曲美他嗪对急性冠状动脉综合征患者介入术后运动耐量的影响

The effect of trimetazidine on exercise capacity in patients with acute coronary syndrome undergoing percu-taneous coronary intervention

目的探讨曲美他嗪对急性冠状动脉综合征（ACS）患者介入术后运动耐量的影响。方法将88例ACS且行介入治疗患者完全随机分为对照组（41例）及曲美他嗪组（47例），对照组给予常规治疗，曲美他嗪组在对照组基础上加曲美他嗪20mg，3次／d口服，并于6个月后行平板运动试验（2组各失访1例），比较2组治疗前后的运动耐量。结果曲美他嗪组运动中或运动后sT段水平型或下斜型压低较运动前增加≥0．1mV且持续时间〉1min者明显少于对照组[13．0％（6／46）比20．0％（8／40），P=0．025]；ST段弓背向上型抬高者明显少于对照组[4．3％（2／46）比10．0％（4／40），P=0．011]；出现典型心绞痛者明显少于对照组[8．7％（4／46）比17．5％（7／40），P=0．012]；U波倒置者明显少于对照组[6．5％（3／46）比17．5％（7／40），P=0．000]；出现严重心律失常者明显少于对照组[8．7％（4／46）比15．0％（6／40），P=0．016]；T波变为倒置或双向者明显少于对照组[13．0％（6／46）比25．0％（10／40），P=0．009]；收缩压较运动前或前一级运动时下降大于10mmHg（1mmHg=0．133kPa）者明显少于对照组[8．7％（4／46）比15．0％（6／40），P：0．016]。结论曲美他嗪能提高ACS患者介入术后的运动耐量。

Objective To investigate the effects of trimetazidine on exercise capacity in patients undergoing percutaneous coronary intervention（PCI）. Methods A total of 88 patients treated with PCI were selected random- ly： control group （41 cases） and trimetazidine group （47 cases）. The exercise capacity between two groups was com- pared after six months with ECG exercise test. Results ECG exercise text showed that the percent of ST level of horizontal or downward sloping adding acuity over 0. lmV after exercise, during or after exercise and duration time 〉 1 rain was lower than that of control group （ 13.0% vs 20.0% ,P = 0.025） ; the percent of convex shape of ST eleva- tion was lower than that of control group （4.3% vs 10.0% ,P = 0. 011 ） ; the percent of typical angina was lower than that of control group（8.7% vs 17.5% ,P =0. 012） ; the percent of U wave inversion was significantly lower than that of control group（6.5% vs 17.5% ,P =0. 000） ; the percent of severe arrhythmia was lower than that of control group（8.7% vs 15.0% ,P =0.016） ; the percent of T-wave inversion or two-way was lower than that of con- trol group（ 13.0% vs 25.0% ,P = 0.009） ; the percent of systolic blood pressure before exercise or preceding exer- cise down more than 10 mm Hg was lower than that of control group（8.7% vs 15.0%, P =0.016）. Conclusion Trimetazidine can improve the patients exercise capacity after PCI.