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缺血性心脏病(IHD)其病理特点是冠状动脉内粥样斑块,管腔狭窄或阻塞,导致心肌缺血,患者出现胸痛。斑块破裂提供了血小板聚集和血栓形成的场所,导致不稳定性心绞痛或心肌梗死。稳定性心绞痛常规应用β阻滞剂、硝酸酯类和钙阻滞剂,这些药物是通过增加心肌供氧或减少心肌需氧发挥作用的。近年来,作为代谢调节剂的一组药物,已充分显示其优势。曲美他嗪是该类药物的代表药,已发现在缺血心肌中,脂肪酸氧化增强,葡萄糖氧化受抑制,曲美他嗪通过抑制缺血心肌中脂肪酸的氧化,直接发挥心肌细胞的保护作用。其他的一些研究尚在进行中,以进一步阐明在与IHD有直接或间接关系的其他疾病中曲美他嗪的作用。本综述目的是总结近年来世界范围内所做的各种临床试验研究的结果,以评价该药在IHD中的作用及其确切机制,进一步认识其在心肌保护中的真正价值。
Ischemic heart disease (IHD) pathological features of atherosclerotic plaque, stenosis or obstruction, resulting in myocardial ischemia, chest pain in patients. Plaque rupture provides a site of platelet aggregation and thrombosis, leading to unstable angina or myocardial infarction. Stable angina routine use β-blockers, nitrates and calcium blockers, these drugs act through increasing myocardial oxygen supply or reduce myocardial oxygen demand. In recent years, a group of drugs as metabolic regulators have shown their advantages fully. Trimetazidine is a drug on behalf of these drugs have been found in the ischemic myocardium, enhancing fatty acid oxidation, glucose oxidation inhibition, trimetazidine in ischemic myocardium by inhibiting the oxidation of fatty acids, play a direct protective effect of myocardial cells . Other studies are ongoing to further elucidate the role of trimetazidine in other diseases that have a direct or indirect relationship with IHD. The purpose of this review is to summarize the results of various clinical trials conducted worldwide in recent years in order to evaluate the role of this drug in IHD and its exact mechanism to further understand its true value in myocardial protection.