曲美他嗪联合阿托伐他汀对经皮冠状动脉介入治疗病人的心脏保护作用

目的:探讨术前给予常规剂量的阿托伐他汀和曲美他嗪对经皮冠状动脉介入治疗(PCI)病人围手术期心肌损伤的影响。方法:将323例欲行PCI的急性冠状动脉综合征病人随机分为对照组(162例)和试验组(161例)。对照组给予常规剂量阿托伐他汀钙片(20 mg/次,1次/晚),试验组给予常规剂量阿托伐他汀钙片加服盐酸曲美他嗪(20 mg/次,tid),治疗3 d;随后分别行PCI。测定PCI术前及术后24 h的血清肌酸激酶-MB同工酶(CK-MB)、心脏肌钙蛋白I(cTnI)、超敏C反应蛋白(hs-CRP)浓度和髓过氧化物酶(MPO)活性,随访PCI后4周时病人的左室射血分数。结果:试验组病人PCI术后24 h的cTnI水平显著低于对照组(P<0.05),MPO活性升高值明显低于对照组(P<0.05)。两组病人在术后24 h的CK-MB活性和hs-CRP水平变化无显著差异(P>0.05)。结论:术前3 d给予常规剂量的阿托伐他汀和曲美他嗪联合治疗,对PCI围手术期病人的心肌损伤具有一定的保护作用。

Effects of combined treatment with trimetazidine and atorvastatin on myocardial protection of patients undergoing percutaneous coronary intervention

Objective： To evaluate the myocardial protection effects of combined treatment with trimetazidine and atorvastatin on patients undergoing percutaneous coronary intervention（PCI）.Methods： Three hundred and twenty-three patients with acute coronary syndrome were enrolled and randomly divided into test group（n=161） and control group（n=162）.Patients in the test group were given trimetazidine hydrochloride 20 mg three times per day and atorvastatin calcicum 20 mg per night.Patients in the control group were given the same dose of atorvastatin calcicum.The treatment lasted 3 d before PCI.The activities of creatinine kinase-MB isoenzyme（CK-MB） and myeloperoxidase（MPO）,the levels of cardiac troponin I（cTnI） and high sensitivity C reactive protein（hs-CRP） were determined.Left ventricular ejection fraction during 4 weeks after PCI were determined.Results： There was significant difference in the serum levels of cTnI at 24 h after PCI between control group and test group（P0.05）.The degree of MPO activity elevation in test group was significantly lower than that in control group（P0.05）.There was no significant difference in the serum activity of CK-MB and level of hs-CRP at 24 h after PCI between control group and test group（P0.05）.Conclusion： The combined treatment with normal dose of trimetazidine hydrochloride and atorvastatin calcicum 3 days before PCI has a protective effect against myocardial damage.