曲美他嗪治疗不稳定型心绞痛的疗效观察

Therapeutic effect of trimetazindine on patients with unstable angina pectoris

目的 观察在常规治疗基础上加用曲美他嗪治疗不稳定型心绞痛的疗效。方法 选择确诊的不稳定型心绞痛患者 30例,随机分为 2组,对照组 15例,采用硝酸酯类、血管紧张素转换酶抑制剂 (ACEI)、β 受体阻滞剂、利尿剂、抗血小板药物及调脂治疗,治疗组 15例在常规治疗基础上加用曲美他嗪, 2组均治疗 30d,观察治疗前后每日心绞痛发作次数、每日硝酸甘油用量、心率、血压、收缩压与心率乘积、24h心电图ST段最大下移幅度、总下移时间及 24h缺血的次数及不良反应。结果 与对照组相比,治疗组每日硝酸甘油用量、24h缺血发作次数、ST段最大下降幅度、ST段总下降时间均明显减少 (P<0.01 );治疗后心率、收缩压和心率乘积变化无统计学意义(P>0.05)。结论 在常规治疗基础上加用曲美他嗪能明显减少心绞痛发作次数、ST段最大下降幅度和总缺血时间。对血流动力学无影响,不良反应轻,是安全、有效、更完善的治疗方案。

Objective To evaluate the effect of trimetazidine in patients with unstable angina pectoris on conventional therapy.Methods 30 patients with unstable angina pectoris,who were randomized into conventional therapy group (15) and TMZ therapy group (15) were involved in this study.In the conventional therapy group,patients accepted the treatment with nitrate,angiotensin-converting enzyme inhibitor,β-blocker and aspirin.In the TMZ group,TMZ(trimetazindine) were given (20mg 3times daily) in addition to conventional therapy.The treatment durations in both groups were 30 days.The symptoms,heart rate,blood pressure,ambulatory 24-hour electrocardiogaphy and side effects were observed.Results Compared with the conventional therapy group,the efficacy of TMZ group was better (P<0.01);TMZ had no effect on heart rate,blood pressure;The reduction of the number of ischemic episodes,maximal ST-segment depression and the total time of ischemic episodes were more significant ( P<0.01).Conclusion Combinating therapy of TMZ with conventional drugs releases unstable angina pectoris more effectively,reduces the number of ischemic espisodes,maximal ST-segment depression and total time of ischemic episodes more significantly.There is no effect on circulation kinetics.It is safe,effective and more perfect theraeutpic protocol to unstable angina pectoris.