摘要
冠心病是常见的内科疾病之一,冠心病的治疗主要集中于改善症状和二级预防,其治疗的目的是提高患者生活质量、防止心血管不良事件发生、改善患者预后。目前临床上治疗冠心病的药物主要包括硝酸酯类、β受体阻滞剂及钙通道拮抗剂,它们通过扩张冠状动脉、降低心肌耗氧量等方式改善患者心绞痛症状,但在发挥作用的同时会影响血流动力学从而导致患者的耐受性差。而曲美他嗪通过减少心肌细胞对脂肪酸的利用,增强心肌细胞对糖的利用,提高腺苷三磷酸合成效率,增加心肌细胞的能量供应,在不改变血流动力学的前提下,通过增加心肌细胞的能量供应来缓解心绞痛症状,目前对冠心病治疗的效果及耐受性良好,期望未来在治疗心肌病、心力衰竭方面有更好的应用。
Coronary heart disease is one of the most common internal diseases.The treatment of coronary heart disease mainly focuses on improving the symptoms and secondary prevention,aming to improve the patients′life quality,prevent adverse cardiovascular events and improve the prognosis.Currently,clinical drugs for coronary heart disease mainly include nitrate esters,βreceptor antagonist and calcium channel antagonists,which can relieve angina pectoris by expanding coronary arteries and reducing myocardial oxygen consumption.However,hemodynamics will be affected after drug administration resulting in poor patient tolerance.Trimetazidine improves the efficiency of adenosine triphosphate synthesis by reducing myocardial cells′utilization of fatty acid and enhancing sugar utilization in myocardial cells,therefore by increasing the energy supply of cardiomyocytes without affecting hemodynamics it alleviates angina pectoris.Currently,trimetazidine has a good therapeuti effect on coronary heart disease and good patient tolerance,and better applications are expected in treatment of cardiomyopathy and heart failure in the future.
作者
赵海双
李永东
ZHAO Haishuang;LI Yongdong(Inner Mongolia Medical University,Hohhot 010000,China;Department of Cardiovascular Medicine,Baogang Hospital,Inner Mongolia,Baotou 014000,China)
出处
《医学综述》
2020年第1期148-152,158,共6页
Medical Recapitulate
关键词
冠心病
曲美他嗪
心肌保护
Coronary heart disease
Trimetazidine
Myocardial protection
