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目的:研究曲美他嗪对心脏X综合征合并2型糖尿病患者冠状动脉慢血流的治疗作用。方法:将87例心脏X综合征合并2型糖尿病冠状动脉造影时出现慢血流的患者随机分为曲美他嗪组(45例)和对照组(42例)。对照组采用拜阿司匹林100mg/d、单硝酸异山梨酯20mg/d、阿托伐他汀20mg/d联合严格控制血糖治疗,曲美他嗪组在此基础上加用曲美他嗪20mg/次,3次/d,连续治疗6个月。观察治疗前后两组患者冠状动脉TIMI血流分级和冠状动脉血流储备的变化。结果:6个月治疗结束后,曲美他嗪及对照组冠状动脉血流储备值较治疗前均有明显提高(P<0.05),且曲美他嗪组提高幅度显著高于对照组(P<0.05)。曲美他嗪组冠状动脉TIMI血流改善的有效率也显著高于对照组(P<0.05)。结论:长期曲美他嗪治疗可改善心脏X综合征合并糖尿病及冠状动脉慢血流患者的TIMI血流分级和冠状动脉血流储备功能。
Objective: To study the therapeutic effect of trimetazidine on coronary blood flow in patients with type 2 diabetes mellitus and cardiac X syndrome. Methods: 87 patients with cardiac X syndrome complicated with type 2 diabetes undergoing coronary angiography were randomly divided into trimetazidine group (n = 45) and control group (n = 42). The control group was treated with aspirin 100mg / d, isosorbide mononitrate 20mg / d, atorvastatin 20mg / d combined with strict control of blood glucose treatment, trimetazidine group on this basis with trimetazidine 20mg / times, 3 times / d, continuous treatment for 6 months. The change of TIMI grade and coronary flow reserve in the two groups were observed before and after treatment. Results: After 6 months treatment, the blood flow reserve of coronary artery in trimetazidine and control group was significantly higher than that before treatment (P <0.05), and the increase in trimetazidine group was significantly higher than that of control group (P <0.05). Trimetazidine group TIMI coronary blood flow improved effective rate was also significantly higher than the control group (P <0.05). CONCLUSIONS: Long-term trimetazidine treatment improves TIMI flow classification and coronary flow reserve in patients with cardiac X syndrome complicated with diabetes and chronic coronary artery disease.