曲美他嗪治疗不稳定型心绞痛合并糖尿病患者疗效观察

目的探讨曲美他嗪治疗不稳定型心绞痛合并糖尿病患者的疗效以及临床副作用。方法78例不稳定型心绞痛合并糖尿病患者随机分为曲美他嗪治疗组（40例）和常规治疗组（38例），治疗60d，观察治疗前后患者心绞痛症状、心率、血压、24h心电图情况以及副作用。结果与常规治疗组比较曲美他嗪治疗组患者心绞痛发作明显减少，心肌缺血减轻，无明显并发症状。结论曲美他嗪治疗不稳定型心绞痛合并糖尿病患者有良好的效果。     

曲美他嗪与低分子肝素治疗不稳定型心绞痛临床观察

目的:观察低分子肝素与曲美他嗪治疗不稳定型心绞痛(UAP)的疗效。方法:172例UAP患者随机分为2组,其中对照组88例;两组均常规给予硝酸酯类、β-受体阻滞剂及阿司匹林等;治疗给予低分子肝素钠4000 IU,2次/d,皮下注射,连用5~7d,加用曲美他嗪20?,每日3次及心电图改变情况。结果:治疗组临床总有效率为90.91%,对照组总有效率为69.05%,治疗组明显优于对照组(P<0.01)。治疗后治疗组ST段下降导联数(NST)ST段下降的数值总和(ΣST)及心肌缺血总负荷均较治疗前显著改善(P<0.01)。治疗组有5例皮下瘀斑,2例进展为AM I;而对照组有8例进展为AM I。结论:低分子肝素联用曲美他嗪,治疗UAP安全有效。     

The acute effect of trimetazidine on the high frequency fatigue in the isolated Rat diaphragm muscle

The objective of this study was to determine the acute effect of trimetazidine (TMZ) on the pre-fatigue, fatigue and post-fatigue contractile characteristics and tension-frequency relationships of isolated rat diaphragm muscle. Muscle strips were taken from the ventral-costal aspects of the diaphragm muscle of rats killed by decapitation. The muscle strips were suspended in organ baths containing Krebs solution, with a gas mixture of 95% O2 and 5% CO2 at 37 degrees C and pH 7.35-7.45. After determining the thermoregulation and optimum muscle length the muscles were subjected to direct supramaximal stimulation with 0.05 Hz frequency square pulses for periods of 0.5 msec to obtain control values. After adding 5 x 10(-6) and 5 x 10(-5) M trimetazidine solution to the respective bath media, the contractile parameters of the muscles were recorded. The contractile parameters were also recorded for both the trimetazidine and trimetazidine-free media after application of the high frequency fatigue protocols. Later, the tension-frequency relationship was determined by applying stimulating pulses of 10, 20, 50 and 100 Hz to the muscle strips. Whilst the twitch tension obtained from the 5 x 10(-6) and 5 x 10(-5) M trimetazidine media showed numerical increases compared to that of the controls, these were not statistically significant (p>0.05). The contraction time exhibited a dose dependent increase (p<0.001), whilst the contraction and relaxation rates did not differ significantly. The isometric contraction forces obtained with the different stimulating frequencies showed a significant increase in the tetanic contraction only at 100 Hz (p<0.05). A comparison of the pre- and post-fatigue twitch tensions in the trimetazidine media showed the post- fatigue twitch tensions to be significantly higher than those of the pre-fatigue contraction forces (p<0.05). In the 5 x 10(-6) and 5 x 10(-5) M trimetazidine media the increases in the post-fatigue contraction force were 22 and 30%, respectively. These results demonstrated that in isolated rat diaphragm muscle, TMZ significantly limited the mechanical performance decrease during fatigue. It is our opinion that trimetazidine contributed to the observed fatigue tolerance by eliminating the factors of fatigue, due to preservation of intracellular calcium homeostasis, provision of the ATP energy levels needed by ATPase dependent pumps and especially by keeping the intracellular pH within certain limits.     

曲美他嗪联合培哚普利治疗慢性充血性心力衰竭疗效观察

目的观察曲美他嗪（TMZ）联合培哚普利治疗慢性充血性心力衰竭（CHF）患者的临床疗效。方法72例CHF患者随机分为研究组和对照组，均给予内科常规抗心衰治疗。对照组加服培哚普利，初始剂量2mg，每日1次，逐渐加至靶剂量4mg，每日1次；研究组在对照组的基础上接受曲美他嗪20mg／次，3次/d。治疗12周。结果治疗12周，两组心功能较治疗前有明显改善，治疗组临床总有效率为93．4％，较对照组（80．6％）显著提高（P〈0．05）；超声心动图LVEF均较治疗前有明显改善（P〈0．01或P〈0．051．但治疗组较对照组改善更为显著（P〈0．05）。治疗组LVEDD、LVESD、LADD均较治疗前改善，差异有显著性（P〈0．01或P〈0．05），而对照组无改善；两组均未发现有明显的不良反应。结论TMZ联合培哚普利治疗CHF是一种安全有效的方法。     

肾功能不全的急性心梗患者PCI术后服用曲美他嗪的疗效观察

目的 观察合并慢性肾功能不全的急性心肌梗死患者经皮冠状动脉介入治疗术(PCI)后长期服用曲美他嗪的有效性和安全性.方法 合并慢性肾功能不全的初发急性心肌梗死患者40例,PCI术后随机分为2组,2组年龄、性别、合并病变、肾功能及心功能分级均相仿.对照组(30例)PCI术后不服用曲美他嗪;治疗组(30例)PCI术后口服曲美他嗪治疗12个月.各组其他冠心病二级预防药物均相同.观察2组患者24 h尿蛋白定量、肌酐清除率和超声心动图变化.结果 与对照组相比,曲美他嗪治疗组肾功能未见恶化(P＜0.05),24 h尿蛋白定量未增加,而心功能恢复较好(P＜0.05).结论 合并慢性肾功能不全的急性心肌梗死患者PCI术后长期服用曲美他嗪安全有效.     

