曲美他嗪对维持性血透患者心脏功能的保护作用

Protective effect of trimetazidine on cardiac function of the patients with maintenance hemodialysis

目的观察曲美他嗪在维持性血透(MHD)患者中的疗效。方法选取衢化医院2011年3～8月MHD患者82例,NYHA分级在Ⅰ～Ⅱ级,依入院顺序将患者随机分为治疗组42例与对照组40例,治疗组在常规治疗上予曲美他嗪20 mg,3次/d,连续3个月。比较治疗前后B型脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、心彩超射血分数(LVEF)、每搏输量(SV)、心输出量(CO)的结果。结果治疗组与对照组相比,各项指标有明显改善(P<0.05)。结论曲美他嗪改善MHD患者心功能,减轻微炎性反应状态,降低MHD患者CVD事件的发生,值得临床推广。

Objective To observe the effect of trimetazidine on the patients with maintenance hemodialysis. From March to August in 2011, in accordance with the order to be in the Zhejiang Quhua Hospital. Methods Eighty-two patients with maintenance hemodialysis and New York Heart Association （NYHA） cardiac function classification in level I to the level 1] were randomly divided into treatment group （n = 42） and control group （n = 40）. The patients in the control group had been given conventional treatment, and the patients in the treatment group had been given trimetazidine 20 mg three times/d for 3 months, based on the conventional treatment.All patients accepted color Doppler ultrasound measurement of the heart for stroke volume （SV）, cardiac output （CO）, left ventricular ejection fraction （LVEF）and examination of BNP, hs-CRP,TNF-α before treatment and 3 months after treatment with. Results Compared with the control group,all results of the treatment group were significant different after 3 months treatment （P 〈 0.05）. Conclusion We conclude that Trimetazidine can ameliorate myocardial energy metabolism to improve heart function in patients with maintenance hemodialysis and alleviate inflammatory reaction and oxidative stress. For reducing （MHD） patient＇s CVD event, it is worth to be promoted in the clinical.