作　　者： (瞿兵）;

机构地区： 湖北省恩施土家族苗族自治州中心医院中医部消化内科,湖北恩施445000

出　　处： 《实用药物与临床》 2017年第8期899-903,共5页

摘　　要： 目的比较质子泵抑制剂和H_2受体拮抗剂对口服低剂量阿司匹林患者上消化道损伤的预防作用。方法系统检索Pub Med、The Cochrane Library、Embase、中国知网(CNKI)及万方数据库,检索时间至2016年10月31日。同时查阅相关文献的引文目录,纳入符合入选标准的临床研究。结果最终纳入随机对照试验15篇。总样本量为2 093例,其中质子泵抑制剂组1 116例,H_2受体拮抗剂组977例。总体结果显示,与H_2受体拮抗剂相比,质子泵抑制剂能够减少低剂量阿司匹林引起的上消化道出血事件(RR 0.33,95%CI 0.20~0.54,P<0.01)。质子泵抑制剂比H_2受体拮抗剂更能降低口服低剂量阿司匹林患者的上消化道糜烂或溃疡的风险(RR0.35,95%CI 0.24~0.52,P<0.01)。结论相比H_2受体拮抗剂,质子泵抑制剂能更有效地预防低剂量阿司匹林导致的上消化道损伤。 Objective To compare the preventive effects of proton pump inhibitors with H2-receptor antagonists on upper gastrointestinal injury in patients receiving oral low-dose aspirin.Methods A systematical search was conducted in PubMed,the Cochrane Library,Embase,CNKI and Wanfang databases until October 31,2016,complemented with reference scrutiny of relevant literatures,to indentify clinical studies eligible for inclusion.Results A total of 15 randomized controlled trials were finally included with 2 093 participants.There were 1 116 patients in the proton pump inhibitors group and 977 patients in the H2-receptor antagonists group.Pooled results demonstrated that compared with H2-receptor antagonists,proton pump inhibitors were associated with less fewer gastrointestinal bleeding events induced by low-dose aspirin（RR 0.33,95% CI 0.20 ～ 0.54,P〈0.01）.Moreover,proton pump inhibitors could reduce the risk of gastrointestinal erosions or ulcers（RR 0.35,95% CI 0.24 ～ 0.52,P〈0.01） as compared with H2-receptor antagonists in low-dose aspirin users.Conclusion Compared with H2-receptor antagonists,proton pump inhibitors are more effective in the prevention of upper gastrointestinal injury caused by low-dose aspirin.

关 键 词： 质子泵抑制剂 受体拮抗剂 阿司匹林 消化道损伤 分析