ppi药物代谢机理及临床相互作用ppt课件

GilardMetal.2008;51:256–260.血小板再活化指数(PRI)Placebo奥美拉唑100806040200MeanPRIDay7Regimens:OME+Clopid+ASAPlacebo+Clopid+ASAp<0.0001PezallaEetal.2008;52:1038–1039.HoPMetal.JAMA2009;301:937–944.al.CMAJ2009;180:713–718.AubertREetal.Circulation2008;118:S815.eResultsPenzalla14800ptsMIover1yr1.38%(C),3.08%(LowPPI),5.03%(HighPPI)Ho28205ptsAllcausemortalityorreadmit(~3yr)20.8%(C)29.8%(PPI)AdjOR1.25*Juurlink313,636pts90daysMI,readmitOverall,AdjOR1.27*PAN:1.02(0.7-1.47)OtherPPIAdjOR1.4*Aubert414,383ptsReadmit1yrStroke,MI,angina,CABG21.2%(C)32.5%(PPI)AdjOR1.79*AllPPIs(RABnotevaluated)与氯吡格雷-PPIs相关的不良反应危险性:回顾性资料PezallaEetal.2008;52:1038–1039.HoPMetal.JAMA2009;301:937–-944.al.CMAJ2009;180:713–718.AubertREetal.Circulation2008;118:S815.与氯吡格雷-PPIs相关的不良反应危险性:回顾性资料回顾性分析指出PPIs增加服用氯吡格雷患者的不良反应的危险性各种PPIs的影响不一致氯吡格雷的代谢途径