中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
3期
205-209
,共5页
许晓晗%张维君%周玉杰%周志明%马涵英%胡宾%康云鹏%雒芳芳
許曉晗%張維君%週玉傑%週誌明%馬涵英%鬍賓%康雲鵬%雒芳芳
허효함%장유군%주옥걸%주지명%마함영%호빈%강운붕%락방방
血管成形术,经腔,经皮冠状动脉%曲美他嗪%肌钙蛋白%心室功能,左
血管成形術,經腔,經皮冠狀動脈%麯美他嗪%肌鈣蛋白%心室功能,左
혈관성형술,경강,경피관상동맥%곡미타진%기개단백%심실공능,좌
Angioplasty,transluminal,percutaneous coronary%Trimetazidine%Troponin%Ventricular function,left
目的 探讨曲美他嗪对经皮冠状动脉介入治疗(PCI)术相关心肌损伤及术后左心室功能的影响.方法 本研究为一项单中心前瞻、随机、对照研究,采用随机数字表法将132例拟行择期PCI术的不稳定性心绞痛患者分为曲美他嗪组和对照组.最终纳入106例成功完成PCI术的不稳定性心绞痛患者,曲美他嗪组51例,对照组55例.曲美他嗪组在常规药物的基础上,于PCI术前0.5~1.0 h一次性口服60 mg曲美他嗪,PCI术后随访期间坚持口服常规剂量曲美他嗪(20 mg、3次/d).分别测定PCI术前和术后16 ~ 18 h患者血清心肌肌钙蛋白I(cTnI)浓度,通过超声心动图随访、评价两组患者PCI术后心功能,比较主要心血管事件(MACE)的发生情况.结果 PCI术后16~ 18 h时,曲美他嗪组患者cTnI水平由术前[0.02(0.01,0.03)] μg/L升至[0.11 (0.07,0.13)] μg/L (P<0.05),对照组患者cTnI水平由术前[0.02(0.01,0.03)] μg/L升至[1.31(0.44,2.31)] μg/L (P<0.05);曲美他嗪组术后cTnI水平明显低于对照组(P<0.05),且曲美他嗪组术后cTnI>0.10 μg/L患者的比例明显低于对照组[54.9% (28/51)比94.5%(52/55),P<0.01].平均随访12个月后,曲美他嗪组左心室收缩末内径低于对照组[(31.00 ±4.33)mm比(33.29 ±2.11) mm,P<0.05],左心室射血分数高于对照组[(65.65±3.94)%比(62.29±3.06)%,P<0.01],两组MACE发生率差异无统计学意义.结论 PCI术前口服负荷剂量曲美他嗪可以减少手术相关心肌损伤,术后长期服用可以改善患者的左心室功能.
目的 探討麯美他嗪對經皮冠狀動脈介入治療(PCI)術相關心肌損傷及術後左心室功能的影響.方法 本研究為一項單中心前瞻、隨機、對照研究,採用隨機數字錶法將132例擬行擇期PCI術的不穩定性心絞痛患者分為麯美他嗪組和對照組.最終納入106例成功完成PCI術的不穩定性心絞痛患者,麯美他嗪組51例,對照組55例.麯美他嗪組在常規藥物的基礎上,于PCI術前0.5~1.0 h一次性口服60 mg麯美他嗪,PCI術後隨訪期間堅持口服常規劑量麯美他嗪(20 mg、3次/d).分彆測定PCI術前和術後16 ~ 18 h患者血清心肌肌鈣蛋白I(cTnI)濃度,通過超聲心動圖隨訪、評價兩組患者PCI術後心功能,比較主要心血管事件(MACE)的髮生情況.結果 PCI術後16~ 18 h時,麯美他嗪組患者cTnI水平由術前[0.02(0.01,0.03)] μg/L升至[0.11 (0.07,0.13)] μg/L (P<0.05),對照組患者cTnI水平由術前[0.02(0.01,0.03)] μg/L升至[1.31(0.44,2.31)] μg/L (P<0.05);麯美他嗪組術後cTnI水平明顯低于對照組(P<0.05),且麯美他嗪組術後cTnI>0.10 μg/L患者的比例明顯低于對照組[54.9% (28/51)比94.5%(52/55),P<0.01].平均隨訪12箇月後,麯美他嗪組左心室收縮末內徑低于對照組[(31.00 ±4.33)mm比(33.29 ±2.11) mm,P<0.05],左心室射血分數高于對照組[(65.65±3.94)%比(62.29±3.06)%,P<0.01],兩組MACE髮生率差異無統計學意義.結論 PCI術前口服負荷劑量麯美他嗪可以減少手術相關心肌損傷,術後長期服用可以改善患者的左心室功能.
