盐酸曲美他嗪对冠状动脉支架术后患者心绞痛发作频率及活动耐量的影响

Impact of Trimetazidine on angina frequency and exercise tolerance in patients undergoing percutaneous coronary intervention

目的:评价盐酸曲美他嗪对冠状动脉支架治疗术后患者,心绞痛发作频率及活动耐量的影响。方法:选取首次行冠状动脉支架治疗术患者104例,植入支架后,随机分为盐酸曲美他嗪组(20mg,3次/d,口服)及常规治疗组(安慰剂1片,3次/d,口服),各52例。所有患者每2周门诊随访1次,共6个月,记录心绞痛发作的次数、硝酸甘油的应用、心绞痛分级(CCS分级),主要心脏不良事件(MACE)发生情况;并于开始服药治疗前以及服药6个月后,行超声心动图检查及6min步行试验。结果:2组患者MACE发生率差异无统计学意义(盐酸曲美他嗪组:7.8%,常规治疗组:9.7%P>0.05);在心绞痛发作例数、发作次数及心绞痛CCSⅢ级,发作时需用硝酸甘油缓解例数方面盐酸曲美他嗪组均优于常规治疗组(P<0.05)。治疗6个月后盐酸曲美他嗪组左心室射血分数(LVEF)及6min步行距离较自身改善,差异有统计学意义(P<0.05);且6min步行距离较常规治疗组明显增加(P<0.05)。结论:冠状动脉支架治疗术后在常规治疗基础上,加用盐酸曲美他嗪可以减少心绞痛的发作,改善左心功能,提高活动耐量。

Objective：To investigate the Impact of Trimetazidine on angina frequency and exercise tolerance in patients undergoing percutaneous coronary intervention.Methods：A total of 104 patients treated with PCI was randomized to Trimetazidine group（20 mg,3/d） and routine therapy group,and were followed up for 6 months.Angina frequency,number of CCS Ⅲ class,consumption of nitroglycerol and major adverse cardiac events（MACE） were recorded.2-dimensional echocardiography and 6-mintute walk test were performed in all patients at baseline and 6 months.Results：No difference of MACE was found in two groups.Angina frequency,CCS Ⅲ class,need of nitroglycerol were all significantly reduced in Trimetazidine group compared to routine therapy group（P 0.05）.LVEF and mean distance of 6-mintute walk test were significantly increased in Trimetazidine group after 6 months than those at baseline.Mean distance of 6-mintute walk test was longer in Trimetazidine group than that in routine therapy group（P 0.05）.Conclusion：Trimetazidine therapy can reduce angina frequency and increase exercise tolerance in patients undergoing PCI.