曲美他嗪对陈旧性心肌梗死后室性心律失常影响的随机配对、交叉研究
The pair-matched crossover study of the effects of the trimetazidine on the ventricular arrhythmia in old myocardial infarcted cases
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摘要: 目的: 研究曲美他嗪（Trimetazidine）对于处于常规治疗中的心肌梗死后的室性心律失常的作用。方法: 冠心病陈旧心肌梗死病例（OMI）,共29对（58例）；男性27对,女性2对；配对主要条件: 性别、年龄、梗死部位、梗死后时间、高血压病史及分级；糖尿病史；采用病例配对、随机进入试验、交叉、单盲的试验设计；结果分析采用方差分析（ANOV／ F检验）。结果: 综合交叉试验结果,Trimetazidine处理组室性心律失常的发生低于对照组（F＝4.20,P＜0.05）；对于清醒时间段即活动时间段的室性心律失常的分析显示: Trimetazidine也具有显著的抑制作用（F＝5.87,P＜0.05）；对于Lown3级以上室性心律失常的单独分析,也显示出其较明显的抑制作用（F＝7.61,P≈0.01）；对于OMI后LVE F ≤40％患者组的室性心律失常,Trimetazidine也表现出明确的抑制作用（F＝5.43,P＜0.05）。结论: 对于陈旧性心肌梗死所伴发的室性心律失常,除基础药物的处理外,应用曲美他嗪可对其产生显著地抑制作用,并减少抗心律失常药物的应用；改善缺血心肌的能量代谢可能是此作用的主要基础。Abstract: Objective: For further comprehending the effects of the trimetazidine on the ventricular arrhythmia in old myocardial infarction patients Methods: total 58 cases （29 pairs） of coronary heart disease/old myocardial infarction patients/OMI were studied;the major matching limitations are: age,sex,infarcted section,infarcted time,hypertension or not （the grade）,diabetes or not The study is randomized,pair matched,cross over and single blinded clinic study,the statistic analysis of variance （ANOV） was used Results: the incidence of ventricular arrhythmia was remarkably decreased in statistic difference（P＜0.005）after be treated by trimetazidine;and also decreased the incidence of the ventricular arrhythmia in activitiesperiod（P＜0.005）;For more severe ventricular arrhythmia （above the grade Lown3）,the using of trimetazidine also showed more significant positive effects（P ≈ 0.01） Conclusion: for the ventricular arrhythmia accompany with OMI,in addition to the routine treatment,the trimetazidine could also play an important role,with the usage decreasing of other anti arrhythmia drugs
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