泮托拉唑钠注射剂联合氯吡格雷片治疗急性心肌梗死伴消化道出血的临床疗效及不良反应

摘要

目的 探究泮托拉唑钠注射剂与氯吡格雷片联合治疗急性心肌梗死(AMI)并消化道出血对临床疗效、前列腺素E2(PGE2)以及不良反应的影响.方法 选取本院2016年10月至2017年10月收治的100例急性心肌梗死并消化道出血患者临床资料进行分析,将其分成对照组与研究组,各50例.对照组行氯吡格雷与奥美拉唑配合治疗,研究组行氯吡格雷与泮托拉唑钠配合治疗,比较两组临床疗效、不良反应、PGE2水平.结果 研究组治疗总有效率显著高于对照组(90.00％比74.00％,P＜0.05);研究组不良反应总发生率与对照组比较差异无统计学意义(8.00％比6.00％,P＞0.05);两组治疗前PGE2水平比较差异无统计学意义(P＞0.05),治疗3、7d后PGE2水平均高于对照组[(81.02±18.47)ng/ml比(67.08±15.19) ng/ml]、[(116.71±21.92) ng/ml比(92.57±16.33) ng/ml],两组比较差异有统计学意义(P＜ 0.01).结论 AMI并发消化道出血经泮托拉唑钠及氯吡格雷片结合治疗,能有效提升疗效,促PGE2升高,且药物不良反应少.%Objective To explore the clinical efficacy and adverse reactions of pantoprazole sodium injection combined with clopidogrel tablets for acute myocardial infarction (AMI) complicating by gastrointestinal bleeding and its effect on prostaglandin E2 (PGE2).Methods 100 patients with acute myocardial infarction complicating by gastrointestinal bleeding who had been admitted to our hospital from October 2016 to October 2017 were divided into control group and study group with 50 cases in each group.The patients in the control group received clopidogrel combined with omeprazole for treatment,while the patients in the study group received clopidogrel combined with pantoprazole sodium for treatment.The clinical efficacy,adverse reactions,and PGE2 levels in the two groups were compared.Results The total effective rate of treatment in the study group was 90.00％,significantly higher than that in the control group (74.00％) (P＜0.05).The total incidence of adverse reactions in the study group was 8.00％,without statistically significant difference compared with the control group (6.00％) (P＞0.05).There was no statistically significant difference in the PGE2 level between the two groups before treatment (P＞0.05);the PGE2 levels registered after 3 days and 7 days of treatment were (81.02±18.47) ng/ml and (116.71±21.92) ng/ml in the study group,both were higher than those in the control group [(67.08±15.19)ng/ml,(92.57±16.33)ng/ml] (P＜0.01).Conclusion For patients with AMI complicating by gastrointestinal bleeding,the combination of pantoprazole sodium and clopidogrel tablets can effectively improve the curative effect and increase the PGE2 level,with less adverse drug reactions.