中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
11期
1312-1314
,共3页
李霞%杨海晨%李侠%徐培敬
李霞%楊海晨%李俠%徐培敬
리하%양해신%리협%서배경
心绞痛,不稳定型%老年人%曲美他嗪%左卡尼汀%疗效
心絞痛,不穩定型%老年人%麯美他嗪%左卡尼汀%療效
심교통,불은정형%노년인%곡미타진%좌잡니정%료효
Angina,unstable%Elderly%Trimetazidine%L-carnitine%Therapeutic effect
目的 对比分析曲美他嗪联合左卡尼汀治疗老年不稳定型心绞痛的临床疗效.方法 85例老年不稳定型心绞痛患者,按随机数字表法分为对照组(18例)、曲美他嗪组(22例)、左卡尼汀组(23例)和联合治疗组(22例).对照组行常规治疗(硝酸酯类药物、β受体阻滞剂/钙离子拮抗剂、阿司匹林、血管紧张素转换酶抑制剂等),在常规治疗基础上,曲美他嗪组给予曲美他嗪口服20mg,3次/d；左卡尼汀组给予左卡尼汀静脉滴注2 9,1次/d;联合治疗组给予口服曲美他嗪20 9并静脉滴注左卡尼汀2 9.4组均用药14 d,观察比较4组治疗后心绞痛改善程度和心电图及动态心电图缺血改善程度.结果 曲美他嗪组、左卡尼汀组总有效率分别为81.9％ (18/22)、82.6％( 19/23),优于对照组总有效率77.8％ (14/18),差异有统计学意义(P＜0.05).联合治疗组总有效率为86.4％ (19/22),优于其他3组,差异有统计学意义(P＜0.01或P＜0.05).心电图sT段下降导联数(NST)和sT段压低之和以及动态心电图心肌缺血总负荷各组治疗后对比,曲美他嗪组[(3.8±1.5)个、(4.0±1.7)mm、(37.0±16.5) mm× min]和左卡尼汀组[(3.6±1.7)个、(3.8±2.0)mm、(35.6±13.7)mm×min]优于对照组[(4.1±2.2)个、(4.1±1.9)mm、(40.3±12.4) mm×min](P＜0.05).而联合治疗组[(3.3±1.3)个、(3.4±1.9)mm、(31.4±15.4)mm×min]优于对照组、曲美他嗪组、左卡尼汀组,差异有统计学意义(P＜0.01或P＜0.05).4组均无药物不良反应发生.结论 对老年不稳定型心绞痛,在常规治疗基础上辅以曲美他嗪或左卡尼汀能改善疗效,以曲美他嗪联合左卡尼汀效果更明显,药物安全性良好.
目的 對比分析麯美他嗪聯閤左卡尼汀治療老年不穩定型心絞痛的臨床療效.方法 85例老年不穩定型心絞痛患者,按隨機數字錶法分為對照組(18例)、麯美他嗪組(22例)、左卡尼汀組(23例)和聯閤治療組(22例).對照組行常規治療(硝痠酯類藥物、β受體阻滯劑/鈣離子拮抗劑、阿司匹林、血管緊張素轉換酶抑製劑等),在常規治療基礎上,麯美他嗪組給予麯美他嗪口服20mg,3次/d；左卡尼汀組給予左卡尼汀靜脈滴註2 9,1次/d;聯閤治療組給予口服麯美他嗪20 9併靜脈滴註左卡尼汀2 9.4組均用藥14 d,觀察比較4組治療後心絞痛改善程度和心電圖及動態心電圖缺血改善程度.結果 麯美他嗪組、左卡尼汀組總有效率分彆為81.9％ (18/22)、82.6％( 19/23),優于對照組總有效率77.8％ (14/18),差異有統計學意義(P＜0.05).聯閤治療組總有效率為86.4％ (19/22),優于其他3組,差異有統計學意義(P＜0.01或P＜0.05).心電圖sT段下降導聯數(NST)和sT段壓低之和以及動態心電圖心肌缺血總負荷各組治療後對比,麯美他嗪組[(3.8±1.5)箇、(4.0±1.7)mm、(37.0±16.5) mm× min]和左卡尼汀組[(3.6±1.7)箇、(3.8±2.0)mm、(35.6±13.7)mm×min]優于對照組[(4.1±2.2)箇、(4.1±1.9)mm、(40.3±12.4) mm×min](P＜0.05).而聯閤治療組[(3.3±1.3)箇、(3.4±1.9)mm、(31.4±15.4)mm×min]優于對照組、麯美他嗪組、左卡尼汀組,差異有統計學意義(P＜0.01或P＜0.05).4組均無藥物不良反應髮生.結論 對老年不穩定型心絞痛,在常規治療基礎上輔以麯美他嗪或左卡尼汀能改善療效,以麯美他嗪聯閤左卡尼汀效果更明顯,藥物安全性良好.
