曲美他嗪对PCI心肌损伤及术后再发心绞痛的影响

Influence of trimetazidine on PCI-induced myocardial injury and postoperative recurrence of angina pectoris

目的:分析曲美他嗪对经皮冠状动脉介入治疗术(PCI)心肌损伤及术后再发心绞痛症状的影响。方法:以随机数字表法抽选96例不稳定型心绞痛患者,均在基础治疗上行PCI,分为曲美他嗪组(48例)和常规治疗组(48例);比较两组心绞痛再发情况,以及对手术心肌损伤作用的差异。结果:PCI手术后各时间点两组患者的cTnI水平不断升高,除手术后1h外,其余时间段两组的cTnI水平均有明显差异(P<0.05或<0.01),且术后24h两组间cTnI水平差异最明显[曲美他嗪组的cTnI(0.21±0.12)ng/ml显著低于常规治疗组的(0.66±0.12)ng/ml],P<0.01;随访期间,与常规治疗组比较,曲美他嗪组心绞痛再发生率明显降低(29.17%比8.33%),左室射血分数明显提高[(50.89±2.45)%比(57.11±2.13)%],P均<0.05。结论:曲美他嗪对经皮冠状动脉介入治疗术后心肌有一定保护作用,并且对再发心绞痛症状有一定减少作用。

Objective： To analyze the influence of trimetazidine on percutaneous coronary intervention （PCI） -induced myocardial injury and postoperative recurrence of angina pectoris. Methods： A total of 96 patients with unstable angina pectoris （UAP） were selected according to random number table, all patients received PCI based on basic therapy and they were divided into trimetazidine group （n = 48） and routine treatment group （n = 48）; recurrence of angina pectoris and condition of myocardial injury after PCI were compared between two groups. Results： Beside lh after PCI, the cTnI levels continuously elevated in each time point after PCI in both groups （P〈0.05 or 〈0.01）, and cTnl level difference was most significant between two groups on 24h after PCI [cTnI （0.21 ± 0.12） ng/ml in trimetazidine group was significantly lower than that of routine treatment group [ （0.66 ± 0.12） ng/ml, P〈0.01] ; During follow-up, compared with routine treatment group, there was significant reduction in recurrence rate of angi- na pectoris （29. 17% vs. 8. 33%） and significant rise in left ventricular ejection fraction [- （50. 89 ± 2. 45）% vs. （57. 11 ± 2. 13）%] in trimetazidine group, P〈0. 05 both. Conclusion： Trimetazidine possesses certain protective effect on myocardi- um after percutaneous coronary intervention and has certain reduction in recurrent angina pectoris.