阿司匹林引起的胃肠道症状，降低胃黏膜损伤的发生率和严重程度，发挥积极的保护作用。
