曲美他嗪联合替格瑞洛治疗不稳定型心绞痛并慢性心力衰竭患者的临床疗效及安全性

Clinical Effect and Safety of Trimetazidine Combined with Ticagrelor in Treating Unstable Angina Pectoris Patients Complicated with Chronic Heart Failure

目的分析曲美他嗪联合替格瑞洛治疗不稳定型心绞痛(UAP)并慢性心力衰竭(CHF)患者的临床疗效及安全性。方法选取2016年1—10月新疆维吾尔自治区职业病医院心血管内科收治的UAP并CHF患者128例,根据治疗方法分为对照组和观察组,每组64例。在常规治疗基础上,对照组患者予以替格瑞洛治疗,观察组患者在对照组基础上加用曲美他嗪治疗;两组患者均连续治疗3个月。比较两组患者UAP和CHF临床疗效,治疗前后心功能指标及血清脑钠肽(BNP)、胰岛素样生长因子1(IGF-1)水平,并观察两组患者治疗期间不良反应发生情况。结果观察组患者UAP、CHF临床疗效均优于对照组(P<0.05)。治疗前两组患者左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)比较,差异无统计学意义(P>0.05);治疗后两组患者LVEF、LVEDD、LVESD比较,差异有统计学意义(P<0.05)。治疗前两组患者血清BNP、IGF-1水平比较,差异无统计学意义(P>0.05);治疗后两组患者血清BNP、IGF-1水平比较,差异有统计学意义(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论曲美他嗪联合替格瑞洛治疗UAP并CHF患者的临床疗效确切,能有效改善患者心功能,降低血清BNP水平,升高血清IGF-1水平,且安全性较高。

Objective To analyze the clinical effect and safety of trimetazidine combined with ticagrelor in treating unstable angina pectoris（ UAP） patients complicated with chronic heart failure（ CHF）. Methods From January to October in 2016,a total of 128 UAP patients complicated with CHF were selected in the Department of Cardiovascular Medicine,Occupational Disease Hospital of Xinjiang Uygur Autonomous Region,and they were divided into control group and observation group according to therapic methods, each of 64 cases. Based on conventional treatment, patients of control group received ticagrelor,while patients of observation group received trimetazidine combined with ticagrelor; both groups continuously treated for 3 months. Clinical effect for UAP and CHF,index of cardiac function,serum levels of BNP and IGF-1 before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during the treatment. Results Clinical effect for UAP and CHF of observation group were both better than those of control group（ P 0. 05）. No statistically significant differences of LVEF,LVEDD or LVESD was found between the two groups before treatment（ P 0. 05）,while there were statistically significant differences of LVEF,LVEDD and LVESD between the two groups after treatment（ P 0. 05）. No statistically significant differences of serum level of BNP or IGF-1 was found between the two groups before treatment（ P 0. 05）,while there were statistically significant differences of serum levels of BNP and IGF-1 between the two groups after treatment（ P 0. 05）. No statistically significant differences of incidence of adverse reactions was found between the two groups during the treatment（ P 0. 05）. Conclusion Trimetazidine combined with ticagrelor has certain clinical effect in treating UAP patients complicated with CHF,can effectively improve the cardiac function and serum IGF-1 level,reduce the serum BNP level,and is relatively safe.