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目的探讨在急性心肌梗死(AMI)直接经皮冠状动脉介入治疗(PCI)前应用曲美他嗪(商品名:万爽力)(TMZ)对AMI再灌注治疗的影响。方法分析行直接PCI血流达TIMI2-3级的60例初发ST段抬高型急性心肌梗死患者;除冠心病2级预防用药外,30例直接PCI前使用TMZ作为研究组,30例未使用TMZ患者作为对照组。研究组在确诊AMI后即刻服用TMZ60mg,随后20mg,3次/d。比较两组直接PCI前后的心电图ST段降幅,血心肌肌钙蛋白I(cTnI)水平及4周后超声心动图检测的左室射血分数(LVEF),左室短轴缩短率(LVFS)变化。结果研究组患者直接PCI后ST段下降幅度值显著高于对照组P<0.05;研究组的cTnI于PCI治疗后6 h显著低于对照组P<0.05,并持续到24小时P<0.01;两组4周末LVEF,LVFS均较入院24h内差异有显著性P<0.05,两组间比较差异有显著性P<0.05。结论 AMI患者在直接PCI前使用TMZ可增加ST段的降幅,减少心肌损害,对心肌细胞保护作用明显,有利于心功能恢复。
Objective To investigate the effect of trimetazidine (TMZ) on AMI reperfusion after acute percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods Sixty patients with primary ST-segment elevation myocardial infarction who underwent direct PCI with TIMI2-3 grade were enrolled. Thirty patients with TMZ as the study group and 30 patients without TME TMZ patients were used as control. The study group received TMZ 60 mg immediately after diagnosis of AMI, followed by 20 mg, 3 times / d. The changes of ST segment decline, the level of cardiac troponin I (cTnI) and left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) after echocardiography were compared between two groups before and after direct PCI. . Results The reduction rate of ST segment in the study group after PCI was significantly higher than that in the control group (P <0.05). The cTnI in the study group was significantly lower than that in the control group 6 h after PCI (P <0.05), and continued to 24 h There were significant differences in LVEF and LVFS between the two groups at 24h after admission (P <0.05), with a significant difference between the two groups (P <0.05). Conclusions The use of TMZ in patients with AMI before direct PCI can increase the decline of ST segment, reduce myocardial damage and protect cardiomyocytes significantly, which is good for cardiac function recovery.