曲美他嗪对稳定型劳力性心绞痛患者临床疗效及其对运动耐量的影响

Clinical Efficacy of Trimetazidine for Stable ExertionalAngina Pectoris Patients and its Influence on Exercise Tolerance

目的:观察曲美他嗪对稳定型劳力性心绞痛患者临床疗效及其对运动耐量的影响。方法:将心血管内科病房住院的确诊为稳定型劳力性心绞痛190例随机分为观察组和对照组各95例。组患者均予以常规治疗,包括严格卧床休息,严密监护,吸氧及抗心绞痛治疗;对照组在常规治疗基础予以口服二硝酸异山梨醇脂;治疗组予以口服盐酸曲美他嗪片20mg,3次/d。两组患者疗程均连续治疗2周。结果:治疗组总有效率94.74%,对照组总有效率85.26%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,治疗组患者的运动诱发心绞痛发作所需时间、运动后ST段下降≥1mm所需时间均明显优于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组患者的心电图ST段下移、T波倒置、24h缺血总负荷变化明显优于对照组,差异均有统计学意义(P<0.05,或P<0.01)。结论:在传统常规抗心绞痛药物治疗基础上应用曲美他嗪治疗稳定型劳力性心绞痛疗效肯定,同时还能够增加心绞痛患者的运动耐量,减少心绞痛发作频率。

Objective：To observe clinical efficacy of Trimetazidine for patients and its influence on exercise tolerance.Methods：190 cases of in hospital patients diagnosed with stable exertional angina pectoris in cardiovascular medical ward were randomly assigned into observe group and control group,each with 95 cases.Patients were all treated with conventional treatment,including strict bed rest,intensive care,oxygen and anti-anginal therapy;Patients in control group were treated with oral Isosorbide Dinitrate besides the conventional therapy;while treatment group were treated with 20mg oral Trimetazidine Dihydrochloride Tablets,3 times / d.The two groups of patients were treated for two weeks.Results：The total effective rate of treatment group was 94.74% and 85.26% in the control group,and the difference between two groups was statistically significant（P〈0.05）.After treatment,exercise-induced angina pectoris required time and after exercise ST segment depression ≥ 1mm required time of patients in treatment group was significantly better than the control group,and the differences were statistically significant（P〈0.05）.After treatment,ST segment depression,T wave inversion,and 24h ischemia total load changes of treatment group patients was significantly better than the control group,and the differences were statistically significant（P〈0.05,or（P〈0.01）.Conclusion：On the basis of conventional anti-anginal drug treatment,application of Trimetazidine to treat stable exertional angina pectoris is effective.It also can increase angina pectoris patients’ exercise tolerance and reduce the frequency of attacks of angina.