曲美他嗪对老年冠心病多枝病变患者不完全血运重建术预后的影响

Effect of incomplete revascularization by percutaneous coronary intervention on the outcome and prognosis in aged patients with multivessel coronary artery disease trimetazidine

目的:评价盐酸曲美他嗪对老年患者冠状动脉多枝病变行不完全血运重建术后疗效及预后的影响。方法:选取通过冠状动脉支架治疗术进行部分血运重建的老年患者73例,根据置入支架后服用曲美他嗪与否分为2组:盐酸曲美他嗪组(20 mg,3次/d,口服)38例,常规药物治疗组35例。统计所有患者随访12个月后心绞痛分级(CCS分级)、主要心脏不良事件(MACE)发生情况;并于开始服药治疗前以及服药12个月后,行超声心动图检查及6 min步行试验。结果:2组患者12个月的MACE发生率差异有统计学意义,盐酸曲美他嗪组:5.3%(2/38),常规治疗组:14.3%(5/35),P<0.05;盐酸曲美他嗪组患者的心绞痛发作例数、发作次数及心绞痛CCS级别等方面均优于常规治疗组(P<0.05)。治疗12个月后盐酸曲美他嗪组左心室射血分数(LVEF)较对照组改善,差异有统计学意义P<0.05;6min步行距离较常规治疗组明显增加(P<0.05)。结论:对于老年冠状动脉多枝病变患者行不完全血运重建术后,盐酸曲美他嗪可减少其术后心绞痛的发作,提高运动耐量,改善左心功能。

Objective ：To evaluate the influence of trimetazidine on efficiency and exercise tolerance in aged patients with multivessel coronary artery disease undergoing incomplete revascularization by percutaneous coronary intervention （PCI）. Methods ：73 aged patients with multivessel coronary artery diease complicated un- dergoing incomplete revascularization by PCI were divided into trimetazidine group （ n = 38 ） and routine therapy group （ n = 35 ）. MACE events, angina frequency, angina duration and number of CCS class were follow-up at 12 months after PC1. Results：The incidence of MACE after 12 months follow-up showed there were significantly differences between two groups,P 〈0. 05. Angina and CCS class were all significantly reduced in trimetazidine group compared to routine therapy group （ P 〈 0. 05 ）. LVEF and mean distance of 6-mintute walk test were sig- nificantly increased in trimetazidine group afterl2 months than those at baseline （ P 〈 0. 5 ）. The distance of 6- mintute walk-test in trimetazidine group was longer than that in routine therapy group （ P 〈 0. 05 ）. Conclusion： Trimetazidine could reduce the frequency of angina pectoris events and myocardial damage during PCL It also improves left ventricular function during follow-up after PCI.