泮托拉唑联合吉法酯对经皮冠状动脉介入术后双联抗血小板药物治疗的患者上消化道出血的预防作用研究

目的 探讨泮托拉唑钠肠溶胶囊联合吉法酯片对经皮冠状动脉介入治疗（PCI）术后双联抗血小板药物治疗的患者上消化道出血的预防作用。方法 选取2014年10月-2017年10月在西电集团医院行PCI的患者121例作为研究对象，按照入院先后顺序分为两组。对照组在术后第1天开始口服吉法酯片，100 mg/次，3次/d。观察组在对照组的基础上联合泮托拉唑钠肠溶胶囊，40 mg/d。比较两组患者术后6个月内上消化道出血的发生率、心血管不良事件、消化道不良反应和血小板聚集率。结果 术后6个月观察组患者的上消化道出血发生率显著低于对照组（P<0.05）；心血管不良事件发生率两组比较无统计学差异，观察组消化道不良反应发生率显著低于对照组（P<0.05）。两组患者治疗前后的血小板聚集率相比无统计学差异。结论 泮托拉唑钠肠溶胶囊联合吉法酯片对PCI术后双联抗血小板药物治疗患者上消化道出血具有较好的预防作用，且显著降低消化道不良反应发生率，不增加心血管不良事件发生率，值得临床应用。

Prophylactic effect of pantoprazole combined with gefarnate on upper gastrointestinal hemorrhage after dual antiplatelet treatment of PCI patients

Objective To explore the preventive effect of Pantoprazole Sodium Enteric-coated Capsules combined with Gefarnate Tablets on upper gastrointestinal hemorrhage after dual antiplatelet treatment of PCI patients. Methods Patients (121 cases) who received percutaneous coronary intervention (PCI) in Xi''an XD Group Hospital from October 2014 to October 2017 were selected and divided into two groups according to the sequence of admission. Patients in the control group began to take Gefarnate Tablets orally on the first day after the operation, 100 mg/time, three times daily. Patients in the observation group were po administered with Pantoprazole Sodium Enteric-coated Capsules on the basis of control group, 40 mg/d.The incidence of upper gastrointestinal hemorrhage, cardiovascular adverse events, gastrointestinal adverse reactions and platelet aggregation within 6 months after surgery were compared between two groups. Results Within 6 months after surgery, the incidence of upper gastrointestinal hemorrhage in the observation group was significantly lower than that in the control group (P<0.05). There was no statistical difference in the incidence of cardiovascular adverse events between the two groups, and the incidence of gastrointestinal adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in platelet aggregation before and after treatment between the two groups. Conclusion Pantoprazole Sodium Enteric-coated Capsules combined with Gefarnate Tablets has a good preventive effect on upper gastrointestinal hemorrhage after dual antiplatelet treatment of PCI patients, and significantly reduces the incidence of gastrointestinal adverse reactions and does not increase the incidence of cardiovascular adverse events, which is worthy of clinical reference.