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。     

曲美他嗪对非ST段抬高急性冠脉综合征患者心肌缺血和心率变异的影响

目的:观察曲美他嗪对非ST段抬高的急性冠脉综合症(NSTEACS)患者疗效及心率变异(HRV)的影响,评价其心肌保护作用。方法:选择NSTEACS患者74例,随机分为两组:一组使用阿司匹林、单硝酸异山梨酯、氟伐他汀、美托洛尔等常规治疗,另一组在常规治疗基础上加用曲美他嗪治疗。总观察疗程为8周,观察患者用药前后心率、血压、胸痛发作频率及持续时间、硝酸甘油每天含服次数、心肌缺血的范围及程度以及24 h动态心电图变化,进行疗效评定和HRV分析。结果:曲美他嗪组(有效率94.4%,显效率72.2%),疗效明显优于常规治疗组(有效率65.8%,显效率36.8%)(P<0.05或P<0.01)。SDNN、SDANN、rMSSD、PNN50均升高,低频谱功率(LF)、低频/高频谱功率比值(LF/HF)均降低,有统计学差异(P均<0.05)。高频谱功率(HF)升高,但无统计学差异(P<0.05)。结论:曲美他嗪能有效改善NSTEACS患者心肌缺血及HRV。     

盐酸曲美他嗪治疗稳定型心绞痛50例分析

目的 探讨盐酸曲美他嗪在防治稳定型心绞痛中的作用.方法 对50例稳定型心绞痛,随机分成观察组和对照组各25例.对照组按常规心绞痛治疗,观察组在常规治疗基础上给予盐酸曲美他嗪20mg每次口服,每日3次.6个月后比较两组治疗前后心绞痛发作次数、持续时间、平板运动试验终点时的"心率×收缩压"水平.结果 观察组心绞痛的总改善率是92%,心率×收缩压乘积无明显差异.结论 盐酸曲美他嗪能够显著延长运动致心绞痛发作的时间,减少发作次数,增加心脏运动耐量.     

Acute effects of trimetazidine evaluated by exercise testing

Summary A single dose of 60 mg trimetazidine (the normal daily dose) improved exercise capacity in angina pectoris, as reflected by an increase in the duration of exercise, total work performed, and improvement in ECG signs of ischaemia. All these effects occurred without any detectable chronotropic or vasomotor effect. The importance of this study is to demonstrate that these beneficial effects, already well-recognized after chronic administration of 20 mg three times a day, also occur after a single administration equivalent to the normal daily dose.Vastarel 20 mg. Laboratoires Biopharmaceutiques de France     

Trimetazidine has protective effects on spermatogenesis in a streptozotocin‐induced diabetic rat model

The aim of this study was to investigate the protective effects of trimetazidine (TMZ), as an antioxidant agent, on streptozotocin (STZ)‐induced diabetic rats. A total of 50 male Sprague Dawley rats were randomly classified into five groups as follows: Group 1 (control), Group 2 (STZ‐induced diabetic rats), Group 3 (STZ‐induced diabetic rats treated orally with 1 cc/day isotonic saline), Group 4 (diabetic rats treated orally with 10 mg/kg/day TMZ) and Group 5 (diabetic rats treated orally with 20 mg/kg/day TMZ). After 8 weeks, orchiectomy was carried out. Histopathological and electron microscopic examinations were performed in all groups. In groups 1 and 5, the structural and ultra‐structural findings of the testicular tissue and spermatogenesis were found normal. In groups 2, 3 and 4, similar results were obtained in terms of the impaired testicular architecture and degeneration of spermatogenesis. The administration of an optimal dose of TMZ protects against the harmful effects of diabetes mellitus on spermatogenesis in rats. TMZ therapy can be used to maintain normal spermatogenesis in diabetic rats.     

阿托伐他汀联合曲美他嗪对冠心病患者心功能和hs-CRP、IL-6、Fib的影响

目的 研究阿托伐他汀联合曲美他嗪对冠心病患者心功能和超敏C-反应蛋白（hs-CRP）、白介素-6（IL-6）、血浆纤维蛋白（Fib）的影响。方法 选择2014年1月-2016年1月在咸阳市第一人民医院进行诊治的冠心病患者120例,随机分为两组。观察组采用阿托伐他汀联合曲美他嗪治疗,对照组采用曲美他嗪治疗,观察和比较两组的疗效、左心室射血分数、左心室舒张末期内径、左心室后壁厚度及血清hs-CRP、IL-6、Fib水平。结果 观察组的治疗有效率为91.67%（55/60）,明显高于对照组的76.67%（46/60）（P<0.05）;两组的左心室射血分数、左心室舒张末期内径、左心室后壁厚度均较治疗前明显改善（P<0.05）,且观察组的改善程度明显优于对照组（P<0.05）;两组的血清hs-CRP、IL-6、Fib水平均明显降低（P<0.05）,且观察组降低的更为明显（P<0.05）;两组不良反应发生率相比无明显差异。结论 阿托伐他汀联合曲美他嗪治疗冠心病患者疗效确切,能改善心功能,明显降低hs-CRP、IL-6、Fib水平,值得临床应用推广。     

