尼可地尔与曲美他嗪治疗X综合征疗效的对比研究

Comparison of the Effect of Nicorandil and Trimetazidine in X-syndrome Patients

目的比较尼可地尔与曲美他嗪治疗X综合征的疗效。方法选择2010年7月至2012年9月在湘潭市中心医院心脏中心确诊为心脏X综合征的患者60例,按完全随机设计分为尼可地尔组(n=30)及曲美他嗪组(n=30)。两组患者均给予钙离子拮抗剂、β受体阻滞剂及硝酸酯类药物等常规药物治疗,尼可地尔组在此基础上给予尼可地尔每次5 mg治疗,每日3次,共治疗4周;曲美他嗪组给予曲美他嗪每次20 mg治疗,每日3次,连续治疗4周。治疗4周后,随访患者胸痛改善情况,复查平板运动试验及冠状动脉血流储备(CFR)。结果与治疗前相比,用药后两组患者平板运动试验到达终点时间均显著延长、CFR显著升高,差异有统计学意义(P<0.05),尼可地尔组较曲美他嗪组更为明显。尼可地尔组在胸痛例数、到达运动心绞痛例数以及到达终点ST段压低>1 mV例数与曲美他嗪组比较均显著减少(P<0.05)。结论尼可地尔与曲美他嗪均能提高X综合征患者的运动耐量及CFR,尼可地尔较曲美他嗪更为有效。

Objective To investigate the effects of nicorandil and trimetazidine on patients with cardiac X-syndrome. Methods Sixty patients with cardiac X-syndrome from Xiangtan Central Hospital during July 2010 and September 2012 were randomly divide into nicorandil group（ n = 30 ）and trimetazidine group （n = 30）. The two group were both treated with calcium antagonists,beta blockers and nitrates,on the basis of which the nieorandil group was given 5 mg nicorandil （3 times a day）for 4 weeks, and the trimetazidine group was given 20 mg trimetazidine（3 times a day）for 4 weeks. Chest pain, treadmill exercise test and coronary flow reserve were followed and compared. Results The duration of treadmill exercise test and CFR after treatment were significantly increased （ P 〈 0.05 ）, nieorandil was better than trimetazidine. The number of chest pain and positive treadmill exercise test, and ST 〉 1 mV arriving at the finishing point of nicorandil group were decreased than trimetazidine group, with statistically significant difference （ P 〈 0.05 ）. Conclu- sion Nieorandil and trimetazidine can improve the exercise tolerance and CFR for the patients with cardiac X-syndrome, and nieorandil is more effective.