曲美他嗪对冠心病患者血管内皮功能的改善作用  

Effect of trimetazine on vascular endothelial function in patients with coronary heart disease

作　　者：吴源[1] 高东梅[2] 宋军[2] 周雪艳[1] 孟繁波[1] 曾红[1] 

机构地区：[1]吉林大学中日联谊医院心内科,吉林长春130033 [2]吉林大学中日联谊医院电诊科,吉林长春130033

出　　处：《吉林大学学报（医学版）》2009年第4期685-689,共5页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(30770883)

摘　　要：目的:探讨曲美他嗪减轻冠心病患者血管内皮功能的损伤、恢复内皮细胞功能的作用。方法:明确诊断为冠心病的患者58例,按治疗方法不同分为曲美他嗪组(30例)和对照组(28例)。两组均常规应用血小板抑制剂,必要时加服小剂量β-受体阻滞剂及丹参粉针;曲美他嗪组在上述基础上加用曲美他嗪,用量为20 mg,3次.d-1,连服4周。用药前后分别采用高分辨超声仪检测肱动脉血管内径、血流介导(FMD)和硝酸甘油介导的血管舒张反应比(NMD)、基础内膜-中层厚度(IMT)、血流介导和硝酸甘油介导的IMT改变率、收缩期血流速度、阻力指数(RI)。结果:治疗前曲美他嗪组与对照组FMD和NMD、IMT、血流介导IMT的改变率和硝酸甘油介导的IMT的改变率、收缩期血流速度、RI比较差异无显著性(P>0.05);治疗后曲美他嗪组FMD和NMD较对照组明显升高(P<0.05),曲美他嗪组IMT较对照组减小(P<0.05),曲美他嗪组血流介导IMT的改变率和硝酸甘油介导IMT的改变率、收缩期血流速度、及RI较对照组明显升高(P<0.05)。结论:曲美他嗪对冠心病患者的血管内皮功能具有改善作用,可以减轻内皮细胞的损伤,恢复内皮细胞功能,以及恢复血管的弹性并减少痉挛。Objective To investigate the effect of trimetazine on vascular endothelial function in patients with coronary heart disease.Methods Fifty eight patients with coronary heart disease were divided into trimetazine group（n=30） and control group（n=28）.With high resolution ultrasound,flow-mediated dilation（FMD） and nitroglycerin-mediated dilation（NMD）,intima-media thickness（IMT） and the change rates of FMD and NMD,velocity of systolic phase of the brachial artery were measured in control group and trimetazine group.Results The FMD,NMD,the change rates of IMT with flow-mediated and nitroglycerinmediated,velocity of systolic phase,resistent index（RI） of the brachial artery in trimetazine group and control group had no differences before treatment（P〈 0.05）.The FMD and NMD,IMT,the change rates of IMT with flow-induced and nitroglycerin-induced,velocity of systolic phase and RI in trimetazine group were significantly higher than those in control group after treatment（P〈0.05）,but the IMT waslower than that in control group（P〈0.05）.Conclusion Trimetazine can improve the vascular endothelial function of coronary heart disease.It can relieve the damage of endotheliocytes,and revival the function of endotheliocytes.

关 键 词：曲美他嗪 冠心病 内皮功能 超声 

分 类 号：R541.4[医药卫生—心血管疾病]