曲美他嗪治疗冠状动脉肌桥疗效观察

Treatment effects of trimetazidine on coronary artery bridge

目的观察曲美他嗪治疗冠状动脉肌桥的效果。方法选择因不同程度胸闷、心悸、气短、心前区疼痛等心脏不适症状在我院心内科住院、经冠脉造影检查确诊为心肌桥的患者76例,随机分为2组。对照组40例,给予β受体阻滞剂或(和)钙拮抗剂为基础的常规治疗。治疗组36例,在对照组治疗基础上加用曲美他嗪,20 mg/次,每日3次。平均随访12周,观察比较2组患者每周胸痛发作次数、运动耐量、焦虑及抑郁评分、24 h缺血总负荷、6分钟最远步行距离等改善情况。结果与对照组相比,治疗组每周胸痛发作次数、运动耐量、焦虑及抑郁评分、24 h缺血总负荷、6分钟步行距离均明显改善,能有效缓解症状,提升患者生活质量。结论常规治疗基础上加用曲美他嗪治疗冠状动脉肌桥安全有效,可进一步改善心肌能量代谢及运动耐量,提高临床疗效及患者生活质量。

Objective To observe the treatment effects of trimetazidine on myocardial bridge. Methods A total of 76 patients with clinical symptoms, such as different degrees of chest tightness, palpitation, breath shortness, chest pain, were diagnosed as coronary myocardial bridge by coronary angiography, and were divided into two groups randomly. While control group (n=40) was given beta-blocker or (and) calcium antagonist as routine treatment. The treatment group (n=36) was given routine treatment and trimetazidine, 20 mg, three times daily. The mean follow-up period was 12 weeks. The episodes of chest pain per week, exercise tolerance, anxiety and depression scores, total ischemic burden in 24 h and walking distance in 6 min were observed in two groups of patients. Results The parameters of chest pain times per week, exercise tolerance, anxiety and depression scores, total ischemic burden in 24 h and walking distance in 6min were improved in treatment group compared with control group, and the symptoms were effectively relieved, the life quality of patients were improved. Conclusion The conventional treatment combined with trimetazidine is safe and effective, which can further improve myocardial energy metabolism and exercise tolerance, and enhance the clinical effect and the life quality of patients.