PCI 术前应用曲美他嗪对AMI患者术后氧化应激反应指标的影响
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篇名: PCI 术前应用曲美他嗪对AMI患者术后氧化应激反应指标的影响
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摘要: 目的:探讨经皮冠状动脉介入治疗(PCI) 术前应用曲美他嗪对急性心肌梗死(AMI)患者术后氧化应激反应指标的影响。方法:回顾性分析行PCI术的100例AMI患者资料,按用药的不同分为对照组(50例)和观察组(50例)。两组患者PCI术前1 d晚上口服硫酸氢氯吡格雷片、阿司匹林肠溶片。在此基础上,对照组患者于PCI术中根据病情酌情给予盐酸替罗非班氯化钠注射液,术后给予血管紧张素转化酶抑制剂或血管紧张素受体拮抗剂、氯吡格雷、阿司匹林及低分子肝素等。观察组患者在对照组治疗的基础上于PCI术前给予盐酸曲美他嗪片20 mg,口服,每日3次。两组疗程均为3周。观察两组患者治疗前及治疗后1、3周的血清超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)和一氧化氮合酶(NOS)水平及不良反应发生情况。结果:治疗1周后,两组患者SOD水平均显著低于同组治疗前,但观察组显著高于对照组,差异均有统计学意义(P<0.05);治疗3周后,观察组患者SOD水平显著高于同组治疗前和对照组,差异均有统计学意义(P<0.05),但对照组治疗前后比较差异无统计学意义(P>0.05)。治疗1周后,两组患者MDA水平均显著高于同组治疗前,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05);治疗3周后,观察组患者MDA水平显著低于同组治疗前及对照组,差异均有统计学意义(P<0.05),但对照组治疗前后比较差异无统计学意义(P>0.05)。治疗1周后,对照组患者NO、NOS水平均显著高于同组治疗前,观察组患者NO、NOS水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。治疗3周后,两组患者NO、NOS水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:PCI术前应用曲美他嗪可降低AMI患者的氧化应激反应指标水平,且安全性较好。
ABSTRACT: OBJECTIVE: To investigate the effects of trimetazidine before percutaneous coronary intervention (PCI) on oxidative stress indexes of acute myocardial infarction (AMI) patients after surgery. METHODS: Medical information of 100 AMI patients underwent PCI were analyzed retrospectively and divided into control group (50 cases) and observation group (50 cases) according to drug use. Both groups were given Clopidogrel bisulfate tablet+Aspirin enteric-coated tablets 1 d before PCI, taking at a draught. Based on this, control group was given Tirofiban hydrochloride sodium chloride injection during PCI according to disease condition; they were given ACEI inhibitor or angiotensin receptor blocker (ARB), clopidogrel, aspirin and low molecular weight heparin. Observation group was additionally given Trimetazidine hydrochloride tablet 20 mg orally, 3 times a day, before PCI on the basis of control group. Treatment course of 2 groups lasted for 3 weeks. The serum levels of SOD, MDA, NO and NOS, the occurrence of ADR were observed in 2 groups before treatment and 1,3 weeks after treatment. RESULTS: After 1 week of treatment, SOD of 2 groups were significantly lower than before treatment, and the observation group was significantly higher than the control group,with statistical significance(P<0.05); after 3 weeks of treatment, SOD of observation group was significantly higher than before treatment and control group, with statistical significance (P<0.05); but there was no statistical significance in control group before and after treatment (P>0.05). After 1 week of treatment, MDA of 2 groups were significantly higher than before treatment, with statistical significance (P<0.05), but there was no statistical significance between 2 groups (P>0.05). After 3 weeks of treatment, MDA of observation group was significantly lower than before treatment and control group, with statistical significance (P<0.05), there was no statistical significance in control group before and after treatment (P>0.05). After 1 week of treatment, NO and NOS levels of control group were significantly higher than before treatment, while NO and NOS of observation group were significantly lower than before treatment; the observation group was significantly lower than the control group, with statistical significance (P<0.05). 3 weeks after treatment, NO and NOS of 2 groups were significantly lower than before treatment, and the observation group was significantly lower than the control group, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS: The application of trimetazidine before PCI can reduce oxidant stress indexes of AMI patients with good safety.
期刊: 2017年第28卷第18期
作者: 李定良,李锋
AUTHORS: LI Dingliang,LI Feng
关键字: 曲美他嗪;急性心肌梗死;经皮冠状动脉介入治疗;氧化应激
KEYWORDS: Trimetazidine; Acute myocardial infarction; Percutaneous coronary intervention; Oxidative stress
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