曲美他嗪对急性心肌梗死患者介入治疗后胎盘生长因子、心功能和左心室重构的影响

目的:探讨曲美他嗪对急性心肌梗死患者介入治疗(PCI)后心功能、左心室重构的影响及可能的机制。方法:选择60例首次行择期PCI的急性心肌梗死患者,随机分成曲美他嗪治疗组(31例)和常规治疗组(29例),两组均接受冠心病二级预防治疗且使用血管紧张素转换酶抑制剂(ACEI)种类及剂量相同,曲美他嗪组在术前7d加用曲美他嗪治疗(20mg,3次/d)共12周。分别在用药前及用药12周后行超声心动图检查,比较两组患者的心功能指标每搏量(SV),心输出量(CO),心脏指数(CI),左室射血分数(LVEF),左房(LA),左室(LV),左室舒张末期内径(LVEDD),左室收缩末期内径(LVESD),左室舒张末期容积指数(LVEDVI),左室收缩末期容积指数(LVESVI)。同时测定两组患者用药前和用药12周后血清胎盘生长因子水平。结果:用药12周后曲美他嗪治疗组患者的SV,CO,CI及LVEF较常规治疗组显著增高(P<0.05),而LA,LV,LVEDD,LVESD,LVEDVI,LVESVI较常规治疗组明显减小(P<0.05)。曲美他嗪组用药前和用药12周后血清胎盘生长因子水平低于常规治疗组,两组之间差异有统计学意义(P<0.05)。结论:曲美他嗪可能通过抗炎作用而改善冠心病患者介入治疗后心功能及左心室重构。

The effects of trimetazidine on serum placental growth factor, cardiac function and left ventricular remodeling of acute myocardial infarction patients undergoing precutaneous coronary intervention

Objective:To investigate the effects of trimetazidine on cardiac function and left ventricular remollding of acute myocardial infarction patients undergoing precutaneous coronary intervention(PCI)and its possible mechanism.Methods:Sixty patients with acute myocardial infarction(AMI),who firstly treated by PCI,were enrolled.All patients were randomly divided into trimetazidine-treated group(31 cases)and routine-treated group(29 cases).The patients in the two groups were all received the coronary secondary prevention,the same species and dose of angiotensin converting enzyme inhibitors(ACEI).The trimetazidine-treated group added trimetazidine(20mg,three times per day)on 7 days before PCI,it was used 12weeks.The indices of cardiac function in two groups including SV,CO,CI,LVEF,LA,LV,LVEDD,LVESD,LVEDVI and LVESVI were measured by echocardiogram before treatment and 12weeks after treatment.The serum levels of placental growth factor(PlGF)in both two groups were measured before treatment and 12weeks after treatment.Results:At 12weeks after treatment,the parameters SV,CO,CI and LVEF were significantly higher in trimetazidine group than those in routine-treated group(P<0.05),LA,LV,LVEDD,LVESD,LVEDVI,LVESVI were decreased significantly in trimetazidine-treated group than those in routine-treated group(P<0.05).The serum level of PlGF in trimetazidine-treated group was significantly lower than that in routine-treated group before treatment and 12weeks after treatment.Conclusion:Trimetazidine may improve cardiac function and left ventricular remodeling of CHD patients undergoing PCI by anti-inflammatory effect.