목적 대비분석곡미타진연합좌잡니정치료노년불은정형심교통적림상료효.방법 85례노년불은정형심교통환자,안수궤수자표법분위대조조(18례)、곡미타진조(22례)、좌잡니정조(23례)화연합치료조(22례).대조조행상규치료(초산지류약물、β수체조체제/개리자길항제、아사필림、혈관긴장소전환매억제제등),재상규치료기출상,곡미타진조급여곡미타진구복20mg,3차/d；좌잡니정조급여좌잡니정정맥적주2 9,1차/d;연합치료조급여구복곡미타진20 9병정맥적주좌잡니정2 9.4조균용약14 d,관찰비교4조치료후심교통개선정도화심전도급동태심전도결혈개선정도.결과 곡미타진조、좌잡니정조총유효솔분별위81.9％ (18/22)、82.6％( 19/23),우우대조조총유효솔77.8％ (14/18),차이유통계학의의(P＜0.05).연합치료조총유효솔위86.4％ (19/22),우우기타3조,차이유통계학의의(P＜0.01혹P＜0.05).심전도sT단하강도련수(NST)화sT단압저지화이급동태심전도심기결혈총부하각조치료후대비,곡미타진조[(3.8±1.5)개、(4.0±1.7)mm、(37.0±16.5) mm× min]화좌잡니정조[(3.6±1.7)개、(3.8±2.0)mm、(35.6±13.7)mm×min]우우대조조[(4.1±2.2)개、(4.1±1.9)mm、(40.3±12.4) mm×min](P＜0.05).이연합치료조[(3.3±1.3)개、(3.4±1.9)mm、(31.4±15.4)mm×min]우우대조조、곡미타진조、좌잡니정조,차이유통계학의의(P＜0.01혹P＜0.05).4조균무약물불량반응발생.결론 대노년불은정형심교통,재상규치료기출상보이곡미타진혹좌잡니정능개선료효,이곡미타진연합좌잡니정효과경명현,약물안전성량호.
Objective To compare the therapeutic effect of trimetazidine combined with L-carnitine on unstable angina in elderly.Methods Totally 85 cases of elderly patients with unstable angina were randomly divided into four groups which included control group,trimetazidine group,L-carnitine group and combined treatment group.The control group received routine treatment.Other groups were respectively treated with trimetazidine,L-carnitine and both of them on the basis of the routine treatment.The therapeutic period was 14 days.Before and after the treatment,we observed the improvement of angina and changes of Electrocardiograph(ECG) and Dynamic Electrocardiography(DCG).Results The angina improved significantly more in the three treatment groups than in the control group.In the aspect of ECG and DCG,the treatment groups improved significantly more in the three treatment groups than in the control group in NST,ΣST and TIB.Compared to the control group,the differences were statistically significant among Trimetazidine group ( P ＜ 0.05 ),L-carnitine group ( P ＜ 0.05 ) and trimetazidine combined L-carnitine group ( P ＜ 0.01 ).The combined treatment group had better effect than single treatment group.There were no adverse reactions in the two drugs.Conclusions Treatment with trimetazidine or L-carnitine can improve the therapeutic effect in elderly with unstable angina on the basis of the routine treatment.Combined treatment of the two drugs has optimistic effect with less adverse accidents.
