曲美他嗪对经冠脉介入治疗的急性心肌梗死患者的临床影响

The clinical effect of trimetazidine in patients with acute myocardial infarction after percutaneous coronary intervention

目的分析曲美他嗪对接受经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者的临床影响。方法 2014年1月-2015年6月选择我院收治的84例接受PCI治疗的AMI患者作为观察对象,按照治疗方法不同,将其分为对照组（n=42）及观察组（n=42）。对照组接受常规治疗,观察组加用曲美他嗪;比较两组术中靶血管复流现象（NR）、TIMI血流分级情况;术后血清肌钙蛋白I（CTnI）、超敏C反应蛋白（hs-CRP）、左室射血分数（LVEF）、左室短轴缩短率（LVFS）变化情况及再发心绞痛发生率。结果术中两组NR及TIMI血流分级情况对比,差异无统计学意义（P〉0.05）;术后48h,观察组CTnI、hs-CRP水平均显著低于对照组（P〈0.05）。术后3个月,观察组LVEF、LVFS均显著高于对照组（P〈0.05）;观察组再发心绞痛发生率为9.52%,显著低于对照组26.19%（P〈0.05）。结论曲美他嗪可有效改善接受PCI治疗AMI患者的CTnI、hs-CRP、LVEF及LVFS水平,减低再发心绞痛发生率,值得推广。

Objective To explore the clinical effect of trimetazidine in patients with acute myocardial infarction（AMI） after percutaneous coronary intervention（PCI）. Methods According to the treatment methods, 84 patients with AMI after PCI, who were in hospital from January 2014 to June 2015, were randomly divided into the control group（n=42） and the observation group（n=42）. The control group was given the conventional treatment. The observation group was treated with trimetazidine. The no-reflow phenomenon（NR）, TIMI flow grades, cardiac troponin I（CTnI）, high sensitive C-reactive protein（hs-CRP）, Left ventricular ejection fraction（LVEF）, Left ventricular fractional shortening（LVFS） and the incidence of recurrent angina of two groups were compared. Results The NR and TIMI flow grades of two groups had no statistically significant difference（P〉0.05）. At postoperative 48 h, the Ctn I and hs-CRP of the observation group were significantly lower than that of the control group（P〈0.05）. At postoperative 3 months, the LVEF and LVFS of the observation group were significantly higher than that of the control group（P〈0.05）. The incidence of recurrent angina of the observation group was 9.52%, which was significantly lower than the control group of 26.19%（P〈0.05）. Conclusion Trimetazidine can improve CTnI, hs-CRP, LVEF and LVFS of patients with AMI after PCI, and reduce the incidence of recurrent angina pectoris, worthy of promotion.