曲美他嗪治疗非ST段抬高型急性冠状动脉综合征患者的疗效观察及其对脂联素和内脂素的影响

Effect of Trimetazidine Dihydrochloride on Serum Adiponectin and Visfatin and Therapeutic Effect for Patients with Non-ST Elevation Acute Coronary Syndrome

目的观察曲美他嗪治疗非ST段抬高型急性冠状动脉综合征(NSTEACS)患者的疗效及其对脂肪因子脂联素、内脂素水平的影响。方法 NSTEACS患者80例,随机分为对照组和治疗组各40例。分别在用药前,用药后7、30d抽取空腹静脉血,检测血清脂联素、内脂素水平,并观察用药30d 2组主要不良心脏事件的发生情况。结果 2组用药后7、30d血清内脂素水平均有降低(P<0.05),脂联素水平均有升高(P<0.05),治疗组血清脂联素、内脂素水平变化较对照组更显著(P<0.05),且主要不良心脏事件发生率明显降低(P<0.05)。结论曲美他嗪对NSTEACS具有心血管保护作用,减少心脏事件发生率,其机制可能与调节脂肪因子水平变化、优化能量代谢有关。

Objective To observe the therapeutic effect of trimetazidine dihydrochloride and its influence on serum adiponectin and visfatin in patients with non-ST elevation acute coronary syndrome（NSTEACS）.Methods Eighty patients with NSTEACS were randomized into 2 groups： the control group and trimetazidine dihydrochloride group（treatment group）.Patients in the control group were given traditional treatment.The treatment group were given trimetazidine dihydrochloride in addition to traditional treatment.The clinical symptoms and incidence of cardiac event of the 2 groups were observed.The concentrations of adiponectin and visfatin were detected in all the patients before as well as 7 and 30 d after the administration of medicine.Results Compare with those in control group,the clinical symptoms and major cardiac occurrence in treatment group decreased significantly（P0.05）.Seven and thirty days after the administration of medicine,the concentrations of visfatin in both groups decreased significantly（P0.01）,the concentrations of adiponectin increased significantly（P0.01）,but the treatment group was more significant than the control group（P0.05,P0.01）.Conclusion Trimetazidine dihydrochloride has some protective effect on the cardiovascular system and reduces the major cardiac occurrence in patients with NSTEACS.The mechanism may relate to regulating the expression of adiponectin and visfatin in addition to optimizing myocardial energy metabolism.