曲美他嗪治疗急性心肌梗死伴糖尿病患者的短期效果  

Short-term effect of trimetazidine in the treatment of acute myocardial infarction patients with diabetes

作　　者：汤秀英[1] 李润军[2] 韩孝宇[1] 赵甲彧 杨红梅[1] 侯萍[1] 王庆胜[1] TANG Xiu-ying;LI Run-jun;HAN Xiao-yu;ZHAO Jia-yu;YANG Hong-mei;HOU Ping;WANG Qing-sheng(a. CC;b.Department of Critical Care Medicine, The First Hospital of Qinhuangdao, Hebei Qinhuangdao 066000, Chin)

机构地区：[1]河北省秦皇岛市第一医院冠心病重症监护室,河北秦皇岛066000 [2]河北省秦皇岛市第一医院重症医学科,河北秦皇岛066000

出　　处：《临床药物治疗杂志》2018年第4期71-75,共5页Clinical Medication Journal

基　　金：秦皇岛市科学技术计划项目(201502A218)

摘　　要：目的:为了观察曲美他嗪对急性心肌梗死伴糖尿病患者心肌酶、肝肾功能及血糖的影响,进一步探讨其对于急性心肌梗死患者心脏保护及代谢功能的作用。方法:选取2014年1月至2015年9月于秦皇岛市第一医院因急性心肌梗死伴糖尿病入院的患者100例,根据随机数字表法随机分为对照组和曲美他嗪治疗组各50例。对照组患者在无禁忌证情况下均常规给予低分子肝素钙抗凝治疗、阿司匹林加氯吡格雷或替格瑞洛组双联抗血小板、硝酸酯类血管扩张剂、他汀类药物、β受体阻滞剂、血管紧张素转换酶抑制剂等。曲美他嗪治疗组患者在常规治疗基础上,给予曲美他嗪60 mg即刻口服,之后每次20 mg,3次·d^(-1)口服治疗,分析比较两组患者治疗前后的肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、谷丙转氨酶、谷草转氨酶、血肌酐、尿素氮、血糖及心脏超声指数。结果:治疗后两组患者除了血肌酐、尿素氮、左室舒张末径及心脏每分输出量无明显变化之外,CK、CK-MB、cTnI、ALT、AST、血糖和左室射血分数等观察指标曲美他嗪治疗组均有明显改善(P<0.05)。结论:曲美他嗪能有效改善急性心肌梗死伴糖尿病患者心脏及肝功能,并能调节血糖。Objective： This study was designed to observe short-term effect of trimetazidine（TMZ） on blood biochemistry of acute myocardial infarction（AMI） patients with diabetes, and thus comprehensively evaluate protective effect of TMZ on cardiac and liver functions of the patients. Methods： One hundred AMI patients with diabetes were included, who were randomly divided into two groups： control group（n=50） and observation group（n=50）. All included patients were given antiplatelet drugs, anticoagulants and statins etc. Patients in the observation group were additionally administrated a loading dose of 60 mg TMZ, followed by 20 mg TMZ three times a day. The patients were monitored for creatinine kinase（CK and CK-MB）, cardiac troponin I（c Tn I）, glutamic pyruvic transaminase（ALT）, glutamic oxaloacetic transaminase（AST）, serum creatinine（Cr）, serum urea, glucose and echocardiographic indexes before and after treatment. Results： Except for Cr, serum urea, left ventricular end-diastolic diameter（LVEDD） and cardiac output（CO）, the CK, CK-MB and c Tn I for the aforementioned indexes were significantly improved after treatment in trimetazidine treatment group（P〈0.05）. Conclusion： TMZ can significantly improve te cardiac and liver functions and adjust the blood glucose levels of AMI patients with diabetes.

关 键 词：曲美他嗪 急性心肌梗死 糖尿病 心肌酶 肝功能 血糖 

分 类 号：R542.22[医药卫生—心血管疾病]