曲美他嗪对冠心病慢性心力衰竭的疗效观察

Effect of trimetazidine on cardiac function in patients with chronic congestive heart failure due to coronary atherosclerotic heart disease

目的观察曲美他嗪对冠心病慢性心力衰竭的治疗效果。方法观察冠心病慢性心力衰竭患者62例,随机分为对照组和治疗组,其中对照组30例,应用血管紧张素转换酶抑制剂、硝酸酯类、钙拮抗剂、β受体阻滞剂、地高辛、阿司匹林、氢氯噻嗪或呋塞米等进行常规治疗;治疗组32例,在上述常规治疗基础上加用曲美他嗪治疗,分别观察用药前及用药6月后两组患者临床心功能改善情况并测定超声心动图心功能指标LVEDD、LVESD、LVEF以及6min步行距离。结果用药6月后曲美他嗪组患者的总有效率明显优于对照组,LVEDD、LVESD及LVEF均显著改善,6min步行距离明显延长,与对照组比较差异有统计学意义(P<0.05)。结论曲美他嗪通过改善缺血心肌细胞的能量代谢,可显著改善冠心病慢性心力衰竭患者的临床心功能分级和心脏收缩功能,治疗效果确切。

Objective To observe the effect of trimetazidine on cardiac function in patients with chronic congestive heart failure due to coronary atherosclerotic heart disease. Methods 62 patients with chronic congestive heart failure due to coronary atherosclerotic heart disease were randomely divided into two groups,32 patients in treatment group and 30 in control group. The control group were given the routine drugs and the treatment group were given both the routine drugs and Trimetazidine 20 mg,3 times daily for 6 months and the clinical effect was observed and the echocardiogram indexes of LVEDD,LVESD and LVEF were measured and the 6- min walk test was carried out before and after treatment. Results The total effective rate was higher in the treat- ment group than that in the control group. The indexes LVEDD,LVESD,LVEF and 6-min walk test changed significantly in trimetazidine group, and the differences were of statistically sense when compared with those in control group （ P 〈 0.05 ）. Conclusion Trimetazidine can significantly and definitely improve systolic function and clinical cardiac function grade of ischemic heart by improving the energy metabolism of ischemic heart and hare a reliable curative effect.