The Effects Of Statins And Proton Pump Inhibitors Combination On The Aminotransferase In Patients With ACS

Objective: By observing the effects of the two different metabolic pathways of statins and proton pump inhibitors combination on the aminotransferase in patients with acute coronary syndrome(ACS),analysis whether proton pump inhibitors aggravate statins on the level of aminotransferase,guide the clinical drug selection.Method:We chose 160 patients who were diagnosed ACS(accord with standard of international society for heart disease diagnosis of ACS)in The Second Hospital of HeBei Medical University from 2015.01 to 2015.12,which including 91 male cases,69 female cases.The patients were 31~81 years old.Randomly divided into 4 groups: Atorvastatin 20 mg QN + Pantoprazole Sodium 20 mg QD(group 1),Atorvastatin 20 mg QN(group 2),Fluvastatin Sodium 80 mg QN + Pantoprazole Sodium 20 mg QD(group 3),Fluvastatin Sodium 80 mg QN(group 4).The liver function of the patients were examined before taking drugs,1 week,1 month,3 months after taking drugs.Statins and proton pump inhibitors were suspended when aminotransferase of the patients rise to 3 times over normal reference limit.Exclusion criteria: 1)serious diseases such as acute and serious infection,serious metabolic and endocrine disorders,electrolyte imbalance,severe renal abnormalities;2)patients with gastric or duodenal diseases;3)patients with obviously abnormal liver function(aspartate aminotransferase AST,alanine aminotransferase ALT> 3 times the upper limit of normal);4)Statins and proton pump inhibitors allergies or other contraindication.The data were analyzed by SPSS21.0 statistical software.The measurement data were expressed by mean ±standard deviation and the enumeration data were expressed by frequency.The measurement data were analyzed by repeated measures analysis of variance,the enumeration data were analyzed by Fisher exact probability.P<0.05 was considered as significance.Results: 1 The levels of ALT and AST in plasma in different time,were not significantly difference in the same group(P>0.05).Through the analysis of taking two different metabolic pathways of statins,statins and proton pump inhibitors combination,the levels of ALT and AST in plasma were not significantly difference in the time of before taking drugs and 1 week,1month,3months after taking drugs in the groups(P>0.05).2 Compared with the level before therapy,the ALT level of Atorvastatin and Pantoprazole Sodium combination group at 1week and 1 month after treatment elevated significantly,but they were not statistical difference.The ALT levels reduced to the levels before therapy at 3 months after treatment.In the Atorvastatin group,the ALT level at 1week,1 month,3 months after treatment with the before therapy were significantly different,but the ALT levels at 1 week,1month,and 3 months after treatment were not significantly different.In the Fluvastatin Sodium and Pantoprazole Sodium group,the ALT level at 1 month after treatment elevated significantly.In the Fluvastatin Sodium group,the ALT levels were no statistical differences before and after medication.3 In the Atorvastatin and Pantoprazole Sodium combination group,the AST levels were no statistical differences before and after medication.Compared with the level before therapy,the AST level of Atorvastatin group at 1week and 1 month after treatment elevated significantly.In the Fluvastatin Sodium and Pantoprazole Sodium group,the AST level at 1 week after treatment elevated significantly.In the Fluvastatin Sodium group,the AST levels were no statistical differences before and after medication.4 The ratios of ALT and AST in plasma increased to 3ULN were not significantly different in four groups,in the same time after taking medicine(P>0.05).5 The ratios of ALT and AST in plasma increased to 3ULN were not significantly different in the same group,in the difference times after taking medicine.Conclusions:1 In the short time(?3months),there was no significant difference in aminotransferase level of patients with ACS between moderate intensity of Atorvastatin group and Fluvastatin group.2 In the short time,moderate intensity of Atorvastatin and Fluvastatin respectively combined with Pantoprazole did not cause aminotransferase level rise further in patients with ACS.