曲美他嗪对缺血性心肌病患者心功能的影响

Influence of trimetazidine on cardiac function in patients with ischemic cardiomyopathy

目的评估曲美他嗪对缺血性心肌病患者心功能的影响。方法纳入2010年10月~2011年6月缺血性心肌病患者52例，随机分为观察组（n=26）和治疗组（n=26），观察组采用传统药物治疗，包括β受体阻滞剂、血管紧张素转换酶抑制剂、利尿剂、醛固酮拮抗剂、洋地黄类等，治疗组在观察组基础上联合盐酸曲美他嗪片（20mg，tid）治疗，疗程6个月。评价两组治疗前后的左室功能[包括左室舒张末容积（LVEDD）、左室射血分数（LVEF）和6分钟步行距离]和N末端脑钠肽前体（NT-proBNP）水平变化。结果两组治疗后心脏功能均较治疗前改善。与观察组相比，治疗组6个月后LVEF增加[（47.46±9.28）%vs.（41.35±7.66）%]，LVEDD降低[（49.50±4.38）mm vs.（59.38±6.85）mm]、6分钟步行距离增加[（508.83±204.61）m vs.（278.49±106.78）m]，同时NT-proBNP亦有明显下降[（1925.00±1287.20）pg/ml vs.（3873.01±3333.59）pg/ml]，两组比较差异均有统计学意义（P＜0.05）。结论曲美他嗪联合常规药物可明显改善缺血性心肌病患者的心功能，增加其运动耐量。

Objective To review the influence of trimetazidine on exercise tolerance of cardiac function in the patients with ischemic cardiomyopathy. Methods The patients （n=52） with ischemic cardiomyopathy were chosen from Oct. 2010 to Jun. 2011, and then randomly divided into observation group and treatment group （each n=26）. The observation group was given traditional drugs including β-blocker, ACE inhibitor, diuretics, aldosterone antagonist and digitalis for 6 months, and treatment group was additionally given trimetazidine （20 mg/tid） for 6 months. The left ventricular function （LVEDD, LVEF and 6MWT） and BNP level were reviewed in two groups before and after the treatment. Results The cardiac function was improved in two groups after the treatment. Compared with observation group, LVEF increased [（47.46±9.28）% vs. （41.35±7.66）%], LVEDD decreased [（49.50±4.38） mm vs. （59.38±6.85） mm], 6MWT increased [508.83±204.61） m vs. （278.49±106.78） m] and BNP decreased significantly [（1925.00±1287.20） pg/mL vs. （3873.01±3333.59） pg/mL] in treatment group （P〈0.05）. Conclusion Trimetazidine integrated with routine drugs can significantly improve cardiac function and exercise tolerance in the patients with ischemic cardiomyopathy.