曲美他嗪联合福辛普利钠治疗慢性充血性心力衰竭的临床观察

Clinical observation of trimetazidine combined fosinopril in treatment for chronic congestive heart failure

目的:观察曲美他嗪联合福辛普利钠(TMZ)治疗充血性心力衰竭(CHF)患者的临床疗效。方法:将96例CHF患者随机分为研究组和对照组,均给予内科常规抗心力衰竭治疗。对照组加服福辛普利钠,初始剂量为5 mg,每日1次,逐渐加至靶剂量10 mg,每日1次;研究组在对照组的基础上接受曲美他嗪20 mg/次,3次/d。疗程12周。观察两组治疗前后临床疗效、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、血清B型尿钠肽(BNP)及6 min步行试验等。结果:治疗12周后,两组心功能较治疗前均有明显改善,研究组临床总有效率为81.3%,较对照组(64.6%)显著提高(P<0.05);在LVESD、LVEF、6 min步行试验及BNP等方面,两组治疗后均较治疗前有明显改善(P<0.05),且研究组较对照组改善更为显著(P<0.05)。两组均未发现有明显的不良反应。结论:曲美他嗪联合福辛普利钠治疗CHF优于单用福辛普利钠,是一种安全有效的方法。

Objective： To observe the curative effect of fosinopril combined with trimetazidine （TMZ） to treat chronic con- gestive heart failure （CHF）. Methods： 96 patients with CHF were randomly divided into experimental group and control group. All patients were given conventional medical treatment. Fosinopril was added to the control group, the initial dose of 5 rag/d, gradually increased to target dose of 10 mg/d; Besides fosinopril, trimetazidine was added to the experimental group, 20 rag, tid. 12 weeks later, the curative effect was evaluated. Results： The cardiac function in two groups were significantly improved. The clinical total effective rate was 81.3% in the experimental group, higher than that in the control group （64.6%） （P〈0.05）. After treatment, LVESD, LVEF, 6 min-walking distance and BNP were significantly improved than before （P〈0.05）, with much more improvement in the treatment group （P〈0.05）. Side effects were neither found in the two groups. Conclusion： Combination of trimetazidine and fosinopril for CHF is more effective than fosinopril used alone.