曲美他嗪治疗缺血性心肌病心力衰竭的疗效观察

Efficacy of Trimetazidine in the treatment of ischemic cardiomyopathy heart failure

目的本研究旨在观察曲美他嗪治疗缺血性心肌病心力衰竭的近期疗效(4周)。方法本试验为随机、开放、对照临床研究。从入院患者中选择缺血性心肌病心力衰竭患者82例,随机分为常规治疗组(41例)和曲美他嗪组(41例),分别给予常规治疗和加用曲美他嗪(万爽力)治疗4周。观察治疗前后NYHA分级,并分别用超声测定左室射血分数(EF)和左室舒张末期内径(LVEDD)。结果治疗组心功能改善临床显效率(36.6%)和总有效率(85.4%)均较对照组(17.1%和61%)显著提高(均P<0.05),常规治疗组和治疗组治疗后LVEF均显著增加(P<0.05,P<0.01),LVEDD均显著缩小(P<0.05),且曲美他嗪治疗组较常规治疗组更加明显(P<0.05)。结论常规治疗缺血性心肌病心力衰竭基础上加用曲美他嗪,可以进一步改善患者心脏功能。

Objective To abscrve the therapeutic effect of patient with ischemic cardiomyopathy heart failure by trimetazidine treatment （4week）. Methods Our study was a random, open control clinical reseach. 82 ischemic cardiomyopathy heart failure patients who had been hospitalized were randomly divided into control group （41 case） and treatment group （41 case）, and were given general remedy or trimetazidine in addition to general remedy for 4 weeks respectively. NYHA functional class, LVEF, LVEDD were evaluated before and after therapy. Results The evident effective rate was36. 6% and the total clinical curative effective rate was 85.4% in the treatment group, markedly exceeded control group （ 17.1% and 61% ）, （ P 〈 0. 05 ）. Afte the therapy, the LVEF were significantly increased both the control group and the treatment group （ P 〈 0.05 P 〈 0. 01 ） , the LVEDD were significantly decreased in the two groups（P 〈 0. 05 ）, and the more evident effect in the trimetazidine group（P 〈 0. 05 ）. Conclusion Combined therapy of trimetazidine and conventional drugs improved the cardiac function in the patients with ischemic cardiomyopathy heart failure.