【摘要】：目的:考察兩種質(zhì)子泵抑制劑治療冠心病的有效性和安全性。方法:采用回顧性研究法,選取2015年6月-2016年5月在我院就診的92例冠心病患者資料,按照治療方案不同分為雷貝拉唑組(30例)、埃索美拉唑組(32例)和對照組(30例)。對照組患者采取基礎(chǔ)治療方案;雷貝拉唑組和埃索美拉唑組患者在對照組基礎(chǔ)上于冠狀動脈介入治療前1天給予雷貝拉唑腸溶片和艾司奧美拉唑鎂腸溶片各20 mg,po,bid。兩用藥組患者均以30 d為1個療程,共治療2個療程。治療前后分別檢測兩組患者的血尿酸水平、尿液p H值和血液中各離子(Na~+、K~+、Ca~(2+)、Cl~-)水平;觀察兩組患者治療期間心血管不良事件、冠脈不良事件以及其他不良事件的發(fā)生情況。結(jié)果:治療前,3組患者上述指標(biāo)比較,差異均無統(tǒng)計學(xué)意義(P0.05);治療后,3組患者的血尿酸、K~+(對照組除外)、Ca~(2+)、Cl~-水平均顯著下降,尿液p H值和血液中Na~+水平均顯著上升,且雷貝拉唑組和埃索美拉唑組患者的血尿酸和Ca~(2+)水平均顯著低于對照組,尿液p H值和Na~+水平均顯著高于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。治療后,雷貝拉唑組患者的血尿酸水平顯著低于埃索美拉唑組,差異有統(tǒng)計學(xué)意義(P0.05),但兩組尿液p H值和各離子水平比較,差異均無統(tǒng)計學(xué)意義(P0.05)。雷貝拉唑組和埃索美拉唑組患者急性血栓的發(fā)生率較對照組顯著降低,關(guān)節(jié)腫痛的發(fā)生率較對照組顯著升高,差異均有統(tǒng)計學(xué)意義(P0.05);3組患者各項冠脈不良事件的發(fā)生率比較,差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:雷貝拉唑和埃索美拉唑可以明顯降低冠心病患者的血尿酸水平和急性血栓的發(fā)生率,提高尿液p H值和血液中Na~+水平,但同時也會降低Ca~(2+)水平,增加低鈣血癥或骨折風(fēng)險,且會升高關(guān)節(jié)腫痛的發(fā)生率,故在臨床實踐中應(yīng)根據(jù)患者具體情況調(diào)整給藥方案。
[Abstract]:Objective: to investigate the efficacy and safety of two proton pump inhibitors in the treatment of coronary heart disease. Methods: 92 patients with coronary heart disease from June 2015 to May 2016 were selected and divided into rabeprazole group (30 cases), esomeprazole group (32 cases) and control group (30 cases). The patients in the control group were treated with basic treatment regimen, the patients in the rabeprazole group and esomeprazole group were given rabeprazole enteric-coated tablets and esomeprazole magnesium enteric-coated tablets for 20 mg,po,bid. each on the basis of coronary intervention in the control group. The patients in both groups were treated with 30 days as a course of treatment. Before and after treatment, the levels of uric acid, urine pH and Na~ K ~ (2) C ~ (2) C ~ (2 +) were measured, and cardiovascular adverse events, coronary artery adverse events and other adverse events were observed. Results: there was no significant difference in the above indexes between the three groups before and after treatment (P0.05), but the levels of serum uric acid K ~ (2) in the control group were significantly decreased, and the levels of urine pH and Na~ in the blood were significantly increased after treatment, and the results showed that there was no significant difference between the three groups before treatment (P0.05), but the level of serum uric acid (K ~ (2) in the control group was significantly lower than that in the control group. The levels of serum uric acid and Ca~ (2) in rabeprazole group and esomeprazole group were significantly lower than those in control group, and the levels of urine pH and Na~ were significantly higher than those in control group (P0.05). After treatment, the serum uric acid level of rabeprazole group was significantly lower than that of esomeprazole group, the difference was statistically significant (P0.05), but there was no significant difference between the two groups in urine pH value and each ion level (P0.05). The incidence of acute thrombus and joint swelling and pain in rabeprazole group and esomeprazole group were significantly lower than those in control group (P0.05). The difference was not statistically significant (P0.05). Conclusion: rabeprazole and esomeprazole can significantly decrease the level of serum uric acid and the incidence of acute thrombus in patients with coronary heart disease, increase urine pH and Na~ level, but also decrease the level of Ca~ (2). Increase the risk of hypocalcemia or fracture, and will increase the incidence of joint swelling and pain, so in clinical practice should be adjusted according to the specific conditions of patients.
【作者單位】： 海南醫(yī)學(xué)院第一附屬醫(yī)院藥學(xué)部;海南醫(yī)學(xué)院第一附屬醫(yī)院心內(nèi)科;
【分類號】：R541.4

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