替普瑞酮在阿司匹林致胃黏膜损伤中的保护作用机制研究

文章摘要：目的 观察替普瑞酮对阿司匹林导致的胃黏膜损伤的保护作用,为阿司匹林等非甾体类抗炎药所致胃黏膜损伤的防治提供理论依据.方法 收集需要长期服用阿司匹林的患者84例,根据治疗方法不同分成阿司匹林组(A组)和替普瑞酮+阿司匹林组(B组),每组42例.记录用药3、6个月及1年时消化道症状、不良反应以及粪隐血试验和胃镜检查评分情况.结果 随着治疗时间的延长,A组和B组用药3、6个月及1年时消化道症状发生率4.76％ (2/42)、9.52％(4/42)、21.43％(9/42),0、2.38％(1/42)、11.90％(5/42)]、粪隐血试验评分(0.052±0.006)、(0.183±0.014)、(0.315±0.028)分,(0.006±0.001)、(0.037±0.008)、(0.206±0.013)分]和胃镜检查评分(0.072±0.011)、(0.283±0.018)、(0.453±0.034)分,(0.008±0.003)、(0.046±0.010)、(0.243±0.016)分]均相应增加,差异有统计学意义(P＜ 0.05或＜0.01).B组用药3、6个月及1年时消化道症状发生率、粪隐血试验评分和胃镜检查评分均显著低于A组,差异有统计学意义(P＜ 0.05或＜0.01).两组患者在用药3、6个月及1年时的消化道不良反应发生率比较差异无统计学意义(P＞0.05).结论 替普瑞酮可以有效防治阿司匹林导致的胃黏膜损伤,且不良反应发生率低,值得临床推广应用. Objective To investigate the clinical efficacy of teprenone on aspirin-induced gastric mucosa injury and provide theoretical basis for protective mechanism.Methods A total of 84 patients who needed long time aspirin treatment were enrolled in this study.All the 84 cases were divided into two groups according to the treatment method:aspirin treatment group (group A,42 cases) and teprenone + aspirin treatment group (group B,42 cases).The gastrointestinal symptoms,adverse reactions,and fecal occult blood test and endoscopy score were recorded after treatment of 3 months,6 months and 1 year.Results The incidence of gastrointestinal symptoms [4.76％ (2/42),9.52％ (4/42),21.43％ (9/42),0,2.38％ (1/42),11.90％ (5/42)],fecal occult blood test score [(0.052 + 0.006),(0.183 + 0.014),(0.315 + 0.028) scores and (0.006 + 0.001),(0.037 + 0.008),(0.206 + 0.013) scores] and endoscopy score [(0.072 + 0.011),(0.283 + 0.018),(0.453 ± 0.034) scores and (0.008 + 0.003),(0.046 + 0.010),(0.243 ± 0.016)scores]was significantly increased in group A and group B along with the time of treatment (P ＜ 0.05 or ＜ 0.01).The incidence of gastrointestinal symptoms,fecal occult blood test score and endoscopy score was significantly lower in group B than that in group A after treatment of 3 months,6 months and 1 year (P ＜ 0.05 or ＜ 0.01).The incidence of gastrointestinal adverse reaction was no significant difference between two groups after treatment of 3 months,6 months and 1 year (P ＞ 0.05).Conclusion Teprenone shows effective activity against aspirin-induced gastric damage with a low incidence of adverse reactions,and it is worthy to spread in the clinical application.