梁峰翎 蒋永亮 周艳 彭友

摘 要 目的：探讨曲美他嗪对老年稳定型心绞痛患者运动耐量及日常生活能力的影响。方法：选取我院老年科收治的稳定型心绞痛患者169例，随机分为治疗组（n=84）与对照组（n=85）。对照组应用谷维素治疗，治疗组应用曲美他嗪治疗，共干预2个月。比较两组治疗前后心率、血压、运动耐量指标、ADL评分及不良反应情况。结果：治疗2个月时，治疗组运动耐量指标、ADL评分明显高于对照组（P<0.05）；两组血压、心率、不良反应比较差异无显著性（P>0.05）。结论：曲美他嗪用于老年穩定型心绞痛患者的治疗，可以提高患者的运动耐量，改善生活质量，用药安全，且对心率、血压无影响。

关键词 老年人 稳定型心绞痛 曲美他嗪 运动耐量 日常生活能力

中图分类号：R972.3； R541.4 文献标志码：A 文章编号：1006-1533（2021）07-0026-03

Effect of trimetazidine on exercise tolerance and daily living ability of elderly patients with stable angina

LIANG Fengling*， JIANG Yongliang， ZHOU Yan， PENG You

（the Third Department of Geriatrics， the Peoples Hospital of Hunan， Changsha 410016， China）

ABSTRACT Objective： To investigate the effect of trimetazidine on exercise tolerance and daily living ability in elderly patients with stable angina. Methods： A total of 169 patients with stable angina pectoris were selected and randomly divided into a treatment group （84 cases） and a control group （85 cases）. The control group was treated with oryzanol and the treatment group with trimetazidine and the intervention was lasted for 2 months. The heart rate， blood pressure， exercise tolerance indexes， ADL scores and adverse reactions were compared between the two groups before and after treatment. Results： After 2 months of treatment， the exercise tolerance indexes and ADL scores were significantly higher in the treatment group than the control group （P<0.05）. There were no significant differences in blood pressure， heart rate and adverse reactions between the two groups（P>0.05）. Conclusion： Trimetazidine for the treatment of elderly patients with stable angina pectoris can improve the exercise tolerance and quality of life of patients， has no effect on heart rate and blood pressure and its medication is safe.

KEy WORDS elderly； stable angina； trimetazidine； exercise tolerance； daily life ability

稳定型心绞痛（stable angina pectoris）又称稳定型劳力性心绞痛，是冠脉病变导致心肌负荷增加而引起心肌暂时、急剧的缺血缺氧的临床综合征[1-2]。多在劳累、饱食、受寒、情绪激动等情况下诱发，但还未引发心肌的坏死。该病是老年人群的常见病与多发病，因其常合并多种基础疾病（如高血压、高血脂等）而往往预后不佳[3]。目前临床对于老年稳定型心绞痛的治疗仍为药物对症治疗，常规药物包括β受体拮抗剂、钙通道阻滞剂、硝酸脂类，虽有一定效果，但对心室重塑及心功能的改善效果不佳。近年来，有文献证实，通过代谢调节方法治疗老年稳定型心绞痛具有较好前景[4-5]，而曲美他嗪是一种改善机体心肌缺血状态和优化心肌的能量代谢、且不影响血流动力学的药物。……