带量采购背景下的泮托拉唑预防脑梗死患者应激性溃疡的队列研究

目的 探讨集中带量采购泮托拉唑在预防急性脑梗死合并使用抗血小板药物致应激性溃疡的疗效和安全性。方法 回顾性分析浙江省立同德医院2021年1月1日——2021年7月30日确诊为急性脑梗死使用抗血小板药物并同时使用泮托拉唑预防应激性溃疡的患者，经纳入排除标准后，共计纳入200例有效病例，包括集采注射泮托拉唑96例作为试验组，非集采泮托拉唑104例作为对照组。采用R3.6.1进行组间的单因素分析、二元logistic回归分析和亚组分析，比较2组在预防应激性溃疡风险方面有无疗效性及安全性差异，并对影响有效性结局的相关因素进行分析。结果 在应激性溃疡发生率的有效性结局指标方面，单因素及多因素回归分析结果均显示，与非集采泮托拉唑相比，集采品种在预防脑梗死患者合并使用抗血小板药物致应激性溃疡的有效性及安全性无统计学差异；风险分析及亚组分析结果显示，在预防应激性溃疡方面，集采泮托拉唑在不同年龄人群中可能存在一定的差异。结论 集采与非集采泮托拉唑在预防急性脑梗死患者合并使用抗血小板药物致应激性溃疡风险方面的疗效具有一致性，临床可安全使用。

Cohort Study of Pantoprazole on Prevention of Stress Ulcer in Patients with Cerebral Infarction Under Background of the Volume-based Procurement

OBJECTIVE To explore the efficacy and safety of pantoprazole in the prevention of stress ulcer induced by acute cerebral infarction combined with the application of anti-platelet drugs. METHODS Retrospective analysis was performed on patients diagnosed with acute cerebral infarction who received antiplatelet drugs and pantoprazole for prevention of stress ulcer from January 1st, 2021 to July 30th, 2021 in Tongde Hospital of Zhejiang Province. According to inclusion and exclusion criteria, a total of 200 effective cases were included, including 96 patients collecting and injected with pantoprazole as experimental group and 104 patients non-collecting with pantoprazole as control group. Univariate analysis, binary logistic regression analysis and subgroup analysis were performed between the two groups using R3.6.1, to compare the efficacy and safety of them in preventing the risk of stress ulcer and to analyze the related factors affecting the effectiveness outcome. RESULTS In terms of effective outcome indicators of incidence of irritability ulcer, univariate and multivariate regression analysis showed that, comparing with the non-collecting with pantoprazole group, there was no statistical difference in the efficacy and safety of the treatment group in the prevention of stress ulcer induced by acute cerebral infarction combined with the application of anti-platelet drugs. The results of risk and subgroup analysis showed that there might be a certain population difference in the prevention of stress ulcer by using pantoprazole in different age groups. CONCLUSION Centrally collected and non-centrally collected pantoprazole have consistent efficacy in preventing the risk of stress ulcer in acute cerebral infarction patients combined with the use of antiplatelet drugs. Pantoprazole can be applied safely in clinical practice.