曲美他嗪对冠心病心力衰竭患者血管内皮依赖性舒张功能的影响

Influence of trimetazidine therapy on endotheliam-dependent dilation function in patients with congestive heart failure caused by coronary heart disease

目的探讨曲美他嗪(TMZ)对冠心病心力衰竭(CHF)患者的治疗作用及其对血管内皮依赖性舒张功能的影响。方法80例冠心病CHF患者随机分为治疗组和对照组,每组40例,对照组给予洋地黄类、利尿剂、血管扩张剂、血管紧张素转化酶抑制剂、β受体阻滞剂常规治疗;治疗组在常规治疗基础上加用TMZ治疗,两组均连续用药6个月。治疗前后进行多普勒超声心动图检查,评定心功能及血管内皮依赖性舒张功能的变化。结果治疗组心功能改善的临床显效率(45.0%)和总有效率(92.5%)均较对照组(25.0%和67.5%)显著提高(P<0.01),且无不良反应发生。治疗后治疗组患者左室射血分数、左室舒张末期容积、左室收缩末期容积、心排血量与血管内皮依赖性舒张功能指标均明显改善(P<0.01或<0.05),与对照组比较差异有统计学意义(P<0.01或<0.05)。结论TMZ有改善左心功能及血管内皮依赖性舒张功能的作用,是辅助治疗CHF的一种有效安全的药物。

Objective To explore the therapeutic efficacy of trimetazidine（TMZ）on congestive heart failure（CHF） and influence on endotheliam-dependent dilation function （EDDF）. Methods 80 patients with CHF were randomly divided into the treatment group （TMZ plus routine therapy,40 cases）and the control group （routine therapy,40 cases）. Both groups of patients were treated for 6 months. The cardiac function and EDDF were assessed by Doppler echocardiograpy before and after treatments. Results The treatment efficiency of the treatment group and control group were92.5% and 67.5% （ P 〈0.01 ）. No adverse reaction related to the drug were observed. The improvements of left ventricular ejection fraction（LVEF） ,left ventricular end diastolic volume （LVEDV） ,left ventricular end systolic volume （ LVESV ） , cardiac output （ CO ） , EDDF parameter （ FMD ） , after treatment in the treatment group were significant（ P 〈 0.01 or 〈 0.05 ）. The difference between the treatment group and the control group was also significant （ P 〈 0.01 or 〈 0.05 ）. Conclusion TMZ exerts significant effects improving on left ventricular function and EDDF. It is an effective and safe drug for supportive treatment in CHF patients.