【摘要】 目的 观察曲美他嗪对经皮冠状动脉介入术(PCI)相关心肌损伤的影响。方法 入选拟行PCI的不稳定型心绞痛患者80例,采用随机数字表法分为曲美他嗪组和对照组,各40例,所有入选患者均服用阿司匹林、氯吡格雷及常规药物治疗,曲美他嗪组PCI术前3 d开始口服曲美他嗪.20mg/次,3次/d,直至采血结束;于PCI术前及术后6、24 h采血测定血清肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、C反应蛋白(CRP)的浓度,另测定术前及术后6 h白细胞介素6(IL-6)的浓度。结果 术前2组患者各项指标差异均无统计学意义(P>0.05)。曲美他嗪组PCI术后在各个测量时点的cTnI、CK-MB、CRP、IL-6均明显低于对照组[术后6 h:cTnI为(0.52±0.22)μg/L比(1.96±1.08)μg/L、CK-MB为(52±13)U/L比(89±19)U/L、CRP为(9.6±2.8)mg/L比(12.7±2.5)mg/L、IL-6为(23±6)ng/L比(32±6)ng/L;术后24 h:cTnI为(0.44±0.26)μg/L比(1.98±I.12)μg/L、CK-MB为(43±10)U/L比(72±18)U/L、CRP为(14.8±5.6)mg/L比(23.2±7.2)mg/L](P<0.05)。结论 曲美他嗪能明显降低PCI术后患者的心肌损伤标志物和炎性因子水平,减轻心肌损伤,对心肌有保护作用。更多还原

【Abstract】 Objective To observe the protective effect of trimetazidine on myocardial injury induced by percutaneous coronary intervention(PCI).Methods Eighty patients with unstable angina were randomly divided into control group(n=40) and trimetazidine group(n =40).All patients were administrated with aspirin,clopidogrel and other medicines;the patients in trimetazidine group were additionally administrated with oral trimetazidine3 days before PCI(20 mg/time,3 times/d) till the end of venous sampling.The levels of myocardial injury markers troponin I(cTnI),creatine kinase isoenzyme(CK-MB) and C-reactive protein(CRP) were measured before,6 and24 h after PCI;the level of interleukin(1L)6 was detected before and 6 h after PCI.Results There were no significant differences of all indexes between two groups before PCI(all P >0.05).The serum levels of cTnI,CK-MB,CRP 6 and 24 h after treatment and the level of IL-6 6 h after treatment in trimetazidine group was significantly decreased compared with those in control group[6 h after PCI:cTnI(0.52 ± 0.22) μg/L vs(1.%± 1.08) μg/L,CK-MB(52±13)U/L vs(89±19)U/L,CRP(9.6 ±2.8)mg/L vs(12.7 ±2.5)mg/L,IL-6(23±6)ng/L vs(32 ±6)ng/L;24 h after PCI:cTnI(0.44 ±0.26)(μg/L vs(1.98 ± I.12)μg/L,CK-MB(43 ±10)U/L vs(72 ±I8)U/L,CRP(14.8±5.6)mg/L vs(23.2 ±7.2)mg/L](all P<0.05).Conclusion Trimetazidine can reduce the levels of myocardial injury markers and inflammatory cytokines after PCI and has myocardial protective effect.更多还原