曲美他嗪在不稳定型心绞痛患者经皮冠状动脉介入治疗围术期中的应用研究

目的 探讨曲美他嗪在经皮冠状动脉介入治疗(PCI)不稳定型心绞痛围术期中的应用效果.方法 将本院收治的88例行冠状动脉介入治疗的不稳定型心绞痛患者随机分为对照组(44例)和观察组(44例),对照组给予阿司匹林、硫酸氢氯吡格雷、阿托伐他汀等常规药物治疗,观察组在对照组常规治疗的基础上给予曲美他嗪治疗.比较两组患者的临床治疗效果及治疗前后血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白T(cTnT)等心肌损伤指标的差异,并采用TIMI帧数(TFC)对冠状动脉血流改善情况进行评估.结果 观察组临床总有效率为88.64％,明显高于对照组的75.00％,差异有统计学意义(P＜0.05);对照组患者术后血清CK、CK-MB和cTnT水平分别为(82.31±22.46)U/L、(16.32±2.67) U/L、(0.07±0.05) ng/ml,明显低于观察组的(102.34±29.58) U/L、(19.29±3.45)U/L、(0.13±0.11) ng/ml,差异有统计学意义(P＜0.05);观察组患者前降支、回旋支、右冠状动脉的TFC值和平均TFC值均明显低于对照组,差异有统计学意义(P＜0.05).结论 曲美他嗪能够有效缓解不稳定型心绞痛患者经皮冠状动脉介入治疗围术期中的心肌损伤,显著改善冠状动脉血流状况,具有临床推广价值.

Application research of trimetazidine during percutaneous coronary intervention in patients with unstable angina pectoris

Objective To investigate the application effect of trimetazidine during percutaneous coronary intervention (PCI) in patients with unstable angina pectoris.Methods 88 patients with unstable angina peetoris treated with PCI were randomly divided into control group (44 eases) and observation group (44 cases).Control group was treated with aspirin,clopidogrel,and atorvastatin,and observation group was treated with trimetazidine on the basis of routine treatment in control group.Compared the clinical effect,serum creatine kinase (CK),creatine kinase isoenzyme (CK-MB),cardiac troponin-T (cTnT) before and after treatment between two groups,and evaluated the coronary blood flow with TIMI frames.Results The clinical total effective rate of observation group was 88.64％,significantly higher than 75％ of control group,with statistically significant difference (P＜0.05).The levels of serum CK,CK-MB,and cTnT in observation group after surgery were (82.31±22.46) U/L,(14.32±±2.67) U/L,(0.05±0.07) ng/ml,significantly lower than (102.34±29.58) U/L,(19.29±3.45) U/L,(0.13±0.11) ng/ml in control group,with statistically significant differences (P＜0.05).The TFC value of anterior descending,circumflex branch,right coronary artery,and the average TFC value in observation group were significantly lower than those in control group,with statistically significant differences (P＜0.05).Conclusion Trimetazidine can effectively alleviate myocardial injury and improve coronary artery blood flow in patients with unstable angina pectoris during PCI,with clinical promotion value.