曲美他嗪对稳定性劳力型心绞痛的疗效观察  

Effect of trimetazidine in patients with stable exertional angina

作　　者：中国曲美他嗪多中心临床研究协作组 胡大一[1] 赵秀丽[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院心脏中心,100020

出　　处：《中华心血管病杂志》2000年第5期339-341,共3页Chinese Journal of Cardiology

摘　　要：目的　试验目的为评价曲美他嗪 (TMZ)与传统药物相结合对稳定性劳力型心绞痛患者抗心绞痛的疗效及耐受性。方法　在 1周的时间内经 2次运动试验 ,结果为阳性且运动持续时间变异低于 10 %的 138例稳定性劳力型心绞痛患者入选试验 ,给予TMZ 2 0mg ,每天 3次联合单一的 β阻滞剂、钙通道阻滞剂或长效的硝酸脂类治疗 12周。 131例患者完成试验 ,行统计学分析。结果　与试验前相比 ,运动耐量和总工作量显著提高 (P <0 0 0 1) ,至心绞痛发作时间及ST段下降 1mm的时间均明显延长 (P <0 0 0 1) ,其中有 32例患者 (2 4 43% )试验后不再有ST段下降 1mm ,而对心率 血压乘积的影响无统计学显著意义 (P >0 0 5 )。TMZ应用 12周后 ,患者心绞痛发作次数显著减少且硝酸甘油消耗量明显降低 ,可能与心绞痛分级明显降低有关。在试验的 12周内 ,药物不良反应报告的较少 ,主要有失眠 1例、上腹部不适 1例、头痛 1例、面红 1例、心悸 1例及眩晕、乏力和心率加快 1例。结论　TMZ 2 0mg每天 3次与其它药物联合应用对稳定性劳力型心绞痛患者能增加运动耐量 ,且安全有效 ,患者易于耐受。Objective To assess the anti anginal efficacy and the acceptability of trimetazidine (TMZ) in combination with conventional treatment in patients with stable exertional angina in China. Methods One hundred and thirty eight stable exertional angina patients with two positive exercise tests within one week and the difference of duration of exercise between two tests ≤10% were included. TMZ 20 mg tid was combined with any one of the three traditional medications including β blockers, calcium antagonists or long acting nitrates. The total period of treatment was 12 weeks. The data from 131 patients who completed the study were used for statistical analysis. Results The results showed that TMZ significantly increased exercise duration, total work load, time to onset of angina and time to 1 mm ST segment depression (P<0 001). After treatment, 32 patients (24.43%) no longer showed ST depression ≥1 mm during exercise, however, rate pressure product did not change significantly (P>0 05). TMZ reduced the number of anginal attacks and the mean nitrate consumption per week. The changes were significantly different. This may be associated with a decrease of grades of exertional angina. During the period of TMZ therapy, there were very few adverse drug effects reported, including one insomnia, one discomfortable feeling in upper abdomen, one headache, one rash, one palpitation and one case with dizziness, weakness and increased heart rate. Conclusion For patients with stable exertional angina, TMZ 20 mg three times daily in combination with existing therapy increases the exercise capacity. The drug is safe and effective and well tolerated by patients.

关 键 词：曲美他嗪 稳定性劳力型心绞痛 药物疗法 疗效 

分 类 号：R541.405[医药卫生—心血管疾病] R972[医药卫生—内科学]