曲美他嗪治疗PCI术后心绞痛患者的疗效及其对内皮功能和运动耐量的影响  

Therapeutic effect of trimetazidine on patients with angina pectoris after PCI and its influence on endothelial function and exercise tolerance

作　　者：秦忠[1] 朱海[1] 廖树森[1] 周骏[1] 

机构地区：[1]北海市人民医院心血管内科,广西北海536000

出　　处：《心血管康复医学杂志》2017年第6期635-639,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究曲美他嗪治疗经皮冠状动脉介入治疗(PCI)术后心绞痛患者的疗效及其对内皮功能和运动耐量的影响。方法:选择在我院接受首次PCI治疗后心绞痛患者108例,随机均分成常规治疗组及曲美他嗪组(在常规治疗基础上,术后第2个月予以曲美他嗪治疗),比较两组治疗后的临床疗效,及治疗前后两组内皮功能和运动耐量的变化情况。结果:曲美他嗪组治疗后总有效率明显高于常规治疗组(98.15%比83.33%,P=0.008)。治疗后两组的心绞痛发作情况、心功能均有明显改善,内皮功能和运动耐量有明显提高(P<0.05或<0.01);与常规治疗组比较,曲美他嗪组的心绞痛发作平均次数[(2.91±1.25)次/月比(1.72±1.04)次/月]与持续时间[(2.06±1.08)h比(1.24±0.97)h]、硝酸甘油[(1.21±0.12)g比(0.84±0.11)g]的用量明显减少,内皮素-1[(50.44±7.43)ng/L比(41.08±6.02)ng/L]水平显著降低,ST段下移幅度[(0.16±0.05)mV比(0.13±0.05)mV]和时间[(18.64±6.41)min比(6.74±4.82)min]、T波倒置幅度[(0.18±0.04)mV比(0.09±0.05)mV]显著减少,左室射血分数[(54.18±8.25)%比(57.82±7.73)%]和6min步行距离[(512.74±86.66)m比(551.24±84.69)m]明显增加,肱动脉内皮依赖性舒张功能[(10.08±3.1)%比(11.79±3.24)%]、一氧化氮[(83.14±5.15)μmol/L比(116.22±6.54)μmol/L]水平明显升高(P<0.05或<0.01)。结论:曲美他嗪对PCI术后心绞痛具有较好的疗效,还有效改善患者的内皮功能和运动耐量,值得推广。Objective： To study therapeutic effect of trimetazidine on patients with angina pectoris after percutaneous coronary intervention （PCI） and its influence on endothelial function and exercise tolerance. Methods： A total of 108 patients with angina pectoris after primary PCI in our hospital were selected, randomly and equally divided into routine treatment group and trimetazidine group （received trimetazidine therapy since second month after PCI based on routine treatment）. Therapeutic effect after treatment, after treatment were compared between two groups. Results endothelial function and exercise tolerance before and Total effective rate of trimetazidine group was signifi- cantly higher than that of routine treatment group （98.15% vs. 83.33%, P = 0. 008）. Compared with before treat- ment, there were significant improvements in angina pectoris onset condition and cardiac function, significant rise in endothelial function and exercise tolerance in two groups after treatment, P^0.05 or d0.01; compared with rou- tine treatment group after treatment, there were significant reductions in mean onset times [ （2.91 ± 1.25） times/ month vs. （1.72 ± 1.04） times/month] and duration [ （2.06 ± 1.08） h vs. （1.24 ± 0.97） hI of angina pectoris, ni- troglycerin dose [- （1.21± 0.12） g vs. （0.84 ± 0.11） g], depression magnitude [- （0.16 ± 0.05） mV vs. （0.13 ± 0.05） mV] and time Y- （18.64± 6.41） min vs. （6.74 ± 4.82） mini of ST segment, T wave inversion magnitude [ （0.18±0.04） mV vs. （0.09±0.05） mV] and endothelin-1 level [- （50.44±7.43） ng/L vs. （41.08±6. 02） ng/ L], and significant rise in left ventricular ejection fraction [- （54. 18 ± 8. 25） % vs. （57.82 ± 7.73） %1, 6rain walking distance F （512.74 ± 86.66） m vs. （551.24 ± 84. 69） m], fore brachial artery endothelium dependent diastolic-sys- tolic function E （10.08 ± 3.1） % vs. （11.79 ± 3.24） %] and nitric oxide level E （83.14 ± 5.15） μmol/L vs. （116. 22 �

关 键 词：心绞痛 血管成形术 气囊 冠状动脉 曲美他嗪 

分 类 号：R541.4[医药卫生—心血管疾病]