曲美他嗪对缺血性心肌病患者QT离散度及心功能的影响

Effect of trimetazidine on QT dispersion and heart function in patients with ischemic cardiomyopathy

目的观察曲美他嗪对缺血性心肌病患者QT离散度（QTd）、心功能及安全性的影响。方法将122例缺血性心肌病心力衰竭患者，随机分为曲美他嗪治疗组（研究组）59例和常规治疗组（对照组）63例，对照组采用传统药物治疗，研究组在此常规治疗上加服曲美他嗪20mg，3次／d，连用24周。观察左心室射血分数（LVEF）、短轴缩短率（Fs）、左心室收缩末期内径（LVSD）及QTd的变化。结果与治疗前相比，治疗后两组患者LVEF及FS明显升高（P〈0．05），LVSD及QTd均降低（P〈0．05）；与对照组相比，研究组LVEF及FS升高更明显（P〈0．05），LVSD及QTd降低更明显（P〈0．05），且无不良反应发生。结论缺血性心肌病患者在常规治疗基础上加服曲关他嗪可以改善心功能，缩短QTd，安全有效。

Objective To observe the effect of trimetazidine on QT dispersion （QTd）, heart function and safety in patients with ischemic cardiomyopathy. Methods One hundred and twenty-two patients with ischemic cardiomyopathy were randomly divided into two groups. Sixty-three patients in con- trol group were treated routinely with traditional medication, 59 patients in study group were treated with traditional medication combined with trimetazidine（20 rag, 3 times/d）. Both groups were treated contin- uously for 24 weeks. LVEF, FS, LVSD and QTd were observed after the treatment. Results LVEF and FS in both groups were significantly elevated after the treatment. LVSD and QTd were significantly short- ened in both groups after the treatment （ P 〈 0. 05 ）. The study group was better than the control group in elevating LVEF and FS （ P 〈 0. 05 ） and shortening LVSD and QTd （ P 〈 0. 05 ）, and there was no ad- verse reaction. Conclusions Trimetazidine combined with traditional medication can improve heart function and shorten QTd in patients with ischemic cardiomyopathy. It is a safe and effective treatment.