曲美他嗪联合培哚普利治疗慢性充血性心力衰竭疗效观察

目的观察曲美他嗪（TMZ）联合培哚普利治疗慢性充血性心力衰竭（CHF）患者的临床疗效。方法72例CHF患者随机分为研究组和对照组，均给予内科常规抗心衰治疗。对照组加服培哚普利，初始剂量2mg，每日1次，逐渐加至靶剂量4mg，每日1次；研究组在对照组的基础上接受曲美他嗪20mg／次，3次/d。治疗12周。结果治疗12周，两组心功能较治疗前有明显改善，治疗组临床总有效率为93．4％，较对照组（80．6％）显著提高（P〈0．05）；超声心动图LVEF均较治疗前有明显改善（P〈0．01或P〈0．051．但治疗组较对照组改善更为显著（P〈0．05）。治疗组LVEDD、LVESD、LADD均较治疗前改善，差异有显著性（P〈0．01或P〈0．05），而对照组无改善；两组均未发现有明显的不良反应。结论TMZ联合培哚普利治疗CHF是一种安全有效的方法。     

曲美他嗪治疗非ST抬高急性冠脉综合征的临床观察

目的：观察曲美他嗪与常规药物相结合治疗非ST段抬高的急性冠脉综合征（NSTEACS）的疗效。方法：60例NSTEACS被随机分为治疗组及对照组各30例,对照组常规给予硝酸酯类、抗血小板药物、β受体阻滞剂、低分子肝素;治疗组在常规治疗的基础上加用曲美嗪20mg,3次/d,连续观察4周,观察胸痛消失率、动态心电图的变化（ST-T改变及恶性心律失常发生率）及心率,血压的变化。结果：治疗组胸痛消失率、ST-T改善更为明显,恶性心律失常发生率明显减少（P〈0.05）,曲美他嗪对心率、血压无影响（P〉0.05）。结论：在常规治疗NSTEACS基础上联合应用曲美他嗪可以改善心肌缺血,减少胸痛的发作次数及恶性心律失常发生率,对血液动力学无影响,是安全、有效的治疗方法。     

曲美他嗪治疗不稳定型心绞痛67例分析

目的 研究曲美他嗪治疗不稳定型心绞痛的疗效. 方法 将不稳定型心绞痛患者133例随机分组,对照组66例采取常规治疗,治疗组67例在常规治疗基础上加服曲美他嗪60mg,3次/d,服药14 d后进行疗效评价. 结果 治疗组不稳定型心绞痛疗效分别是：显效46例,有效18例,无效3例,总有效率95.5%.对照组：显效35例,有效20例,无效11例,总有效率83.3%.治疗组与对照组相比（P＜0.05）;心电图疗效疗效分别是：治疗组显效45例,有效19例,无效3例,总有效率95.5%;对照组显效34例,有效20例,无效12例,总有效率81.8%.两组差异有统计学意义（P＜0.05）. 结论 曲美他嗪治疗不稳定型心绞痛疗效比较肯定.     

曲美他嗪治疗充血性心力衰竭的临床疗效观察

目的　观察曲美他嗪对心力衰竭的治疗效果。方法　对心力衰竭 114例患者在原有抗心衰治疗基础上 ,随机分为加用曲美他嗪组 93例 (观察组 )及未加用曲美他嗪组 2 1例 (对照组 ) ,用单盲法进行了 6个月的对比观察。结果观察组总有效率 90 .3 2 %明显高于对照组的 61.90 % (P <0 .0 1)。且治疗组射血分数明显升高。结论　曲美他嗪可增加衰竭心肌的收缩力 ,提高心排血量 ,改善心衰症状。     

芪苈强心胶囊联合曲美他嗪治疗慢性充血性心力衰竭临床观察

目的:观察芪苈强心胶囊联合西药治疗中、重度慢性充血性心力衰竭(CHF)的疗效及安全性。方法:将80例CHF患者随机分为两组,对照组给予ACEI类、利尿剂、小剂量地戈辛片和酒石酸美托洛尔片,治疗组在对照组治疗基础上加服芪苈强心胶囊(4粒/次,每日3次)、曲美他嗪片(20mg/次,每日3次),4周时比较两组治疗效果。结果:治疗组心功能改善率、总有效率、左室射血分数(LEVF)提高率分别为:97.5%、100%、(30±5)%,而对照组分别为87.5%、92.5%、(13±4)%,两组比较差异有统计学意义(P<0.05或P<0.01),治疗组生活质量改善优于对照组(P<0.01),两组均未发现明显不良反应。结论:芪苈强心胶囊合用曲美他嗪及其他西药治疗CHF具有明显疗效和良好的安全性。