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。

Effects of trimetazidine on myocardial ischemia and heart rate variability in patients with non ST-elevation acute coronary syndrome

AIM:To observe the effects of trimetazi- dine on myocardial ischemia and heart rate variability (HRV)in patients with non ST-elevation acute coronary syndrome(NSTEACS).METHODS:74 patients with NSTEACS were chosen and randomly assigned into two groups:one group was given conventional therapy with as- pirin,isosorbide mononitfate,fluvastatin and metoprolol, trimetazidine was added on the base of conventional thera- py in the other group.The total observation time of thera- py was 8 weeks.The heart rote,blood pressure,frequen- cy and persistence time of chest pain,numbers of times of using Nitroglycerin every day,the extent anti degree of myocardial isehemia,HRV of patients were observed be- fore and after treatment.RESULTS:The therapeutic ef- fect of trimetazidine treatment group(with the effective rate 94.4%,excellence rate 72.2%)was obviously bet- ter than that of the conventional treatment group(with the effective rate 65.8%,excellence rate 36.8%)(P<0.05 or P<0.01).The SDNN,SDANN,rMSSD and PNN50 of HRV were significantly increased(P<0.05); LF,LF/HF of HRV were significantly decreased(P<0.05)in trimetazidine treatment group when compared with those of the conventional treatment group(P<0.05).CONCLUSION:Trimetazidine can improve myocardial ischemia and HRV in patients with NSTEACS.