美托洛尔联合曲美他嗪治疗小儿扩张型心肌病心力衰竭疗效观察

Effect of metoprolol combined with trimetazidine in children with dilated cardiomyopathy heart failure

目的观察美托洛尔联合曲美他嗪治疗小儿扩张型心肌病心力衰竭的临床疗效。方法选择轻中度收缩功能不全性心力衰竭(NYHA心功能Ⅱ～Ⅲ级)患儿64例随机分为对照组(32例)和治疗组(32例),对照组给予洋地黄制剂、利尿剂、血管扩张剂、血管紧张素转换酶抑制剂(ACEI)等常规治疗。治疗组在常规治疗基础上加用美托洛尔和曲美他嗪,疗程为6个月。结果治疗组的疗效优于对照组(P<0.05),总有效率也高于对照组(P<0.05);治疗组治疗前后比较,心率、血压、左室舒张末期内径、左室收缩末期内径、左室射血分数均有明显改善(P<0.05)。治疗后两组比较差异有统计学意义(P<0.05)。结论美托洛尔联合曲美他嗪治疗小儿扩张型心肌病心力衰竭是一种安全有效的方法。

Objective To observe the clinical effects of using metoprolol combined with trimetazidine on the basis of routine treatment of dilated cardiomyopathy （DCM） heart failure for the children. Methods Sixty-four DCM children with mild and moderate systolic insufficiency heart failure （ class NYHA II - m ） were collected and ran- domly divided into control group （32 eases） and treatment group （32 cases）. Both groups were given digitalis prepa- rations, diuretics, vasodilators and angiotensin converting enzyme inhibitors. Added metoprolol and trimetazidine on the basis of the routine treatment in treatment group, a course of 6 months, two groups were compared. Results The clinical effect and the total effective rate were better in treatment group compared with control group （ P 〈0. 05 ）. The heart rate（HR）, blood pressure（BP） , left ventricular end-diastolic diameter （LVEDD）, left ventricular end-stolic diameter （LVESD） and left ventricular ejection fraction （LVEF） were significantly improved after treatment in treatment group compared with those before treatment （P 〈 0.05 ）, these indicators also were significant differences between the two groups after treatment （P 〈 0.05 ）. Conclusion For children with DCM heart failure, metoprolol combined with trimetazidine can improve heart function safely and effectively.