曲美他嗪对PCI患者的心肌保护作用

Cardioprotective Effect of Trimetazidine to PCI Patients

目的探讨曲美他嗪对经皮冠状动脉介入治疗(PCI)患者的心肌保护作用。方法47例因急性心肌梗死(AMI)而行急诊PCI的患者随机分为曲美他嗪组(A组)和对照组(B组),A组在常规治疗的基础上于急诊PCI前后给予曲美他嗪口服,B组不用曲美他嗪。比较两组患者间血肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)峰值浓度、CK-MB恢复正常的时间、再灌注心律失常及2W后的左室功能。结果(1)A组和B组患者分别为24例和23例,两组临床基线资料无统计学差异。(2)A组cTnI峰值浓度和CK-MB峰值浓度分别为(1.23±0.98)ng/mL和(114±67)U/L,显著低于B组的(2.36±1.28)ng/mL和(159±72)U/L(P<0.05);A组CK-MB峰值时间和恢复正常的时间均显著短于B组(P<0.05或0.01)。(3)A组33%(8例)发生再灌注心律失常,显著低于B组的65%(15例)(P<0.05)。(4)2W后超声心动图检测的左室射血分数A组为(58±10)%,显著高于B组的(51±10)%(P<0.05)。结论对急诊PCI的急性心肌梗死患者,曲美他嗪可能缩小梗死面积,减轻再灌注损伤,保护心脏功能。

Objective To investigate the cardioprotective effect to emergency PCI patients.Methods:47 patients with acute myocardial infarction(AMI) who admitted for emergency PCI were randomly divided into two groups:Group A Timmetazidine Group and Group B comparison Group.Patients in Group A tock timmetazidine orally before and after thrombolysis,while those in Group B received conventional therapy.The differences of cTnI、peak consistency of CK-MB、normalization time of CK-MB、repedusion arrhythmias and left ventricular function two weeks later were compared between this two groups.Results:(1)There were 24 patients in Group A and 23 in Group B,no significant differences in baseline characteristics between this two groups.(2) Peak consistency of cTnI and CK-MB of Group A are(1.23±0.98) ng/mL and(114±67) U/L respectively,significantly lower(2.36±1.28) ng/mL and(159±72)U/L(P<0.05) than that in Group B;Peak time of CK-MB and normalization time in Group A were shorter than that in Group B(P<0.05 or 0.01).(3) 33% of patients in Group A(8 patients) suffered reperfussion arrhythmias while 65%(15 patients) in Group B(P<0.05),lower than that in Group A.(4) Examination of supersonic electrocardiogram showed that blood shooting in the left ventricle of the heart was(58±10)% in Group A,higher than that in Group B(51±10)%(P<0.05).Conclusion:For those emergency PCI patients,timmetazidine administration may reduce infarct size and reperfusion damage,protect function of the heart.