盐酸曲美他嗪治疗女性微血管性心绞痛患者的效果及对运动耐量的影响

Clinical effects of trimetazidine hydrochloride on female microvascular angina pectoris and exercise tolerance

目的观察盐酸曲美他嗪治疗女性微血管性心绞痛的效果以及对运动耐量的影响。方法选择2013年10月至2016年9月在首都医科大学附属北京安贞医院住院诊断为微血管性心绞痛的女性患者108例，根据投币正反面法随机分为观察组（58例）和对照组（50例）。对照组给予常规药物治疗，观察组患者在对照组基础上加用盐酸曲美他嗪20 mg，3次/d，口服，2组均治疗12周。比较2组患者临床疗效、心电图疗效总有效率和治疗前后心绞痛发作频率及运动平板试验结果。结果观察组临床疗效和心电图疗效总有效率均明显高于对照组［89.7%（52/58）比58.0%（29/50）、87.9%（51/58）比54.0%（27/50）］，差异均有统计学意义（均P＜0.01）。治疗后与对照组比较，观察组心绞痛发作频率减少，运动总时间、ST段压低≥1 mm时间和平板运动开始至心绞痛发作时间延长，ST段压低最大幅度降低，差异均有统计学意义（均P＜0.05）。结论盐酸曲美他嗪治疗女性微血管性心绞痛可改善患者病情，提高运动耐量，疗效明显。

ObjectiveTo observe clinical effects of trimetazidine hydrochloride on female microvascular angina pectoris and exercise tolerance. MethodsTotally 108 female patients with microvascular angina pectoris who were admitted in Beijing Anzhen Hospital, Capital Medical University from October 2013 to September 2016 were randomly divided into observation group（58 cases） and control group（50 cases）. The control group was treated with conventional medicine; the observation group was treated with trimetazidine hydrochloride（20 mg/time, 3 times/d, orally） on the basis of control group; both groups were treated for 12 weeks. Clinical efficacy, electrocardiogram, frequency of angina attack and results of treadmill exercise test were analyzed. ResultsThe total clinical effective rate and the ECG effective rate in observation group were significantly higher than those in control group[89.7%（52/58） vs 58.0%（29/50）, 87.9%（51/58） vs 54.0%（27/50）]（P〈0.01）. After treatment, frequency of angina attack in observation group was significantly less than that in control group; exercise duration, duration of ST segment 1 mm depression and the duration between beginning of treadmill exercise test and attack of angina pectoris in observation group were significantly longer than those in control group; the maximum amplitude of ST segment depression in observation group was significantly lower than that in control group（P〈0.05）. ConclusionTrimetazidine hydrochloride treating female microvascular angina pectoris can improve exercise tolerance.