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目的:研究曲美他嗪治疗ST段抬高型急性心肌梗死的心功能疗效。方法:入选200例ST段抬高型急性心肌梗死患者,经过溶栓等再灌注治疗,病情稳定(7～10)天后行冠状动脉造影检查结果阴性(主支血管狭窄50%以下)的患者,在常规治疗基础上随机分为治疗组和对照组,对照组按照临床需要给予硝酸脂类,ACEI,B-R阻滞剂,他汀类等药物,治疗组在此基础上给予盐酸曲美他嗪(TMZ,商品名万爽力)20mg,3次/天,疗程8周,对比两组病人在临床活动耐量及心功能方面变化,评价治疗效果。结果:急性心肌梗死患者在常规治疗基础上加曲美他嗪后与对照组相比心功能明显改善(P<0.01),6分钟步行实验距离明显延长(p<0.01),且该药有良好的耐受性和安全性。结论:曲美他嗪能通过优化心肌能量代谢达到改善生活质量和延缓心力衰竭的进展,预示着能进一步降低死亡率,提高生存率。
Objective: To study the effect of trimetazidine on cardiac function in patients with ST-segment elevation acute myocardial infarction. Methods: A total of 200 patients with acute ST-segment elevation myocardial infarction were enrolled in this study. After thrombolysis and reperfusion, the patients with stable coronary artery angiography (less than 50% of the main branch of the blood vessel) On the basis of conventional treatment, the patients were randomly divided into treatment group and control group, and patients in control group were given nitric acid lipids, ACEI, BR blockers and statins and other drugs according to clinical needs. The treatment group was given Trimetazidine Hydrochloride (TMZ , Brand name million cool force) 20mg, 3 times / day, course of treatment for 8 weeks, comparing two groups of patients in clinical activity tolerance and cardiac function changes to evaluate the therapeutic effect. Results: Compared with the control group, the patients with acute myocardial infarction had significantly improved cardiac function (P <0.01), and the distance from the 6-minute walk was significantly prolonged (p <0.01), and the drug was good Tolerance and safety. Conclusion: Trimetazidine can improve the quality of life and delay the progression of heart failure by optimizing myocardial energy metabolism, which indicates that it can further reduce the mortality and improve the survival rate.