曲美他嗪治疗不稳定性心绞痛疗效观察

Therapeutic value of Trimetazidine in patients with unstable angina

目的曲美他嗪是一种新型的抗心肌缺血药物,能够通过代谢改善心绞痛患者的心肌缺血,并有心肌的直接保护作用,同时并没有明显的血液动力学效应。本研究评价不稳定性心绞痛患者在常规治疗的基础上加用曲美他嗪60 mg/d,治疗3个月后观察心电图变化及对心绞痛的影响,评价患者的临床疗效和耐受性。方法44例平均年龄(56.10±4.3)岁不稳定性心绞痛患者进入本项研究,所有患者在常规治疗的基础上加用曲美他嗪60 mg/d治疗3个月,随访观察患者的临床情况和心电图变化。结果44例患者均可耐受在常规治疗的基础上加用曲美他嗪60 mg/d,无药物相关不良反应事件发生,心绞痛发作次数和硝酸甘油用量分别减少3.8次/周和1.2片/周(P<0.001)。结论不稳定性心绞痛患者在常规治疗的基础上加用曲美他嗪60 mg/d治疗是安全的,且能改善心肌供血,减少心绞痛发作频率,对血液动力学没有影响。

Objective Trimetazidine has been shown to have anti-ischemic properties by improving cardiac energetic metabolism without haemodynamic effect and direct cyto-protective effects on myocardium. The aim of this study was to assess the effect of trimetazidine on patients with unstable angina after some conventional therapy. Methods Forty-four patients, average age （56.10 ± 4.3 ） years, with unstable angina on conventional therapy were enrolled in this clinical trial and received trimetazidine （20 mg, tid） for three months, Patients were followed up for three months with assessments including clinical evaluations and electrocardiograms. Results All patients tolerated 60 mg of Trimetazidine everyday on conventional therapy for three months. Attack of angina was relieved to 3, 8 times/week and consumption of nitroglycerin were reduced to 1.2 pills/week （P 〈 0,001 ）. Conclusion It seems to be safe to use 60 mg Trimetazidine everyday in patients with unstable angina after conventional therapy. Trimetazidine can improve clinical status, reduces angina onsets and has no haemodynamic effect.