曲美他嗪改善扩张型心肌病心力衰竭患者心功能的疗效观察

Clinical therapeutic effectiveness of trimetazidine on the treatment of patients with dilated cardiomyopathy associated with chronic congestive heart failure

目的探讨曲美他嗪对改善扩张型心肌病合并心力衰竭患者心功能的临床效果。方法将82例扩张型心肌病合并心力衰竭患者随机分为两组,所有患者均给予常规抗心力衰竭治疗,观察组(41例)在此基础上加用曲美他嗪治疗,对照组(41例)则不给予曲美他嗪。观察治疗前后两组患者心功能改善程度,超声心动图测量计算左心室射血分数、左心室舒张末期内径及每分钟心排量的变化。结果治疗12周后,对照组治疗总有效率为68.29%(28/41),观察组总有效率为87.80%(36/41),两者比较差异有统计学意义(P<0.05);两组治疗后左室射血分数、每分钟心排量、左心室舒张末期内径等指标均较治疗前有显著改善,差异有统计学意义(P<0.05);且观察组治疗后上述指标明显优于对照组,差异有统计学意义(P<0.05)。结论曲美他嗪具有良好的抗心肌缺血、改善心肌能量代谢的作用,能够明显改善扩张型心肌病心力衰竭患者心功能。

Objective To explore the clinical therapeutic effectiveness of trimetazidine on the treatment of dilated cardiomyopathy（DCM） associated with chronic congestive heart failure（CHF）.Methods Eighty two patients with DCM associated with CHF were randomly divided into 2 groups： the control group（n=41） and the observation group（n=41）.Patients in the control group were given routine treatment.Patients in the observation group were treated with trimetazidine on the basis of the routine treatment.The course of treatment lasted 12 weeks.The grade of cardiac function,left ventricular ejection fraction（LVEF）,left ventricular internal diameter at end diastolic diameter（LVIDd） and cardiac output（CO）were determined.Results After 12 weeks of treatment,the total effective rate in the control group was 68.29%（28/41）,and in the observation group was 87.80%（36/41）,the difference was statistically significant（P0.05）.In both groups the level of LVIDd,CO,LVEF were significantly improved compared with before the treatment（P0.05）,and the index in the observation group were better than the control group（P0.05）.Conclusion Trimetazidine has a good effect of anti-myocardial ischemia and can improve myocardial energy metabolism,and left cardiac function.