曲美他嗪对急性冠脉综合征C－反应蛋白、内皮素及一氧化氮的影响

目的研究曲美他嗪对急性冠脉综合征C-反应蛋白（CRP）、内皮素（ET）、一氧化氮（NO）的影响及是否能降低主要不良心脏事件（MACE）的发生率。方法入选急性冠脉综合征患者100例，随机分为曲美他嗪纽50例，常规治疗组50例，另外随机选择50例正常人作对照组。分别测定两组治疗前及治疗后8周血CRP、ET、NO浓度。观察两组治疗8周后MACE的发生情况。结果急性冠脉综合征患者血NO浓度明显下降，与对照组比较差异有统计学意义（P〈0．01）；血CRP、ET浓度明显升高，与对照组比较差异有统计学意义（P〈0．01）。两组治疗前后比较，治疗后血NO浓度升高，血CRP和ET浓度降低，差异有统计学意义（P〈0．01）；两组治疗后比较，曲美他嗪组比常规治疗组血NO浓度升高、血CRP和ET浓度降低，差异有统计学意义（P〈0．01）。两组治疗8周后，曲美他嗪组与常规治疗组比较，MACE的发生明显低于常规治疗组（P〈0．05）。结论在急性冠脉综合征常规药物治疗的基础上加用曲美他嗪治疗，抗炎、调节血管内皮功能的作用增强，并能减少主要不良心脏事件的发生率。

Trimetazidine on C - reactive protein,endothelin and nitric oxide of patients with acute coronary syndrome

Objective To research the effect of trimetazidine on C - reactive protein, endothelin, nitric oxide of patients with acute coronary syndrome, and the impact whether it can reduce the occurrence of major adverse cardiovascular events （MACE）. Methods One hundred patients with acute coronary syndrome were randomly divided into trimetazidine group （50 cases）, conventional treatment group （50 cases）,and randomly selected 50 cases of normal people in the control group. The two groups were measured before and after treatment for 8 weeks in blood CRP, ET, NO concentration. Observated the treatment of the two groups after 8 weeks of the occurrence of MACE. Results In patients with acute coronary syndrome, blood concentrations of NO decreased, compared with the control group there was significant difference （ P 〈 0.01 ） ; blood CRP, ET concentration was significantly increased, compared with the control group there was a significant difference （ P 〈 0.01 ）. Comparing the two groups before and after treatment, after treatment increased the concentration of NO in blood, blood eoncentrations of CRP and ET decreased significantly （ P 〈 0.01 ） ; Comparing the two groups after treatment, trimetazidine group than the conventional treatment group increased the concentration of NO in blood, the blood concentrations of CRP and ET decreased significantly （ P 〈0. 01 ）. The two groups 8 weeks after treatment, trimetazidine group and the conventional treatment group, MACE incidence was significantly lower than conventional treatment group （ P 〈 0.05 ）. Conclusions Acute coronary syndrome in conventional drug treatment bases on the use of trimetazidine treatment, and it can enhance anti - inflammatory, vascular endothelial function and reduce the occurrence of major adverse cardiovascular events.