曲美他嗪治疗急性脑梗死的疗效探究

Curative effect of Trimetazidine in treatment of acute cerebral infarction

摘要:

目的 探究曲美他嗪治疗急性脑梗死的疗效。方法 92 例急性脑梗死患者随机分为治疗组和对照组，各46 例，治疗组在予阿司匹林、辛伐他汀、血栓通及奥拉西坦等常规治疗基础上，加用曲美他嗪20 mg, 口服，3 次/d。对照组：只用上述常规治疗，分别于治疗前和治疗后第2 周采用美国国立卫生院神经功能缺损程度评分标准（NIHSS）进行神经功能缺损评分，日常生活自理能力量表（ADL）检测患者日常生活自理能力，监测血C 反应蛋白（CRP）浓度。同时，分别于治疗前和治疗后第1 周抽静脉血查血栓弹力图（TEG）各指标和血小板聚集率（PAgT）。结果 两组患者治疗后，NIHSS 评分、ADL 评分、CRP 浓度、血栓最大幅度、综合凝血指数及PAGT 均逐渐下降，反应时间、凝固时间及最大凝固时间均升高，两组比较，差异有统计学意义（P <0.05）；治疗组总有效率较对照组升高，进展型脑梗死较对照组减少，且不增加药物副作用。结论 曲美他嗪治疗急性脑梗死不仅具有抗栓作用，而且能改善患者神经功能缺损症状，提高生活自理能力，提高临床疗效，减少进展型脑梗死发生率，并且不增加药物副作用。

Abstract:

Objective To investigate the curative effect of Trimetazidine in the treatment of acute cerebral infarction. Methods A total of 92 patients with acute cerebral infarction were randomized (46 cases per group) into experimental group and control group. The control group was treated with Aspirin, Simvastatin, Xueshuantong,Oxiracetam and other routine treatments, while Trimetazidine was given additionally to the treatment group (20 mg,po, tid). The NIH stroke scale (NIHSS), activities of daily living (ADL) Barthel index and the plasma concentrations of C-reactive protein (CRP) were compared prior and the 2nd week post treatment, and the levels of TEG and PAgT before and the 1st week after treatment were measured between the two groups. Results After treatment, the NIHSS score, the ADL score and the levels of CRP, MA, CI and PAgT were gradually decreased, and r, m, k, were increased markedly. The difference between the two groups showed remarkable significance (P < 0.05). In the treatment group,the total effective rate was increased remarkably, the progressive cerebral infarction was decreased and no additional adverse drug reactions occurred compared with the control group. Conclusions Not only does Trimetazidine in the treatment of acute cerebral infarction exist antithrombotic effect, but also improves neurological symptoms, self-care ability and the clinical effect and reduces the incidence of progressive cerebral infarction without increase in side effect.