曲美他嗪联合阿托伐他汀对老年缺血性心肌病患者心功能和肌钙蛋白Ⅰ水平的影响

Effects of qumei trimetazidine combined with atorvastatin on heart function and cardiac troponin I level of the elderly patients with ischemic cardiomyopathy

目的探讨曲美他嗪联合阿托伐他汀对老年缺血性心肌病(ICM)患者的心功能和血清肌钙蛋白I(cTnI)水平的影响。方法选取70例老年ICM患者作为研究对象,将其随机分为观察组和对照组,每组35例。对照组患者在常规抗心衰疗法基础上应用阿托伐他汀进行治疗,观察组患者在对照组疗法的基础上联合应用曲美他嗪进行治疗。对2组患者治疗前后心功能和血清cTnI水平的变化、治疗效果和不良反应进行观察和分析。结果经过治疗,2组患者的血清cTnI水平、LVEDD、LVESD、LVEF指标和6 min步行距离均较治疗前有显著改善,血清cTnI水平、LVEDD、LVESD显著降低(P<0.05),LVEF和6 min步行距离显著升高(P<0.05),且观察组患者上述指标的改善程度均显著高于对照组(P<0.05);观察组的治疗显效率为54.3%,显著高于对照组的20.0%(P<0.05);观察组的临床有效率为88.6%,显著高于对照组的65.7%(P<0.05);在治疗过程中,2组患者未见严重不良反应。结论曲美他嗪联合阿托伐他汀治疗老年ICM疗效显著,对心功能的改善作用更优,可以显著降低血清cTnI水平,且安全性较高,值得临床推广应用。

Objective To observe and analyze the effects of qumei trimetazidine combined with atorvastatin on the heart [unction and cardiac troponin I level of the elderly patients with is- chemic eardiomyopathy （ICM）. Methods Seventy elderly patients with ICM were selected as the research subjects and randomly divided into the observation group （ n = 35 ） and the control group （ n = 35）. The control group received atorvastatin treatment on the basis of the conventional anti - heart failure therapy, while the observation group was treated with combined qumei trimetazidine treatment on the basis of the therapy in the control group. The changes of heart function and cTnI level in serum before and after treatment, the curative effects and adverse reactions of the patients in the two groups were observed and analyzed. Results After treatment, the serum levels of cTnI, LVEDD, LVESD, LVEF and 6 minutes walking distance of the patients in the two groups im- proved significantly compared with those before treatment. The levels of serum cTnI, LVEDD, LVESD decreased significantly （P 〈 0.05）, LVEF and 6 minutes walking distance increased signif- icantly （P 〈 0.05）, and the improving degrees of the above indexes in the observation group were significantly greater than those of the control group （ P 〈 0 . 0 5 ） . The significant rates of the two groups were 54.3 % and 20 %, and the significant rate of the observation group was higher than that of the control group （ P 〈 0.05）. The clinical effective rates of the two groups were 88.6 % and 65.7 %, and the clinical effective rate of the observation group was significantly higher than that of the control group （P 〈 0.05）. In the course of treatment, no severe adverse reactions were observed in the two groups. Conclusion The effects of qumei trimetazidine combined with atorvastatin in the treatment of elderly patients with ICM are more significant and the effects to improve heart function are better. The treatment can significantly decrease the serum cTnI level, has a high security and is worthy of clinical application.