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目的 观察曲美他嗪治疗老年人稳定型心绞痛对大动脉弹性的影响。方法 采用随机、单盲、前瞻、平行和交叉对照研究法 ,对老年人稳定型心绞痛患者 32例 ,先进行安慰剂Ⅰ 2周洗脱后随机分为A、B组 (各 16例 ) ,平行和交叉对照研究各 8周 ,曲美他嗪组 (32例 )口服曲美他嗪 2 0mg ,3次 /d ;对照组 (32例 )口服安慰剂Ⅱ 1片 ,3次 /d。根据病情可含服硝酸甘油 ,停用其他抗高血压、抗心绞痛、降糖和调脂等药物。结果 治疗 8周后 ,①曲美他嗪组和安慰剂组心绞痛总有效率、心电图总有效率、硝酸甘油用量分别为 96 .9%对 2 5 .0 %、87.5 %对 31.2 %、7.0mg/第 8周对 2 1.0mg/第 8周 ,前者临床疗效明显优于后者(P <0 .0 5～ 0 .0 1) ;②大动脉弹性指标 :脉压、主动脉内径、振幅和射血分数 (EF)的变化 ,两组治疗前各指标无显著差异 (P >0 .0 5 )。治疗 8周后 ,曲美他嗪组收缩压无显著变化 (P >0 .0 5 ) ,舒张压、EF明显增加 (P <0 .0 5 ) ,主动脉内径明显减少 (P <0 .0 5 ) ,振幅明显增加 (P <0 .0 5 ) ;安慰剂组各指标无明显变化 (P >0 .0 5 )。结论 曲美他嗪治疗老年人稳定型心绞痛安全有效 ,无明显不良反应 ,同时可改善大动脉弹性。
Objective To observe the effect of trimetazidine on aortic elasticity in elderly patients with stable angina pectoris. Methods Thirty-two elderly patients with stable angina pectoris were randomly divided into group A and group B (16 in each group), followed by parallel operation And cross-control study for 8 weeks, trimetazidine group (32 cases) oral trimetazidine 20mg, 3 times / d; control group (32 cases) oral placebo Ⅱ 1, 3 times / d. According to the condition can be served nitroglycerin, disable other antihypertensive, anti-angina, hypoglycemic and lipid-lowering drugs. Results After 8 weeks of treatment, the total effective rate of angina pectoris, the total effective rate of ECG and the dosage of nitroglycerin in trimetazidine group and placebo group were 96.9% vs 25.0%, 87.5% vs 31.2%, 7.0mg / 8th week to 2 1.0mg / 8th week, the former clinical efficacy was significantly better than the latter (P <0.05 ~ 0. 01); ② Arterial elasticity indicators: pulse pressure, aortic diameter, amplitude and radiation Blood EF (EF) changes, there was no significant difference between the two groups before treatment (P> 0.05). After 8 weeks of treatment, there was no significant change in systolic blood pressure (P> 0.05), diastolic blood pressure, EF, and aortic diameter (P <0. 05) 5), amplitude increased significantly (P <0.05); there was no significant change in each placebo group (P> 0.05). Conclusion Trimetazidine is safe and effective in the treatment of elderly patients with stable angina pectoris without obvious adverse reactions and can improve the elasticity of aorta.