曲美他嗪对不稳定性心绞痛患者PCI术后心肌损伤的影响  

Effect of trimetazidine on myocardial injury in patients with unstable angina pectoris undergoing percutaneous coronary intervention

作　　者：邵帅[1] 李广平[1] 石昭昭[2] 倪艳萍[1] 刘红梅[1] 

机构地区：[1]天津医科大学第二医院心脏科,天津心脏病学研究所,天津300211 [2]陕西省西安市第一医院心内科,西安710002

出　　处：《天津医科大学学报》2016年第2期97-100,共4页Journal of Tianjin Medical University

摘　　要：目的:观察不稳定性心绞痛(UAP)患者经皮冠状动脉介入(PCI)治疗前后心肌损伤标记物血清肌酸激酶同工酶(CKMB)、血浆肌钙蛋白I(cTnI)及心脏型脂肪酸结合蛋白(h-FABP)的水平变化,评价曲美他嗪对CK-MB、cTnI及h-FABP的影响。方法:将98例UAP患者随机分为曲美他嗪组(37例)及对照组(61例),于PCI术前即刻及术后次日清晨6时分别检测血清CK-MB、cTnI及h-FABP,另选取对照组加测术前即刻、术后3 h、6 h及术后>10 h的血清h-FABP水平。结果:对照组术后CKMB及cTnI含量较同组术前明显增高(P<0.05),曲美他嗪组术后CK-MB及c Tn I含量较同组术前有所增高(P>0.05),对照组和曲美他嗪组术后>10 h测得h-FABP值分别较术前有所升高(P>0.05)。曲美他嗪组CK-MB、cTnI术前-术后差值分别较对照组显著降低(P<0.05),h-FABP术前-术后差值较对照组有所降低(P>0.05)。对照组术前即刻、术后3 h及术后6h h-FABP值逐渐增高,术后>10 h降低,但仍高于术前即刻水平(P<0.05)。结论:PCI术治疗对UAP患者术后心肌细胞可造成微小损伤,PCI术前至少24 h以上给予曲美他嗪能够减轻UAP患者PCI术后的心肌损伤。Objective： To observe the effect of trimetazidine on myocardial injury in patients with unstable angina pectoris（UAP）undergoing percutaneous coronary intervention（PCI）. Methods：Ninety-eight patients with UAP randomly were divided into trimetazidine group（37 cases） and control group（61 cases）. Standard medical therapies were given to all 98 patients. The creatine kinase MB（CK-MB）,cardiac troponin I（cTnI） and heart-type fatty acid-bindling protein（h-FABP） were measured in all enrolled subjects before PCI right time and at 6：00 in the next day morning after PCI, and heart-type fatty acid-bindling protein（h-FABP） was also measured in another control group before PCI right time at 3 h, 6 h and more than 10 h after PCI. Results：The levels of CK-MB and cTnI were elevated significantly after PCI in control group（P〈0.05）, but there were no significant changes in the increased level of CK-MB and cTnI after PCI in the trimetazidine group（P〈0.05）. The levels of h-FABP were elevated at 10 h after PCI in control group and the trimetazidine group, but not significantly（P〈0.05）.However, the ascended levels of CK-MB（P〈0.05）, cTnI（P〈0.05） and h-FABP（P〈0.05） in the trimetazidine group were lower than those in control group. Furthermore, the levels of h-FABP were elevated step by step before PCI right time, 3 h and 6 h after in control group, though decreased 10 h after PCI, but still higher than before PCI right time（P〈0.05）. Conclusion：PCI may cause some minor damage of myocardium to patients with UAP. Trimetazidine therapy at more than 24 h before PCI can effectively protect myocardium in patients with UAP.

关 键 词：曲美他嗪 不稳定性心绞痛 经皮冠状动脉介入治疗 心肌损伤 

分 类 号：R541.4[医药卫生—心血管疾病]