曲美他嗪治疗不稳定心绞痛的临床观察

Clinical Observation of Trimetazidinein Treatment of Unstable Angina

目的评价曲美他嗪治疗不稳定型心绞痛的临床疗效。方法确诊为UAP患者76例随机分为常规药物治疗组(对照组,n=38)和常规药物加曲美他嗪组(治疗组,n=38),治疗组在常规用药的基础上加用曲美他嗪(商品名:万爽力,法国施维雅药厂生产)20mg,tid,连用6周。以12导联心电图ST段压低数值总和(∑ST)和1周内心绞痛发作次数作为心肌缺血指标,空腹取静脉血测定血糖、血脂、肌酸磷酸肌酶、肌钙蛋白Ⅰ、肝、肾功能及血、尿常规。6周后复测上述指标,同时观察患者的硝酸甘油耗量(片/月)、药物耐受性及不良反应。两组患者年龄、性别、血压、心率、吸烟、空腹血糖及危险分层比例无明显差异。结果两组患者用药后心绞痛发作次数、及∑ST、硝酸甘油耗量(片/月)均较用药前明显下降,均有显著性差异(P<0.05及P<0.01)但治疗组下降更明显,两组治疗前无差别,而治疗后差异显著(P<0.01)。结论曲美他嗪治疗不稳定型心绞痛疗效确切,值得临床推广使用。

Objective To evaluate clinical effect of trimetazidine treatment of unstable angina.Methods Patients diagnosed UAP 76 cases randomly divided into routine drug treatment group（control,n=38） and conventional drugs,because trimetazidine group（treatment group,n=38）,the treatment group in the basis of conventional medicine add trimetazidine（brand name： cool force,France ShiWeiYa million pharmaceutical production） 20mg（tid,6 weeks）.With 12-lead couplet electrocardiogram st-segment depress numerical sum（∑ ST） and 1 weeks anginal attacks as myocardial ischemia index,fasting blood glucose,blood fat take venous blood determination,creatine phosphate muscle enzyme,muscle calcium protein Ⅰ,liver,kidney and blood,routine urine.Six weeks after retest measure the above indexes,at the same time the patients were observed Nitroglycerin consumption quantity（sheet/month）,drug and tolerability adverse reactions.Two groups of age,sex,patient blood pressure and heart rate,smoking,fasting blood sugar and risk stratification proportion no obvious difference.Results Two sets of patients when the drug anginal attacks,and ∑ ST,Nitroglycerin consumption quantity（sheet/month） which is before using this drug declined obviously,all have significant difference（P0.05,P0.01） but the treatment group drop more apparent,two groups before treatment non-differently functioning,and after the treatment of significant difference（P0.01）.Conclusion Trimedazidine can improve the UAP in patients and is valuable to be spread broadly in clinic.