药物联合治疗缺血性心肌病并发心力衰竭的临床优势与机制分析

The clinical advantages and mechanism analysis of drugs combination treatment for ischemic cardiomyopathy with heart failure

目的探讨药物联合治疗缺血性心肌病并发心力衰竭的临床优势与机制。方法将80例缺血性心肌病并发心力衰竭患者随机分为治疗组与对照组,各40例,在各种常规治疗的基础上,治疗组加用曲美他嗪联合阿托伐他汀治疗。结果经过治疗后,两组均无死亡病例。治疗组总有效率为95.0%,对照组总有效率为72.5%,两组对比差异有统计学意义(P<0.05)。治疗后两组的左室舒张末径内径和射血分数较治疗前均有明显改善(P<0.05),治疗组的改善程度较对照组更明显(P<0.05)。治疗组血浆纤维蛋白原(Fg)和血管性假性血友病因子(vWF)含量都明显下降(P<0.05),对照组无明显变化。结论药物联合治疗缺血性心肌病并发心力衰竭能提高治疗疗效,其机制的发挥可能与改善心脏学指标与血液状态有关。

Objective To investigate the clinical advantages and mechanisms of drug combination treatment for ischemic cardiomyopathy with heart failure.Methods 80 patients with ischemic cardiomyopathy and heart failure were equally divided into treatment group and control group,all cases were given a variety of conventional treatment,on the basis of which,the treatment group was given Trimetazidine combined with Atorvastatin.Results After treatment,both groups had no cases of death.The total effective rate of treatment group and control group was 95.0% and 72.5% respectively,with significant difference（P 0.05）.the two groups of left ventricular end diastolic diameter inner diameter and ejection fraction had improved after treatment,but the improvement of the treatment group was better than the control group（P 0.05）.The plasma fibrinogen and vWF content of the treatment group were significantly decreased（P 0.05）,but had no significant changes in the control group.Conclusion The drug combination treatment for ischemic cardiomyopathy with heart failure can improve the efficacy,the mechanism of it may improve cardiac markers and blood state.