曲美他嗪对不稳定型心绞痛患者PCI术后心脏功能的影响

Effects of Trimetazidine on Heart Function in Unstable Angina Pectoris Patients after PCI

目的:观察曲美他嗪对不稳定型心绞痛患者经皮冠状动脉介入(PCI)术后心脏功能的影响。方法:150例不稳定型心绞痛行PCI术患者,按随机数字表法均分为A、B、C组。所有患者行PCI术,术后A组患者给予常规治疗;B组患者在A组常规治疗基础上给予曲美他嗪20 mg/次,tid,1个月后改为常规治疗;C组患者在A组常规治疗基础上给予曲美他嗪20 mg/次,tid。3组患者疗程均为6个月。观察所有患者左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、E波与A波峰值速度比值(E/A)、左室射血分数(LVEF)、室壁运动评分、6 min步行距离,记录患者随访情况及不良反应发生情况。结果:B、C组患者的住院天数、心绞痛发作例数、心绞痛发作频率、发作持续时间、发作时需用硝酸甘油例数、硝酸甘油用量、LVESD、LVEDD、室壁运动评分均显著低于A组,且C组显著低于B组;B、C组患者LVEF、E/A、6min步行距离均显著高于A组,且C组显著高于B组,差异均有统计学意义(P<0.05);3组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:曲美他嗪可改善不稳定型心绞痛患者PCI术后心脏功能,且安全性较好。

OBJECTIVE： To observe the effects of trimetazidine on heart function in unstable angina pectoris patients after PCI. METHODS： A total of 150 patients with unstable angina pectoris underwent PCI were averagely assigned into group A, B, C according to the method of random digits table. After PCI, group A was given conventional treatment; group B was additionally given trimetazidine 20 mg per time, tid, on the basis of conventional treatment and changed to conventional treatment after a month; group C was given trimetazidine 20mg per time, tid, on the basis of conventional treatment. Treatment course of 3 groups lasted for 6 months. Left ventricular end diastolic diameter （LVEDD）, left ventricular end systolic diameter （LVESD）, peak velocity ratio of E wave and A wave （E/A）, left ventricular ejection fraction （LVEF）, regional movement score, 6-min walking distance of all patients were observed. Follow-up and adverse drug reaction were recorded. RESULTS： Hospitalization day, case number of angina attack, frequency of angina pectoris attack, attack duration, case number of nitroglycerin during attack, dosage of nitroglycerin, LVESD, LVEDD, regional movement score in group B and C were significantly lower than in group A; group C were higher than in group B. LVEF, E/A, 6-min walking distance in group B and C were significantly higher than in group A; group C were higher than in group B; there were statistical significance （P〈0.05）. There was no statistical significance in the incidence of ADR among 3 groups （P〉0.05）. CONCLUSIONS： Trimetazidine can improve heart function in unstable angina pectoris patients after PCI and has better safety.