曲美他嗪对高血压伴冠心病患者肾功能的影响

Analysis of Protective Effect of Trimetazidine on Renal Function in Hypertensive Patients with Coronary Heart Disease

[目的]探讨曲美他嗪对高血压伴冠心病患者肾功能的保护作用。[方法]86例高血压伴冠心病患者随机分为两组，各43例，对照组采取常规治疗，观察组在对照组基础上加以曲美他嗪治疗，1疗程4周，均干预3疗程，比较两组治疗前后血压、心功能、肾功能等指标及不良反应情况。[结果]两组治疗3疗程后舒张压（DBP）、收缩压（SBP）水平、左室舒张末期内径（LVEDD）及左室收缩末期内径（LVESD）、治疗1周后血肌酐（SCr）、血尿素氮（BUN）、胱抑素C（CysC）、超敏C反应蛋白（hs—CRP）、白介素-6（IL-6）水平较治疗前均明显下降，左室射血分数（LVEF）显著上升，且差异有显著性（P〈0．05）。观察组治疗3疗程后LVEDD、LVESD、LVEF、治疗1周后SCr、BUN、CysC、hs—CRP、IL-6、NO水平均明显优于对照组（P〈0．05）。两组不良反应发生率比较差异无显著性（P〉0．05）。[结论]曲美他嗪能明显改善高血压伴冠心病患者心功能，对肾功能有一定的保护作用，这可能与该药物降低炎症指标、改善血管内皮功能有关。

[Objective] To investigate the protective effect of Trimetazidine on renal function in hypertensive patients with coronary heart disease. [Methods]Eighty-six cases of hypertension with coronary heart disease were randomly divided into two groups, each of 43 cases. The control group was treated with routine therapy; while on the basts the control group, the observation group was treated with Trimetazidine. One course of treatment for 4weeks, 3 courses were intervened. Blood pressure, heart function and renal function and adverse reaction conditions were compared between the two groups before and after treatment.[Results] After treatment, DBP, SBP levels, LVEDD, LVESD, SCr one week after treatment, BUN, Cys C, hs-CRP and IL-6 levels in the two groups were significantly decreased than those before treatment while LVEF was significantly increased than that before treatment （P 〈 0.05）. 3 courses after the treatment, LVEDD, LVESD, LVEF, SCr one week after treatment, BUN, Cys C, hs-CRP, IL-6 and NO levels in the observation group were significantly improved than those in the control group （P 〈0.05）. There were no significant differences in the incidence of adverse reactions between the two groups （ P 〉0.05）. [Conclusion] Trimetazidine can significantly improve the cardiac function in hypertensive patients with coronary heart disease. It has also protective effect on renal function. This may be related to the drug functions of inflammation reduction and vascular endothelium improvement.