曲美他嗪辅助治疗经皮冠状动脉介入术后不稳定型心绞痛的效果观察

Effect observation of trimetazidine as an adjuvant therapy in patients with unstable angina pectoris after percutaneous coronary intervention

目的评价曲美他嗪在经皮冠状动脉介入术（PCI）后治疗不稳定型心绞痛的效果。方法选取2013年1月~2014年1月收治的100例择期行PCI治疗的不稳定型心绞痛患者,按照随机数字表法将其分为实验组（52例）和对照组（48例）,所有患者均接受冠心病常规药物治疗;实验组于术前5 d开始口服常规剂量的曲美他嗪;两组分别于术前、术后立即、术后24 h抽血检测肌酸激酶同工酶（CK-MB）、肌钙蛋白I（c Tn I）、血小板平均体积（MPV）水平。结果实验组治疗显效率为61.5%、总有效率为88.5%,高于对照组的45.8%和75.0%,差异有统计学意义（P〈0.05）。术后立即两组CK-MB及c Tn I较术前明显升高（P〈0.05）,且对照组比实验组升高幅度更大（P〈0.05）;术后24 h两组CK-MB及c Tn I较术后立即明显下降（P〈0.05）,且实验组的CK-MB及c Tn I水平更低（P〈0.05）。术后立即两组MPV较术前明显增大（P〈0.05）,且对照组比实验组升高幅度更大（P〈0.05）;术后24 h两组MPV下降到术前水平（P〉0.05）。结论口服常规剂量曲美他嗪可减少PCI引起的心肌损伤,发挥心肌保护作用,降低支架内急性血栓形成率。

Objective To evaluate the effect of trimetazidine on treating unstable angina pectoris after percutaneous coronary intervention（PCI）. Methods 100 patients with unstable angina pectoris undergone PCI in our hospital from January 2013 to January 2014 were selected,and were divided into experimental group（n=52） and control group（n=48）according to the random number table.Conventional drug therapy for coronary heart disease was provided to all patients.Administration of trimetazidine in regular dose 5 days before surgery was applied to experimental group.The level of CK-MB,c Tn I,and MPV was tested by blood drawing before surgery,just after surgery,and 24 hours after surgery in the two groups. Results The efficiency rate and total effective rate of experimental group was 61.5% and 88.5% respectively,higher than 45.8% and 75.0% of control group,the difference was significant（P〈0.05）.The level of CK-MB and c Tn I was increased just after surgery compared with that before surgery（P〈0.05）,and the control group increased more than that of experimental group（P〈0.05）.The level of CK-MB and c Tn I decreased remarkably 24-hour after surgery compared with that just after surgery（P〈0.05）,and the experimental group was lower than that of control group（P〈0.05）.The level of MPV was increased just after surgery compared with that before surgery（P 0.05）,and the control group increased more than that of experimental group（P〈0.05）;The level of MPV decreased to preoperative level 24-hour after surgery（P〈0.05）. Conclusion Oral administration of trimetazidine in regular dose can reduce myocardial injury caused by PCI and play a cardioprotective effect,and decrease the possibility of acute stent thrombosis.