曲美他嗪对慢性心力衰竭患者心脏功能及抑制凋亡的作用

The Effect of Treatment with Trimetazidine in Chronic Heart Failure

目的:观察慢性心力衰竭(CHF)患者在心力衰竭(HF)标准治疗基础上,加用代谢药物曲美他嗪治疗对心功能的改善作用及对血清细胞凋亡抑制因子(Fas/APO^(-1))的影响。方法:79例HF患者随机分为标准治疗组(36例)和曲美他嗪组(43例),标准治疗组给予血管紧张素转换酶(ACE)抑制剂、β-阻滞剂、利尿剂和洋地黄制剂治疗,曲美他嗪组在此基础上加用曲美他嗪20mg,每日3次,共3个月。于治疗前后分别测定左室射血分数(LVEF)、6分钟步行试验距离及血清Fas/APO^(-1)水平。结果:治疗前,两组左室射血分数、6分钟步行试验距离和血清Fas/APO^(-1)水平均无差异(P>0.05)。治疗后,两组LVEF和6分钟步行试验距离均较治疗前显著增加(P<0.05),曲美他嗪组较标准治疗组增加显著(P<0.05)。Fas/APO^(-1)水平较治疗前降低,但差异不显著(P>0.05)。结论:通过曲美他嗪联合经典HF治疗可以通过提高心肌细胞的能量利用,改善心功能并提高HF患者的运动耐量。

Objective： To evaluate the clinical effect of trimetazidine on patients with chronic heart failure（CHF）. Methods： 79 patients with CHF were randomly divided into two groups. ACEI ＋ digoxin ＋ diuretic were given to the 36 patients in the group control （C）. The patients in the group trimetazidine（T） were treat with trimetazidine ＋ ACEI ＋ digoxin ＋ diuretic. All the patients were followed up for 3 months. Before and aftertreatment, LVEF, 6,minutes walking distance and the level of Fas/APO^-1 were measured. Results： LVEF and 6-minutes walking distance of the patients in the group T were increased significantly [（46.77±9.42）% vs （42.53 ±8.88）%, P〈0.05; （382.26 ±83.98） m vs （346.50±65.40） m, P〈0,05]. The level 0f Fas/APO＇ were decreased in the group T[ （3.51 ± 1.02） μg/L vs（3.69±1.54） μg/L, P〉0. 05]. Conclusion： Trimetazidine could improve the cardiac function of the patients with CHF and increased the exercise endurance at the same time.