2018 年第 5 期 第 13 卷

质子泵抑制剂预防经皮冠状动脉介入术后消化道出血有效性及安全性的研究进展

Research progress of effectiveness and safety of proton pump inhibitor in prevention of gastrointestinal bleeding after percutaneous coronary intervention

作者：张辰浩王珺

英文作者：

单位：100102北京，中国中医科学院望京医院急诊科

英文单位：

关键词：质子泵抑制剂；经皮冠状动脉介入；氯吡格雷；冠状动脉粥样硬化性心脏病

英文关键词：

• 摘要：

• 消化道出血是经皮冠状动脉介入（PCI）术的严重并发症之一，针对出血高危人群，目前常规加用质子泵抑制剂（PPI）预防PCI术后消化道出血。大部分临床研究认为PPI与氯吡格雷存在细胞色素P2C19酶的竞争性抑制关系，可减弱氯吡格雷抗血小板作用，增加血栓事件。出血和缺血需要平衡，我们查阅近几年国外文献，从药理学及临床医学的角度对PPI与氯吡格雷的相互作用以及PPI预防PCI术后消化道出血的有效性及安全性进行综述。

• 【Abstract】Gastrointestinal bleeding is a common and severe adverse event of percutaneous coronary intervention(PCI). Proton pump inhibitor(PPI) is often used to prevent gastrointestinal bleeding in clinical practice. Current researches have proven that PPI and clopidogrel are related to cytochrome P2C19 enzyme, which may reduce the antiplatelet effect of clopidogrel and increase the risk of thrombus. This paper discussed the interaction between PPI and clopidogrel from clinical and pharmacological perspectives, and it reviewed the effectiveness and safety of PPI in prevention of PCI postoperative gastrointestinal bleeding.

  【Key words】Proton pump inhibitor；Percutaneous coronary intervention；Clopidogrel；Coronary heart disease

  【Fund program】Beijing Science and Technology Project（Z151100004015085）