曲美他嗪对扩张型心肌病心功能及心率变异性的影响

The effect of trimetazidine on heart function and heart rate variability in patients with dilated myocardiopathy

目的观察曲美他嗪对扩张型心肌病患者心功能及心率变异性的影响。方法选择60例扩张型心肌病患者,随机分为常规治疗组及曲美他嗪治疗组各30例,后者在常规治疗基础上加用曲美他嗪20 mg,3次/d,疗程24周。采用心脏彩色多普勒超声测定左心室舒张末期直径(LVEDd)及左室射血分数(LVEF),动态心电图测定心率变异性指标。结果两组治疗后LVEDd均有显著减小,LVEF均有显著改善。治疗后两组间LVEDd并无显著差异,然而曲美他嗪治疗组LVEF的改善更为明显(P<0.05)。两组治疗前后心率变异性各指标也均有显著提高,曲美他嗪治疗组心率变异性提高更为明显(P<0.05)。结论曲美他嗪可改善扩张型心肌病心肌的能量代谢,从而改善扩张型心肌病患者心功能的同时改善心率变异性。

Objective To observe the effect of trimetazidine on heart function and heart rate variability in patients with dilated myocardiopathy. Methods 60 patients with dilated myocardiopathy were randomized into standard therapy group and trimetazidine group. These patients in latter group were added trimetazidine （20 mg tid for 24 weeks） in addition to standard therapy. Left ventricular end diastolic diameter （LVEDd） and left ventricular ejection fraction （LVEF） were measured by color echocardiogram. While heart rate variability was also determined by Hoher. Results Significant decrease in LVEDd and increase in LVEF after treatment were observed in both group. But LVEF improved in trimetazidine group more than that in standard therapy group （P 〈 0. 05 ）. Likewise ,heart rate variability also improved in both group after treatment. The more significant improvement was observed in trimetazidine group. Conclusion Trimetazidine improves both heart function and heart rate variability in patients with dilated myocardiopathy,which may benefit from improvement in myocardial energy metabolism.