目的：探讨经皮冠状动脉介入治疗（PCI）术前应用负荷剂量曲美他嗪60 mg对不稳定性心绞痛患者PCI术后Tp-Te间期的影响。方法：94例拟行PCI手术的不稳定性心绞痛患者分为曲美他嗪组和对照组。最终完成本研究的为曲美他嗪组34例和对照组42例，共76例。两组患者均接受常规药物治疗。曲美他嗪组在常规药物的基础上于PCI术前0.5~1.0 h一次性口服60 mg曲美他嗪。比较两组患者PCI术前后Tp-Te间期变化及术前、术后6 h、术后24 h血清肌酸激酶（CK）、肌酸激酶MB同工酶（CK-MB）和肌钙蛋白I（cTnI）水平以及术中室性心律失常情况。结果：曲美他嗪组和对照组两组术后Tp-Te间期均较术前缩短，但曲美他嗪组术后Tp-Te间期较对照组进一步缩短，差异均有统计学意义（P均<0.05）；两组术前Tp-Te间期差异无统计学意义（P>0.05）。术中对照组室性心律失常发生率（12.52%）高于曲美他嗪组（5.16%），差异有统计学意义（P<0.05）。曲美他嗪组CK、CK-MB、cTnI水平在术后6 h、24 h均较对照组低（P均<0.05）。结论：曲美他嗪可缩短不稳定性心绞痛患者PCI术后Tp-Te间期、预防室性心律失常，对PCI相关心肌损伤有保护作用。%Objective: To explore the effect of trimetazidine (TMZ) on T-peak (Tp) to T-end (Te) interval of resting ECG in patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI). Methods: We investigated 94 UAP patients with PCI and 76 of them ifnished the study as 2 groups. Control group,n=42, the patients received conventional treatment, and TMZ group,n=34, in addition to conventional treatment, the patients received TMZ 60 mg at 0.5 to 1 hour before PCI. The changes of Tp to Te interval before and after PCI were calculated, serum levels of creatine kinase (CK), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) at before and at 6, 24 hours after PCI were compared between 2 groups. Ventricular arrhythmia was recorded during PCI. Results: Both groups had shortened Tp to Te intervals after PCI, and TMZ group had more shortened Tp to Te interval, bothP<0.05, while the Tp to Te intervals were similar between 2 group before PCI,P>0.05. The occurrence rate of ventricular arrhythmia in Control group was higher than that in TMZ group (12.52% vs 5.16%) during PCI,P<0.05. Compared with Control group, TMZ group had lower levels of CK, CK-MB and cTnI at 6, 24 hours after PCI, allP<0.05. Conclusion: TMZ could decrease Tp to Te interval of resting ECG, prevent ventricular arrhythmia and reduce the relevant myocardial injury in UAP patients after PCI.
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