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曲美他嗪治疗心肌缺血再灌注损伤的效果观察

Effect of trimetazidine in the treatment of myocardial ischemia-reperfusion injury

    摘要
  • 摘要:
    目的 观察曲美他嗪治疗心肌缺血再灌注损伤的疗效。
    方法 将90例心肌缺血再灌注损伤患者随机分为对照组和研究组，每组45例。对照组采取常规治疗，研究组采取常规治疗联合曲美他嗪治疗。比较2组治疗前后心肌氧自由基损伤指标谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)、总抗氧化能力(T-AOC)水平、炎症指标核因子κB(NF-κB)、Toll样受体2(TLR2)、超敏C反应蛋白(hs-CRP)水平、心肌损伤指标抗凋亡蛋白B细胞淋巴瘤因子-2(Bcl-2)、蛋白酶激活受体-2 (PAR-2)、心肌肌钙蛋白I (cTnI)、肌酸激酶同工酶(CK-MB)、自噬基因Beclin1、缺血修饰白蛋白(IMA)水平、心功能指标左心室射血分数(LVEF)、二尖瓣舒张早期最大流速(EV)、左心室舒张末内径(LVEDD)水平以及临床疗效。
    结果 治疗后，研究组MDA、NF-κB、TLR2、hs-CRP、PAR-2、Beclin1、cTnI、IMA、CK-MB、LVEDD水平低于对照组, GSH-Px、SOD、T-AOC、Bcl-2、LVEF、EV水平高于对照组，差异均有统计学意义(P < 0.05)。研究组治疗总有效率为97.78%, 高于对照组的86.67%, 差异有统计学意义(P < 0.05)。
    结论 曲美他嗪治疗心肌缺血再灌注损伤患者安全、有效，可抑制氧自由基水平，减轻心肌过氧化反应损伤，抑制炎症相关因子水平，降低PAR-2、Beclin1水平，提高Bcl-2水平，改善心功能。

     

    Abstract:
    Objective To observe the efficacy of trimetazidine in the treatment of patients with myocardial ischemia-reperfusion injury.
    Methods A total of 90 patients with myocardial ischemia-reperfusion injury were randomly divided into control group and study group, with 45 cases in each group. The control group was treated with routine treatment, while the study group was treated with routine treatment and trimetazidine. Before and after treatment, the levels of myocardial oxygen radical injury indexes levelsglutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), total antioxidant capacity (T-AOC), inflammatory indexes levelsnuclear factor κB (NF-κB), Toll-like receptor 2 (TLR2), hypersensitive C-reactive protein (hs-CRP), myocardial injury indexes anti-apoptotic protein B-cell lymphoma factor-2 (Bcl-2), protease activated receptor-2 (PAR-2), cardiac troponin I (cTnI), creatine kinase MB isoenzyme (CK-MB), autophagy gene Beclin1, ischemia modified albumin (IMA), cardiac function indexes levelsleft ventricular ejection fraction (LVEF), maximum early diastolic flow velocity of mitral valve (EV), left ventricular end diastolic diameter (LVEDd) and clinical efficacy were compared between two groups.
    Results After treatment, the levels of MDA, NF-κB, TLR2, hs-CRP, PAR-2, Beclin1, cTnI, IMA, CK-MB and LVEDd in the study group were significantly lower than those in the control group, while the levels of GSH-Px, SOD, T-AOC, Bcl-2, LVEF and EV were significantly higher than those in the control group (P < 0.05). The total effective rate of treatment in the study group was 97.78%, which was significantly higher than 86.67% of the control group (P < 0.05).
    Conclusion Trimetazidine is safe and effective in the treatment of patients with myocardial ischemia-reperfusion injury, which can inhibit the level of oxygen radical, alleviate myocardial peroxidation injury, inhibit the levels of inflammation related factors, reduce the levels of PAR-2 and Beclin1, increase the Bcl-2 level, and improve cardiac function.

     

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