通心络联合曲美他嗪对急性ST段抬高型心肌梗死经皮冠状动脉介入治疗术后患者血脂及心功能的影响

Effects on serum lipid and cardiac function of Tongxinluo combined with Trimetazidine in the treatment of patients with acute ST-elevation myocardial infarction after underwent percutaneous coronary intervention

目的 研究通心络联合曲美他嗪对急性ST段抬高型心肌梗死（STEMI）经皮冠状动脉介入治疗（PCI）后患者血脂及心功能的影响。方法 选择2011年5月～2013年5月三河市医院心内科160例STEMIPCI术后患者，按照随机数字表法分成治疗组和对照组，各80例。对照组常规应用拜阿司匹林、硫酸氢氯吡格雷、硝酸异山梨酯、酒石酸美托洛尔、卡托普利、利尿剂、阿托伐他汀；治疗组在对照组基础上加用通心络胶囊、盐酸曲美他嗪，疗程12周。观察两组患者治疗前后总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）及左心室射血分数（LVEF）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）变化。结果 两组治疗后TC、TG、LDL—C及HDL—C水平与治疗前比较差异有统计学意义（P〈0．05）；治疗组血脂变化水平显著优于对照组（P〈0．05）。两组患者治疗后LVEF升高，LVEDV、LVESV下降，与治疗前比较，差异有统计学意义（P〈0．05），但治疗组LVEF、LVEDV、LVESV指标较对照组变化更显著，差异有统计学意义（P〈0．05）。结论 通心络联合曲美他嗪对STEMIPCI术后患者血脂及心功能的改善效果明显，能显著提高患者生存质量。

Objective To investigate the effect on serum lipid and cardiac function of Tongxinluo combined with Trimetazidine in the treatment of patients with acute ST-elevation myocardial infarction （STEMI） after underwent percutaneous coronary intervention （PCI）. Methods 160 patients with STEMI after underwent PCI in Department of Cardiology of Sanhe City Hospital from May 2011 to May 2013 were chosen and divided into treatment group and control group according to random number table method, with 80 patients in each group. Control group was routinely given Aspirin, Clopidogrel Hydrogen Sulfate, Isosorbide Dinitrate, Metoprolol Tartrate, Captopril, diuretics and Atorvastatin, treatment group was added with Tongxinluo Capsule and Trimetazidine on basis of control group, the course was 12 weeks. The changes of TC, TG, LDL-C, HDL-C, LVEF, LVEDV, LVESV before and after treatment in the two groups were observed. Results There were significant differences of level of TC, TG, LDL-C, HDL-C after treatment in both groups compared with before treatment （P 〈 0.05）. The changes of serum lipid in treatment group were more obviously than control group （P 〈 0.05）. After treatment, the level of LVEF in both groups was increased and LVEDV, LVESV were decreased, which had significant differences compared with before treatment （P 〈 0.05）. while the changes were more remarkable in treatment group compared with control group, the differences were statistically significant （P 〈 0.05）. Conclusion Tongxinluo combined with Trimetazidine can improve cardiac function and plasma lipid level of patients with STEMI after underwent PCI, which can also improve quality of life.