曲美他嗪治疗缺血性心肌病心力衰竭的疗效观察

Therapeutic effect of trimetazidine on patients with ischemic cardiomyopathy heart failure and significance of plasma level of N-terminal pro-B type natriuretic peptide

目的观察曲美他嗪治疗缺血性心肌病心力衰竭的短期疗效。方法采用随机对照研究，将62例缺血性心肌病心力衰竭患者随机分成常规治疗组（给予常规抗心力衰竭治疗，31例）和曲美他嗪治疗组（在常规心力衰竭治疗基础上加用上曲美他嗪，31例），两组疗程均为4周。治疗前后分别检测NT—proBNP浓度，左室射血分数（LVEF）和左室舒张末期内径（LVEDD），心胸比，左室射血分数，心排血量指数。结果治疗前两组患者NT—proBNP水平差异无统计学意义，治疗后两组NT—proBNP均下降（P〈0．05），而曲美他嗪组降低更加明显。并且血浆NT—proBNP与左室射血分数（LVEF）和左室舒张末期内径（LVEDD）差异均有统计学意义（γ分别为-0．472、0．451；P均〈0．05）。结论曲美他嗪对缺血性心肌病心力衰竭患者具有明显的治疗作用，NT-proBNP可作为治疗心力衰竭的效果指标。

Objective To observe the therapeutic effect of trimetazidine on patients with ischemic cardiomyopathy heart failure and the changes of plasma level of N-terminal pro-B type natriuretic peptide（ NT-preBNP）. Methods 62 patients with ischemic cardiomyopathy heart failure were randomly assigned to regular treatment group （31 ） and trimetazidine treatment group（ 31 ）. All of them were given either regular medicine treatment or trimetazidine for 4 weeks. Concentration of NT-proBNP and eehocardiography were detected before and after treatment and the correlation between NT-proBNP and ultra-sound values was studied. Results There was no statistic difference in the NT-proBNP level between two groups before treatment, but after 4-week treatment the NT-preBNP level in both groups were decreased （P 〈 0. 05 ）, the decline in the trimetazidine group was more significant. The NT-proBNP level was significantly correlated to LVEF and LVEDD （＇y = -0.472,0.451 ;P 〈0.05）. Conclusions Trimetazidiue has a positive effect on patients with ischemic cardiomyopathy heart failure,and decreases the plasma NT-proBNP level. NT-proBNP can be used as a follow-up index.