목적 탐토곡미타진대경피관상동맥개입치료(PCI)술상관심기손상급술후좌심실공능적영향.방법 본연구위일항단중심전첨、수궤、대조연구,채용수궤수자표법장132례의행택기PCI술적불은정성심교통환자분위곡미타진조화대조조.최종납입106례성공완성PCI술적불은정성심교통환자,곡미타진조51례,대조조55례.곡미타진조재상규약물적기출상,우PCI술전0.5~1.0 h일차성구복60 mg곡미타진,PCI술후수방기간견지구복상규제량곡미타진(20 mg、3차/d).분별측정PCI술전화술후16 ~ 18 h환자혈청심기기개단백I(cTnI)농도,통과초성심동도수방、평개량조환자PCI술후심공능,비교주요심혈관사건(MACE)적발생정황.결과 PCI술후16~ 18 h시,곡미타진조환자cTnI수평유술전[0.02(0.01,0.03)] μg/L승지[0.11 (0.07,0.13)] μg/L (P<0.05),대조조환자cTnI수평유술전[0.02(0.01,0.03)] μg/L승지[1.31(0.44,2.31)] μg/L (P<0.05);곡미타진조술후cTnI수평명현저우대조조(P<0.05),차곡미타진조술후cTnI>0.10 μg/L환자적비례명현저우대조조[54.9% (28/51)비94.5%(52/55),P<0.01].평균수방12개월후,곡미타진조좌심실수축말내경저우대조조[(31.00 ±4.33)mm비(33.29 ±2.11) mm,P<0.05],좌심실사혈분수고우대조조[(65.65±3.94)%비(62.29±3.06)%,P<0.01],량조MACE발생솔차이무통계학의의.결론 PCI술전구복부하제량곡미타진가이감소수술상관심기손상,술후장기복용가이개선환자적좌심실공능.
Objective To explore the effects of trimetazidine therapy on left ventricular (LV) function after percutaneous coronary intervention (PCI).Methods A total of 106 patients with unstable angina pectoris underwent successful elective PCI were randomly assigned to standard therapy group (control,n =55) or trimetazidine group (n =51,60 mg trimetazidine loading dose prior to PCI followed by 20 mg Tid after PCI on top of standard therapy).cTnI level was measured before and at 16-18 hours after PCI.LV function was evaluated by echocardiography and major adverse cardiac events (MACE,including death,re-infarction and target vessel revascularization) at 12 months after PCI was compared between the two groups.Results Post procedural cTnI level increased from [0.02 (0.01,0.03)] μg/L at baseline to [0.11 (0.07,0.13)] μg/L (P < 0.05) at 16-18 hours in the trimetazidine group,while [0.02 (0.01,0.03)] μg/L to [1.31 (0.44,2.31)] μg/L in the control group (P < 0.05).Post procedural cTnI level was significantly reduced in the trimetazidine group compared to the control group (P < 0.05).At 12 months follow-up,left ventricular ejection fraction in the trimetazidine group was significantly higher than in control group [(65.65 ± 3.94) % vs.(62.29 ± 3.06) %,P < 0.01] while incidence of MACE was similar between the two groups.Conclusion Trimetazidine can reduce the post-PCI cTnI release and improve left ventricular function after PCI in patients with unstable angina pectoris.