曲美他嗪对左心室射血分数正常的心力衰竭的疗效

Efficacy of trimetazidine in patients with heart failure with normal left ventricular ejection fraction

目的观察曲美他嗪在改善左心室射血分数正常的心力衰竭(HFNEF)的疗效。方法 HFNEF患者98例,在接受心力衰竭常规治疗6周后随机分为对照组(n=50)和观察组(n=48),对照组继续给予HFNEF常规治疗,观察组使用曲美他嗪每次20 mg,每日3次口服治疗。分别于治疗前和治疗12个月后进行超声心动图检查,并检测N末端脑利钠肽前体(NT-proBNP),评估两组患者治疗前后的心功能等级(NYHA分级)。结果治疗12个月后,观察组的左室舒张末期内径(LVEDD)为(41.8±2.8)mm、NT-proBNP为(782±238)pg.mL-1,对照组分别为(43.7±2.6)mm和(873±252)pg.mL-1,两组比较差异显著(P<0.05);观察组的心功能等级较对照组显著改善(P<0.05);观察组的左室射血分数(LVEF)为(68.2±2.8)%,与对照组LVEF(67.0±2.5)%相比有升高趋势,但无显著差异(P>0.05)。结论曲美他嗪能改善老年HFNEF患者的心功能,缓解心力衰竭症状。

AIM To investigate the efficacy of trimetazidine （TMZ） in patients with heart failure with normal left ventricular ejection fraction （HFNEF）. METHODS After received routine treatment of 6 weeks, 98 patients with HFNEF were divided into control group （n = 50） and observation group （n - 48）. The patients were given conventional treatment or TMZ treatment （20 rag, po, tid） in the control group and the observation group, respectively. All patients underwent echocardiography and echocardiographic indices were recorded before and 12 months after the treatment. N-terminal pro-B-type natriuretic peptide （NT-proBNP） and cardiac function （NYHA classification） were examined. RESULTS Both left ventricular end diastolic diameter （LVEDD） and NT- proBNP levels were significantly decreased in the observation group compared with the control group （（41.8±2.8） mmvs. （43.7 ±2.6） mm, P〈0.05; （782 ± 238） pg·mL^-1 vs. （873 ± 252） pg·mL^-1, P 〈 0.05 respectively） . Compared with the control group, cardiac function in patients treated with TMZ was significantly improved （P 〈 0.05）. No significant difference between the two groups was noted in LVEF, though TMZ treatment trended towards enhanced LVEF （ （68.2 ± 2.8） % vs. （67.0 ± 2.5） % , P 〉 0.05） .CONCLUSION TMZ improves the cardiac function of patients with HFNEF and alleviates the symptoms of heart failure.