Treatment and prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy.
Treatment and prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy.
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DOI：
10.5492/wjccm.v4.i1.40
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发表时间：
2015-02-04
期刊：
影响因子：
--
通讯作者：
Itoh, Fumio
中科院分区：
文献类型：
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作者：
Yasuda, Hiroshi;Matsuo, Yasumasa;Itoh, Fumio
抗血小板治疗是急性冠状动脉综合征和缺血性卒中二级预防的标准护理，特别是冠状动脉介入治疗后。然而，这种疗法与出血并发症有关，如胃肠道出血，这是最常见的危及生命的并发症之一。大多数急性上消化道出血患者建议早期内镜检查。内镜下止血成功后，建议立即恢复质子泵抑制剂（PPIs）抗血小板治疗，以防止进一步的缺血事件。抗血小板治疗期间预防PPI可降低上消化道出血的风险。PPIs与氯吡格雷之间潜在的负代谢相互作用尚不清楚。
Antiplatelet therapy is the standard of care for the secondary prevention of acute coronary syndrome and ischemic stroke, especially after coronary intervention. However, this therapy is associated with bleeding complications such as gastrointestinal bleeding, which is one of the most common life-threatening complications. Early endoscopy is recommended for most patients with acute upper gastrointestinal bleeding. After successful endoscopic hemostasis, immediate resumption of antiplatelet therapy with proton-pump inhibitors (PPIs) is recommended to prevent further ischemic events. PPI prophylaxis during antiplatelet therapy reduces the risk of upper gastrointestinal bleeding. The potential negative metabolic interaction between PPIs and clopidogrel is still unclear.