曲美他嗪联合丹参酮ⅡA磺酸钠注射液在慢性心力衰竭患者治疗中的疗效研究

Curative effect observation of trimetazidine combined with Sulfotanshinone sodium injection for treating chronic heart failure

目的通过观察曲美他嗪联合丹参酮ⅡA磺酸钠对慢性心力衰竭患者左室射血分数和血浆脑钠肽水平的影响,探讨在慢性心力衰竭的疗效。方法将94例CHF随机分为治疗组和对照组,每组47例。对照组给予利尿剂、洋地黄制剂、血管紧张素转换酶抑制剂、β-受体阻滞剂等常规抗心衰治疗,疗程为24周。治疗组在常规治疗基础上加用曲美他嗪20mg/次口服,3次/d,疗程24周,加用丹参酮ⅡA磺酸钠注射液60mL静脉滴注,1次/d,疗程2周。全部患者均在治疗前和1个疗程结束后测定LVEF和血浆BNP水平变化,并比较治疗效果。结果对照组患者治疗前LVEF(40.2±2.0)%,治疗后LVEF(42.8±1.9)%,两者比较,差异无统计学意义(P>0.05);对照组患者治疗前血浆BNP浓度(980±12)pg/mL,治疗后(630±16)pg/mL,两者比较,差异有统计学意义(P<0.05)。治疗组患者治疗前LVEF(39.8±1.9)%,治疗后LVEF(48.6±2.8)%,两者比较,差异有统计学意义(P<0.05);治疗前患者血浆BNP浓度(996±10)pg/mL,治疗后(326±17)pg/mL,两者比较,差异有统计学意义(P<0.05)。结论曲美他嗪联合丹参酮ⅡA磺酸钠注射液对CHF患者的心脏结构及功能均有明显改善。

Objective To explore curative effect of trimetazidine combined with sulfotanshinone Ⅱ A sulfonate injection on the treatment of chronic heart failure,by observing the levels of left ventricular ejection fraction and plasma brain natriuretic peptide in patients with CHF.Methods 94 patients with CHF were randomly divided into the treatment group and the control group,47 cases in each group.The control group was given conventional therapy of diuretics,digitalis preparations,angiotensin converting enzyme inhibitors （ACEI）,β-blockers,treatment for 24 weeks.Treatment group take trimetazidine oral 20 mg per time,3 times a day,for 24 weeks,and combined with sulfotanshinone Ⅱ A sulfonate injection intravenous infusion of 60 mL once per day,for 2 weeks,on the basis of conventional therapy.Changes of LVEF and plasma BNP levels of all patients were measured before treatment and after one treatment,to compare the efficacy.Results LVEF of patients in control group before treatment was （40.2±2.0）%,and was （42.8±1.9）% after treatment,in comparison,the difference was not statistically significant （P 0.05）.Plasma BNP concentrations of patients in control group was （980 ±12） pg/mL before treatment,（630±16） pg/mL after treatment,in comparison,the difference was statistically significant （P0.05）.LVEF of patients in treatment group was （39.8±1.9）% before treatment,（48.6±2.8）% after treatment,in comparison,the difference was statistically significant （P 0.05）.Before treatment,plasma BNP level of patients in treatment group was （996 ±10） pg/mL,（326±17） pg/mL after treatment,in comparison,the difference was statistically significant （P 0.05）.Conclusion Trimetazidine combined with Tanshinone Ⅱ A Sulfonate Injection can improve the cardiac structure and function in patients with CHF both.