曲美他嗪对不稳定型心绞痛患者炎症因子水平的影响

Effects of trimetazidine on plasma levels of TNF-a, IL-6 in UA patients

目的观察曲美他嗪（TMZ）对不稳定型心绞痛（UA）患者肿瘤坏死因子-α（TNF-α）和白介素-6（IL-6）水平的影响，探讨其作用机制，为临床上治疗不稳定型心绞痛提供理论依据。方法选取住院的不稳定型心绞痛患者107例，随机分为观察组（53例）和对照组（54例）。两组患者具有可比性。对照组接受常规抗不稳定型心绞痛药物治疗；观察组在常规治疗基础上加用曲美他嗪片20mg／次，3次／d，共12周。治疗前后抽取患者清晨空腹静脉血lOml，检测血浆TNF-α和IL-6等细胞因子的表达水平，并于治疗后进行疗效评价。结果①治疗后，观察组总有效率为90．57％，对照组总有效率为75．93％，两组比较差异有统计学意义（r=4．10，P〈O．05）。②与对照组比较，观察组患者血浆TNF-α和IL-6水平下降差异有统计学意义（P〈O．05）。结论曲美他嗪可能有强化抗炎作用．可提高治疗不稳定型心绞痛的效果。

Objective To observe the effects of trimetazidine on inflammation factors of plasma tumorfactor-α （TNF-α）, interleukin-6（IL-6 ） levels, and to study the mechanism and provide evidence of medication for clinical treatment of unstable angina （UA）. Methods A total of 107 cases with UA were selected and were randomly divided into observation group（n=53 ） and control group（n=54）. The two groups was no significant difference（P〉0.05 ）. Patients in the control group received conventional drug therapy against unstable angina, and patients in the observation group treated with trimetazidine tablets 20 mg/time （rid） on the basis of conventional drug therapy for 12 weeks. Pre- and post-treatment, fasting venous bloods of 10 ml were drawn with anticoagulant tube as well for the promptly separation of plasma after centrifugation, to determine TNF-α and IL-6 expression in the blood of patients. The therapeutic effects were evaluated in two groups. Results （1）After treatment, total effective percentage was 90.57% in the observation, compared to that of 75.93% in the control group, which showed significance difference X^2=4.10,P〈0.05）. （2）The patients in the endothelial function index of blood inflammatory cytokines TNF-α, IL-6 were significantly improver than the control group （P〈0.05）. Conclusion Treating with TMZ in patients with UA, potential anti-inflammatory effects, which could reduce blood inflammatory cytokines TNF-α, IL-6 levels.