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

发布时间：2018-05-16 04:25

本文选题：曲美他嗪 + 急性心肌梗死　；参考：《中国药房》2017年18期

【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1d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(P0.05);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(P0.05),但对照组治疗前后比较差异无统计学意义(P0.05)。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(P0.05),但两组间比较差异无统计学意义(P0.05);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(P0.05),但对照组治疗前后比较差异无统计学意义(P0.05)。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(P0.05)。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(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。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 effect of trimetazidine on oxidative stress in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods: the data of 100 AMI patients undergoing PCI operation were retrospectively analyzed and divided into control group (n = 50) and observation group (n = 50). The patients in both groups were treated with clopidogrel sulfate tablets and aspirin enteric tablets 1 day before PCI. On this basis, the patients in the control group were given tirofiban hydrochloride sodium chloride injection according to the condition of PCI, and the angiotensin converting enzyme inhibitor or angiotensin receptor antagonist, clopidogrel, after operation. Aspirin and low molecular weight heparin. Patients in the observation group were given trimetazidine hydrochloride 20 mg before PCI on the basis of treatment in control group, three times a day. The course of treatment was 3 weeks in both groups. The levels of serum superoxide dismutase (SOD), malondialdehyde (MDA) MDAD, nitric oxide synthase (nNOS) and nitric oxide synthase (NOS) and their adverse reactions were observed before and 1 to 3 weeks after treatment in both groups. Results: after 1 week of treatment, the levels of SOD in both groups were significantly lower than those before treatment in the same group, but the level of SOD in the observation group was significantly higher than that in the control group (P 0.05), and after 3 weeks of treatment, the level of SOD in the observation group was significantly higher than that in the same group and the control group. The difference was statistically significant (P 0.05), but there was no significant difference before and after treatment in the control group (P 0.05). After 1 week of treatment, the level of MDA in the two groups was significantly higher than that in the same group before treatment, and the difference was statistically significant (P 0.05), but there was no significant difference between the two groups (P 0.05). After 3 weeks of treatment, the level of MDA in the observation group was significantly lower than that in the same group and the control group. The difference was statistically significant (P 0.05), but there was no significant difference before and after treatment in the control group (P 0.05). After one week of treatment, the levels of NONNOS in the control group were significantly higher than those in the same group before treatment, and the levels of NONNOS in the observation group were significantly lower than those in the same group before treatment, and were significantly lower in the observation group than in the control group (P 0.05). After 3 weeks of treatment, the levels of NONNOS in the two groups were significantly lower than those in the same group before treatment, and the levels in the observation group were significantly lower than those in the control group (P 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion trimetazidine before AMI can reduce the level of oxidative stress response in patients with AMI, and the safety of trimetazidine is better.
【作者单位】：柳州市柳铁中心医院;
【分类号】：R542.22

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