曲美他嗪联合硝酸异山梨酯对冠心病心绞痛患者ET和cEMPs水平的影响  

The efficacy of trimetazidine combined isosorbide dinitrate on the levels of ET and c EMPs in patients with angina pectoris

作　　者：朱宏旭[1] 宋丽萍[1] 刘庚[1] 耿学峰[1] 常宇锋[1] ZHU Hong-xu;SONG Li-ping;LIU Geng(Department of Cardiology,Beijing Haidian Hospital(Beijing Haidian Section of Peking University Third Hospital),Beijing 100080,China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)心内科,北京100080

出　　处：《临床和实验医学杂志》2018年第7期754-757,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨曲美他嗪联合硝酸异山梨酯对冠心病心绞痛(CHDA)患者内皮素(ET)、外周血循环内皮微颗粒(c EMPs)水平的影响。方法前瞻性选取2013年12月至2016年12月北京市海淀医院收治的CHDA患者100例,依据随机数字表分为梨酯组和联合组,每组各50例,梨酯组给予硝酸异山梨酯治疗,联合组在此基础上再给予曲美他嗪治疗。观察比较两组患者治疗前后血清ET、c EMPs、心搏出量(SV)、射血分数(EF)水平、心绞痛发作频率、持续时间和不良反应发生情况。结果联合组和梨酯组治疗后ET、c EMPs水平、心绞痛发作频率、持续时间[(66.11±6.80)μg/ml、(833.47±86.97)×10~6/L、(2.67±0.36)次/周、(4.28±1.34)min/次和(81.43±8.45)μg/ml、(1 031.76±107.01)×10~6/L、(1.27±0.28)次/周、(8.67±1.78)min/次)]明显低于治疗前[(121.75±14.61)μg/ml、(1 220.52±30.97)×10~6/L、(7.59±2.23)次/周、(22.12±4.07)min/次和(120.45±14.13)μg/ml、(1 223.13±131.43)×10~6/L、(7.53±2.18)次/周、(22.43±4.11)min/次)],联合组治疗后ET、c EMPs水平和心绞痛发作频率、持续时间明显低于梨酯组,差异有统计学意义(P<0.05);联合组和梨酯组治疗后SV、EF水平[(70.43±7.24)ml、(60.94±6.31)%和(62.47±6.58)ml、(55.12±5.45)%]明显高于治疗前[(46.13±4.86)ml、(48.69±5.24)%和(46.24±4.82)ml、(48.78±5.28)%],联合组治疗后SV、EF水平明显高于梨酯组,差异有统计学意义(P<0.05);联合组不良反应发生率(16.00%)与梨酯组(12.00%)相比,差异无统计学意义(P>0.05)。结论曲美他嗪联合硝酸异山梨酯治疗可有效改善CHDA患者的内皮功能及心肌收缩力,有利于降低心绞痛的发作频率、时间,且具有良好的安全性,值得临床作进一步推广。Objective To explore the effect of trimetazidine and isosorbide dinitrate on levels of endothelin(ET)and circulating endothelial microparticles(cEMPs)in patients with angina pectoris.Methods One hundred patients with angina pectoris in this hospital during December 2013 to December 2016 were selected for this prospective study,all these patients were divided into isosorbide group and combination treatment group according to the method of treatment,each group with 50 patients.Patients in isosorbide group were given with isosorbide dinitrate for treatment,and patients in combination treatment group were given with trimetazidine on the basis of treatment in isosorbide group.The serum levels of ET,cEMPs,and cardiac output(SV),ejection fraction(EF),frequency and duration of angina attack,and adverse reactions were observed and compared between these two groups before and after treatment.Results After treatment,levels of ET and cEMPs and frequency of attack,sustained time[(66.11±6.80)μg/ml,(833.47±86.97)×10 6/L,(2.67±0.36)times/week,(4.28±1.34)min/time and(81.43±8.45)μg/ml,(1 031.76±107.01)×10 6/L,(1.27±0.28)times/week,(8.67±1.78)min/time)]of isosorbide group and combination group were significantly lower than those before treatment[(121.75±14.61)μg/ml,(1 220.52±30.97)×10 6/L,(7.59±2.23)times/week,(22.12±4.07)min/time and(120.45±14.13)μg/ml,(1 223.13±131.43)×10 6/L,(7.53±2.18)times/week,(22.43±4.11)min/time)],after treatment,levels of ET and cEMPs and frequency of attack in combination group were significantly lower than those of isosorbide group,after treatment heart stroke volume(SV),ejection fraction(EF)levels[(70.43±7.24)ml,were(60.94±6.31)%and(62.47±6.58)ml,(55.12±5.45)%]in isosorbide group and combination group were significantly higher than those before treatment[(46.13±4.86)ml,(48.69±5.24)%and(46.24±4.82)ml,(48.78±5.28)%],after treatment,levels of SV and EF in combination group were significantly higher than those of isosorbide group,and the difference was statistically significa

关 键 词：冠心病心绞痛 曲美他嗪 硝酸异山梨酯 内皮素 外周血循环内皮微颗粒 

分 类 号：R541.4[医药卫生—心血管疾病]