曲美他嗪治疗酒精性心肌病的临床疗效及其对血浆脑钠肽的影响

The effect of trimetazidine on alcoholic cardiomyopathy and plasma brain natriuretic peptide

目的观察在常规治疗基础上加用曲美他嗪对酒精性心肌病（ACM）的治疗效果及其对血浆脑钠肽（BNP）的影响。方法86例ACM患者按随机数字表法分为对照组和观察组，每组43例。对照组采用常规治疗，观察组联合使用曲美他嗪治疗，治疗3个月，观察比较两组左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、6min步行距离、BNP及临床疗效。结果治疗前对照组LVEF、LVEDD、6min步行距离、BNP分别为（37．2±7．4）％、（57．6±7．4）mm、（312．8±21．6）m、（846．2±63．7）μg／L，观察组分别为（38．5士8．1）％、（57．1±6．8）mm、（316．5±23．9）m、（857．6±61．4）μg,／L，两组比较差异无统计学意义（P〉0．05）。对照组治疗后LVEF、LVEDD、6min步行距离、BNP分别为（43．5±8．6）％、（54．3±6．4）mm、（511．6±26．7）m、（679．4±51．3）斗g，L，与治疗前比较差异有统计学意义（P〈0．05）。观察组治疗后LVEF、LVEDD、6min步行距离、BNP分别为（51．6±9．2）％、（51．2±613）mm、（579．3±25．1）m、（536．5±50．6）μg／L，与治疗前比较差异有统计学意义（P〈0．05）。两组治疗后LVEF、LVEDD、6min步行距离、BNP比较差异有统计学意义（P〈0．05）。观察组的治疗总有效率为90．7％（39／43），显著高于对照组的72．1％（31／43），两组比较差异有统计学意义（r=4．914，P〈0．05）。结论在常规治疗基础上联合使用曲美他嗪可更好地改善ACM患者的心功能及心肌重塑，提高临床疗效。

Objective To observe the effect of conventional therapy plus trimetazidine on alcoholic cardiomyopathy （ACM） and plasma brain natriuretic peptide （BNP）. Methods Eighty-six cases of ACM patients were divided into control group and observation group by random digits table method with 43 cases each. Control group was treated with conventional therapy, while observation group was added trimetazidine. Course of treatment was 3 months. The left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （LVEDD）, 6 min walk distance, plasma BNP before and after treatment and the efficiency in two groups was observed and compared. Results LVEF, LVEDD, 6 rain walk distance, BNP before treatment in control group were respectively （37.2 ±7.4）%, （57.6 ± 7.4） mm, （312.8 ± 21.6） m, （846.2 ± 63.7） μg/L, and the indicators in observation group were respectively （38.5 ±8.1）% , （57.1 ±6.8） mm, （316.5 ± 23.9） m, （857.6 ± 61.4） μ g/L. All indicators between two groups was no statistically different （P〉 0.05 ）. LVEF, LVEDD, 6 min walk distance, BNP after treatment in control group were respectively （43.5 ± 8.6）%, （54.3 ± 6.4） mm, （511.6 ± 26.7） m, （679.4 ± 51.3） μ g/L, and there were significant difference compared with those before treatment （P 〈 0.05 ）. LVEF, LVEDD, 6 min walk distance, BNP after treatment in observation group were respectively （51.6 ± 9.2）%, （51.2 ± 6.3） mm, （579.3 ± 25.1 ） m, （536.5 ± 50.6） txg/L,and there were significant difference compared with those before treatment （P 〈 0.05）. There were significant difference in LVEF, LVEDD, 6 min walk distance and BNP after treatment between two groups （P 〈 0.05 ）. The total effective rate in observation group was 90.7% （39/43）, which was significantly higher than that in control group[72.1%（31/43 ） ]（X^2= 4.914,P〈 0.05 ）. Conclusion Adding trimetazidine on the basis of conventional therapy can improve the cardiac function and myocardial remodeling of ACM patients and improve clinical efficacy.