曲美他嗪和PCI术治疗冠心病合并心力衰竭患者

目的 探讨曲美他嗪联合经皮冠状动脉介入治疗对冠心病合并心力衰竭患者血浆NT-pro BNP水平的影响.方法 选择2018年2月—2019年2月收治的冠心病合并心力衰竭的患者70例,随机分为两组,两组患者均进行PCI术,对照组给予常规治疗,研究组给予曲美他嗪治疗.结果 研究组患者治疗后NT-pro BNP水平低于对照组,LVEF水平高于对照组,TIMI帧数少于对照组(P<0.05);研究组患者治疗后TNF-α、IL-6水平均低于对照组(P<0.05);研究组患者治疗后心绞痛发作时间短于对照组,发作频率少于对照组(P<0.05).结论 冠心病合并心力衰竭患者使用曲美他嗪联合PCI术治疗,患者血浆NT-pro BNP水平降低幅度较大,TIMI帧数也有进一步降低,治疗效果有明显提升,心肌微循环有效改善,降低损伤心肌,减轻炎症反应,改善心功能,曲美他嗪联合PCI术治疗是有效、安全的治疗方案.     

阿托伐他汀与曲美他嗪联用治疗冠心病的临床疗效观察

目的:探究采用阿托伐他汀联合曲美他嗪治疗冠心病的临床疗效。方法:抽选2018年1月~2019年1月在我院心血管内科接收的冠心病患者120例作为实验对象,用随机数字表法将患者分为常规组与研究组,各60例。常规组给以曲美他嗪治疗,研究组给以阿托伐他汀与曲美他嗪联用治疗,对比用药后两组患者疗效。结果:研究组与常规组临床治疗有效率数据相对比,研究组比常规组明显较高,同时研究组的血脂水平改善程度明显优于常规组(P<0.05)。结论:阿托伐他汀与曲美他嗪联用治疗冠心病可以有效降低患者的血脂水平,临床疗效显著,值得临床大力推广。     

Effects of trimetazidine in combination with bisoprolol in patients with chronic heart failure and concomitant chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis

Background:To the best of our knowledge, there is no study that has conducted a review investigating the clinical efficacy and safety of bisoprolol combined with trimetazidine on chronic heart failure (CHF) patients with chronic obstructive pulmonary disease (COPD). Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness and safety of bisoprolol combined with trimetazidine on CHF patients with COPD.Methods:Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. For search on PubMed, the following search terms will be used: “trimetazidine, bisoprolol, chronic heart failure, chronic obstructive pulmonary disease.” In order to achieve a consistency of extracted items, the data extractors will extract data from a sample of eligible studies. The outcomes include all-cause mortality and hospitalization for cardiac or/and respiratory causes; left ventricular structure and function; and functional scores. Review Manager software (v 5.4; Cochrane Collaboration) will be used for the meta-analysis. Two independent reviewers will assess the risk of bias of the included studies at study level. Any disagreements will be discussed and resolved in discussion with a third reviewer.Results:The results of our review will be reported strictly following the PRISMA criteria.Conclusions:The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.OSF registration number:10.17605/OSF.IO/ZWPRB.     

曲米他嗪抗心肌缺血的临床观察

目的 评价抗心肌缺血新药曲米他嗪与传统抗心肌缺血药结合治疗稳定性劳累型心绞痛的临床疗效。方法 22例稳定性劳累型心绞痛患经临床及运动试验证实其心肌缺血后入选，予曲米他嗪治疗12wk后复查运动试验并判断临床疗效。结果 与试验前相比运动耐量和总工作量显提高（P＜0．01），运动至心绞痛发作时间明显延长，ST段压低程度亦显改善（P均＜0．01），患周心绞痛发作次数及硝酸甘油消耗量显下降（P＜0．01）。结论 曲米他嗪与传统抗心肌缺血药物联合使用时有显的抗心肌缺血作用，增加运动耐量，安全有效。