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目的分析对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后运用曲美他嗪治疗对患者心功能及左心室重构作用及可能机制。方法 100例择期行PCI治疗的AMI患者采用随机数字表法分为研究组和对照组,各50例。对照组采用血管紧张素转化酶抑制剂(ACEI)、强心药、硝酸酯类等药物进行常规治疗,研究组在对照组治疗基础上,在行PCI前7 d给予曲美他嗪治疗,观察两组患者的治疗效果。结果经过3个月的治疗后,研究组血清胎盘生长因子(PIGF)水平为(7.5±0.5)pg/ml低于对照组的(10.2±1.0)pg/ml,心脏不良事件发生率为4.0%明显低于对照组的16.0%,差异有统计学意义(P<0.05)。研究组左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积指数(LVEDVI)、左心室收缩末期容积指数(LVESVI)水平明显低于对照组;研究组左心室射血分数(LVEF)、心输出量(CO)、每搏量(SV)、心脏指数(CI)水平明显优于对照组,差异有统计学意义(P<0.05)。结论曲美他嗪对炎性因子有抑制作用,适合择期行PCI治疗的AMI患者选用。
Objective To analyze the effects of trimetazidine on cardiac function and left ventricular remodeling in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) and its possible mechanism. Methods A total of 100 AMI patients undergoing PCI during the PCI period were randomly divided into study group and control group, with 50 cases in each group. The control group received conventional angiotensin converting enzyme inhibitors (ACEIs), cardiac drugs, nitrates and other drugs for routine treatment. The study group was treated with trimetazidine 7 days before PCI on the basis of the control group, and observed Therapeutic effect of two groups of patients. Results After 3 months of treatment, the serum levels of placental growth factor (PIGF) in the study group were (7.5 ± 0.5) pg / ml lower than those in the control group (10.2 ± 1.0) pg / ml, and the incidence of cardiac adverse events was 4.0% Significantly lower than 16.0% of the control group, the difference was statistically significant (P <0.05). LVESD, LVEDD, LVEDVI and LVESVI in the study group were significantly lower than those in the control group. In the study group, the left ventricle (LVEDD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume index The levels of LVEF, CO, SV and CI were significantly better than those of the control group (P <0.05). Conclusion Trimetazidine inhibits inflammatory cytokines and is suitable for patients with AMI undergoing elective PCI.