曲美他嗪联合美托洛尔治疗不稳定性心绞痛临床效果及对血管内皮功能的影响

The effect of trimetazidine combined with metoprolol in the treatment of unstable angina pectoris and the changes of vascular endothelial function in patients

目的以不稳定性心绞痛患者为对象,进行曲美他嗪联合美托洛尔治疗,观察其对疾病的改善效果及血管内皮的变化。方法随机选择延安大学附属医院2018年1月至2020年1月确诊的不稳定性心绞痛患者103例,将其随机分为实验组(49例)和对照组(54例),实验组采用口服美托洛尔联合曲美他嗪治疗,对照组单一口服美托洛尔治疗,疗程6个月。分析两组患者不稳定性心绞痛治疗后的有效率、心电图ST段下移改善情况以及不良反应发生率,评价疾病治疗效果;采集患者外周血测量一氧化氮(NO)以及血清内皮素-1(ET-1)评价两组血管内皮功能的变化情况。结果两组治疗效果结果显示,实验组总有效率为93.87%,对照组总有效率为70.37%,实验组治疗效果优于对照组。此外,两种方法均使得心电图ST段下移,实验组改善效果更为明显;不良反应结果显示实验组不良反应发生率也更低,组间差异具有统计学意义。血清ET-1和NO测量结果显示,实验组患者治疗后ET-1和NO下降和上升程度高于对照组,提示实验组患者血管内皮功能改善更好。结论相比于单一美托洛尔治疗,曲美他嗪联合美托洛尔治疗可以有效改善不稳定性心绞痛的不良反应发生率以及提高治疗效果;此外,对于血管内皮也有一定的保护作用,值得在临床治疗中得到广泛应用。

Objective Patients with unstable angina pectoris were treated with trimetazidine combined with metoprolol to observe the improvement effect of the disease and the changes of vascular endothelium.Methods A random selection of 103 patients with unstable angina pectoris diagnosed in the Affiliated Hospital of Yan′an University from January 2018 to January 2020 were randomly divided into an experimental group(49 cases)and a control group(54 cases).The experimental group was treated with oral metoprolol combined with trimetazidine,and the control group was treated with oral metoprolol alone for 6 months.Analyze the effective rate after treatment of unstable angina pectoris,the improvement of ECG ST segment downward shift and the incidence of adverse reactions in the two groups of patients,and evaluate the treatment effect of the disease.The peripheral blood of patients was collected to measure nitric oxide(NO)and serum endothelin-1(ET-1)to evaluate the changes of vascular endothelial function in the two groups.Results The Results of the treatment effect showed that the total effective rate of the experimental group was 93.87%and that of the control group was 70.37%.The treatment effect of the experimental group was better than that of the control group.In addition,both Methods make the ST segment of ECG move down,and the improvement effect of the experimental group is more obvious.The adverse reaction Results showed that the incidence of adverse reactions in the experimental group was also lower,and the difference between the groups was statistically significant.The measurement Results of serum ET-1 and NO showed that the decrease and increase of ET-1 and NO after treatment in the experimental group were higher than those in the control group,suggesting that the vascular endothelial function of the experimental group improved better.Conclusion Compared with single metoprolol treatment,trimetazidine combined with metoprolol treatment can effectively improve the adverse morbidity of unstable angina and improve the treatment effect.In addition,it also has a certain protective effect on the vascular endothelium,which is worthy of being widely used in clinical treatment.