曲美他嗪改善冠心病患者冠状动脉重建术相关心肌损伤的Meta分析  

Trimetazidine for improvement of myocardial damage related to coronary artery revascularization among patients with coronary heart disease: a Meta-analysis

作　　者：吴璠[1] 严广东[2] 周惠明[1] 梁慧[1] 张根水[3] 

机构地区：[1]广州医科大学附属广州市妇女儿童医疗中心心脏中心,广州市510623 [2]广州市红十字会医院心血管内科,广州市510000 [3]广州医科大学药理学教研室,广州市511436

出　　处：《广西医学》2016年第11期1551-1556,共6页Guangxi Medical Journal

摘　　要：目的 评价曲美他嗪对冠状动脉重建术相关心肌损伤的改善效果。方法 计算机检索Cochrane图书馆临床对照试验库、Pub Med、Embase、中国生物医学文献数据库、中国学术期刊全文数据库、万方数据库、维普数据库,纳入有关经皮冠状动脉介入治疗（PCI）和冠状动脉旁路移植术（CABG）术前服用曲美他嗪对术后心肌肌钙蛋白（c Tn）I、cTnT、肌酸激酶同工酶（CK-MB）影响的随机对照试验（RCT）,对纳入文献进行评价质量后,采用Rev Man 5.0软件进行Meta分析。结果 共纳入15项RCT,包括1 473例行PCI的冠心病患者及323例行CABG的冠心病患者。Meta分析结果显示,PCI术后12~18 h、24~48 h试验组c Tn I值均低于对照组（P〈0.05）,PCI术后0~6 h、12~18 h、24~48 h试验组CK-MB值均低于对照组（P〈0.05）,CABG术后0~6 h、12~18 h、24~48 h试验组cTnT、CK-MB值均低于对照组（P〈0.05）。结论 术前服用曲美他嗪可有效改善冠状动脉重建术相关心肌损伤,发挥心肌保护作用。Objective To evaluate the efficacy of trimetazidine for the improvement of myocardial damage related to coronary artery revaseularization. Methods The databases of computer retrieve included Cochrane controlled clinical trials register, PubMed, Embase, CBM, CNKI,Wanfang Database and VIP. Randomized controlled trials （RCTs） about the effect of administration with trimetazidine before perentaneous coronary intervention（PCI） and coronary artery bypass grafting（CABG） on the postoperative levels of cardiac troponin （cTn） I, cTnT or creatinine kinase MB isoenzyme（ CK-MB ） were enrolled. The quality assessment of included studies was performed, then a Meta-analysis was conducted using RevMan 5.0 software. Results Fifteen RCTs were involved, which consisted of 1 473 patients with coronary heart disease receiving PCI and 323 receiving CABG. The result of Meta-analysis showed that the cTnI levels in the experiment group were lower than those in the control group after 12 - 18 hours, 24 - 18 hours of PCI（ P 〈 0. 05 ） , the CK-MB levels in the experiment group were lower than those in the control group after 0 -6 hours, 12 - 18 hours,24 - 18 hours of PCI（ P 〈 0.05 ）, and the eTnT and CK-MB levels in the experiment group were lower than those in the control group after 0 -6 hours, 12 - 18 hours ,24 - 18 hours of CABG （P 〈0.05 ）. Conclusion Preoperative administration with trimetazidine can effectively improve myocardial injury related to coronary artery revascularization, and play a role in myocardial protection.

关 键 词：冠心病 经皮冠状动脉介入治疗 冠状动脉旁路移植术 曲美他嗪 心肌损伤 系统评价 

分 类 号：R541.4[医药卫生—心血管疾病]