曲美他嗪对稳定型心绞痛患者造影剂肾病的临床疗效  

Efficacy of trimetazidine in patients with stable angina pectoris with contrast induced nephropathy

作　　者：黄潆莹 叶自亮 苏强[1] HUANG Ying- ying;YE Zi - liang;SU Qiang.(Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Naning 530021, Guangxi, China.)

机构地区：[1]广西医科大学第一附属医院心内科,广西南宁530021

出　　处：《广东医学》2018年第8期1223-1227,共5页Guangdong Medical Journal

基　　金：广西高校中青年教师基础能力提升项目(编号:KY2016YB084)

摘　　要：目的观察曲美他嗪对稳定型心绞痛患者造影剂肾病(CIN)的临床疗效。方法选取行冠状动脉造影术的99例稳定型心绞痛患者作为研究对象,按照是否服用曲美他嗪将99例患者分成对照组(n=53)和曲美他嗪组(n=46),对照组给予冠心病常规治疗,曲美他嗪组在对照组的基础上服用曲美他嗪(术前3 d给予曲美他嗪片20 mg,3次/d,术后服用7 d),观察并记录两组患者术后24 h、48 h和72 h的血肌酐(Scr)、胱抑素C(Cystatin C)和肾小球滤过率(e GFR)。结果曲美他嗪组术后CIN的发病率(4.35%)明显低于对照组(16.98%),差异具有统计学意义(X^2=3.979,P=0.046);曲美他嗪组在24 h后的Scr、Cystatin C和e GFR明显优于对照组(分别为:OR=1.78,95%CI:1.54~1.89;OR=0.32,95%CI:0.28~0.53;OR=1.53,95%CI:1.26~1.79);曲美他嗪组在48 h后的Scr、Cystatin C和eGFR明显优于对照组(分别为:OR=1.72,95%CI:1.43~2.06;OR=0.28,95%CI:0.24~0.41;OR=1.58,95%CI:1.22~1.74);曲美他嗪组在72 h后的Scr、Cystatin C和eGFR明显优于对照组(分别为:OR=1.78,95%CI:1.43~2.06;OR=0.26,95%CI:0.22~0.35;OR=1.50,95%CI:1.24~1.63);按性别进行分组分析后,曲美他嗪组术后的Scr、Cystatin C和eGFR仍明显优于对照组(均P<0.05)。结论曲美他嗪能显著减少稳定型心绞痛患者CIN的发生。Objective To observe the efficacy of trimetazidine in patients with stable angina pectoris with contrast induced nephropathy （CIN）. Methods Totally 99 patients with stable angina pectoris who underwent coronary angiography in our hospital from April 2015 to April 2017 were selected and divided into control group （n = 53 ） and trimetazidine group （n = 46） according to whether they were treated with trimetazidine. The control group was given conventional treat- ment of coronary heart disease, and the trimetazidine group was given with trimetazidine on the basis of the control group （trimetazidine was given from 3 days before operation, to 7 days after operation, 3 times a day）. The serum ereatinine （Scr） , cystatin C and glomerular filtration rate （eGRF） were recorded at 24 h, 48 h and 72 h. Results The incidence of CIN （4.3%） in trimetazidine group was significantly lower than that in control group （P = 16. 98% ） （χ^2 =3. 979, P = 0. 046）. The Scr, cystatin C and eGRF in the trimetazidine group were significantly better than those in the control group after 24 h （OR=1.78, 95% CI： 1.54-1.89; 0R=0.32, 95% CI： 0.28-0.53; 0R=1.53,95% CI： 1.26-1.79, respectively）. The Scr, Cystatin C and eGRF in the trimetazidine group were significantly better than those in the control group after 48 h （OR = 1.72, 95% CI： 1.43 -2.06; OR =0.28, 95% CI： 0.24 -0.41; 0R=1.58, 95% CI： 1.22 - 1.74, respectively）. The Scr, Cystatin C and eGRF in the trimetazidine group were significantly better than those in the control group after 72 h （ OR = 1.78, 95% CI： 1.43 -2. 06; OR =0. 26, 95% CI： 0.35 ; OR = 1.50; 95% CI： 1.24 - 1.63, respectively）. The Scr, Cystatin C and eGRF of trimetazidine group were significantly better than those of control group after grouping analysis by gender （ all P 〈 0.05 ）. Conclusion Trimetazidine can significantly reduce the incidence of CIN in patients with stable angina peetoris.

关 键 词：曲美他嗪 稳定型心绞痛 造影剂肾病 

分 类 号：R541.4[医药卫生—心血管疾病]