曲美他嗪对冠状动脉介入术后心肌缺血再灌注损伤的保护作用研究

    Protective effect of trimetazidine on myocardial injury by percutaneous coronary intervention

    • 摘要: 目的:评价曲美他嗪对冠状动脉介入术(PCI)后心肌缺血再灌注损伤的保护作用。方法:入选拟行PCI的稳定性或不稳定性心绞痛患者72例,随机分为曲美他嗪组38例和对照组34例,曲美他嗪组PCI术前7 d开始口服曲美他嗪20 mg,每天3次,术后继续服用3个月;所有入选患者给予阿司匹林及常规药物治疗。每例在PCI术前及术后6、24 h测定血清肌钙蛋白I(cTnI)、磷酸肌酸激酶同工酶(CK-MB);在PCI术前及术后1、3个月分别超声心动图测定左室射血分数。结果:术前2组患者cTnI、CK-MB水平差异均无统计学意义(P0.05),与对照组比较,PCI术后曲美他嗪组在各个测量时段均能显著降低患者cTnI、CK-MB水平(P0.01),PCI术后1、3个月曲美他嗪组左室射血分数值均高于对照组(P0.01)。结论:PCI术前应用曲美他嗪能显著降低手术诱导的心肌损害,进一步改善PCI术后的左心功能。

       

      Abstract: Objective:To evaluate the protective effect of trimetazidine on myocardial injury by percutaneous coronary intervention(PCI).Methods:Seventy-two cases with stable or unstable angina were randomly divided into control group(n=34) and trimetazidine group(n=38).Treatment group received trimetazidine of 20 mg three times a day for 7 days before PCI) and Continuous oral three months after PCI.Control group did not receive trimetazidine.All cases(n=72) were administered aspirin and conventional drugtreatment.The cardiac troponin Ic(cTnI) and creatine kinase-MB(CK-MB) levels of each case were measured at 6,24 hour and left ventricular ejection fraction were also detcted at 1,3 month before and after PCI.Results:In all cases,the cardiac troponin Ic(cTnI) and creatine kinase-MB(CK-MB) levels had no significantly difference(P〉0.05)before PCI,but its levels of trimetazidine group were also significantly lower than that of control group throughout procedure after PCI.Left ventricular ejection levels of trimetazidine group were also significantly higher than control group at 1,3 month after PCI(P〈0.01).Conclusions:Using trimetazidine before PCI can significantly reduce myocardial injury PCI-induced,and improves left ventricular contractility function.

       

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