质子泵抑制剂（兰索拉唑）对老年慢性心力衰竭患者药物不良反应及合理用药的影响
Effect of proton pump inhibitor (lansoprazole) on adverse drug reactions and rational drug use in elderly patients with chronic heart failure.
作者信息
Zhou Lei, Kuang Su-Qing, Lv Yuan, Yu Wen-Min, Wei Xiao-Bing, Lin Song
机构信息
Department of Cardiology, Jintan First People's Hospital Changzhou 213200, Jiangsu, China.
Department of Geriatrics, Dongfang Hospital Affiliated to Tongji University, Jiaozhou Hospital Jiaozhou 266318, Shandong, China.
出版信息
Am J Transl Res. 2025 Feb 15;17(2):1290-1301. doi: 10.62347/BZED8420. eCollection 2025.
OBJECTIVE
To evaluate the efficacy and rationale of proton pump inhibitors (PPIs) for adverse drug reactions in elderly patients with heart failure (HF).
METHODS
From February 2019 to September 2021, 120 elderly patients with chronic heart failure (CHF) treated at Jintan First People's Hospital were enrolled as subjects. The patients were classified into a control group (n=60) and a research group (n=60). In addition to clopidogrel, the control group received cimetidine, while the research group received lansoprazole. Clinical efficacy, oxidative stress markers, echocardiographic indices, vascular endothelial function, cardiac function indicators, and adverse reactions were compared between the two groups. A cost-effectiveness analysis was also performed, and risk factors affecting patient efficacy were examined.
RESULTS
The clinical efficacy of the research group was remarkably superior to that of the control group (88.33% versus 63.33%, P<0.05). The combination of clopidogrel and cimetidine was identified as a risk factor affecting patient efficacy (P=0.003). Besides, the research group showed significant elevation in superoxide dismutase (SOD), glutathione peroxidase (GPx), left ventricular ejection fraction (LVEF), and nitric oxide (NO) after treatment, all higher compared to the control group (all P<0.05). Additionally, significant reductions in malondialdehyde (MDA), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic dimension (LVSD), endothelin-1 (ET-1), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase (CK), lactate dehydrogenase (LDH), and free fatty acids (FFA) were observed in the research group, all lower than the control group (P<0.05). The incidence of bradycardia, hypotension and electrolyte disturbances in the research group was remarkably lower (P<0.05). Additionally, the research group demonstrated greater cost-effectiveness compared to the control group.
CONCLUSION
The use of PPIs in elderly patients with HF not only improves efficacy but also enhances safety, making this drug treatment approach worth promoting.
目的
评估质子泵抑制剂（PPIs）用于老年心力衰竭（HF）患者药物不良反应的疗效及合理性。
方法
选取2019年2月至2021年9月在金坛区第一人民医院接受治疗的120例老年慢性心力衰竭（CHF）患者作为研究对象。将患者分为对照组（n = 60）和研究组（n = 60）。对照组在服用氯吡格雷的基础上，加用西咪替丁，研究组则加用兰索拉唑。比较两组的临床疗效、氧化应激指标、超声心动图指标、血管内皮功能、心功能指标及不良反应。同时进行成本效益分析，并探究影响患者疗效的危险因素。
结果
研究组的临床疗效显著优于对照组（88.33%对63.33%，P < 0.05）。氯吡格雷与西咪替丁联用被确定为影响患者疗效的危险因素（P = 0.003）。此外，研究组治疗后超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GPx）、左心室射血分数（LVEF）和一氧化氮（NO）均显著升高，均高于对照组（均P < 0.05）。另外，研究组丙二醛（MDA）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVSD）、内皮素-1（ET-1）、N末端B型利钠肽原（NT-proBNP）、肌酸激酶（CK）、乳酸脱氢酶（LDH）和游离脂肪酸（FFA）均显著降低，均低于对照组（P < 0.05）。研究组心动过缓、低血压及电解质紊乱的发生率显著更低（P < 0.05）。此外，研究组的成本效益高于对照组。
结论
PPIs用于老年HF患者不仅可提高疗效，还能增强安全性，该药物治疗方法值得推广。
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