曲美他嗪治疗心房颤动致心动过速性心肌病疗效观察

Effect of trimetazidine on patients with tachycardia cardiomyopathy induced with atrial fibrillation

目的评估曲美他嗪对心房颤动致心动过速性心肌病患者心功能的影响。方法纳入2011年1月至2013年12月心房颤动致心动过速性心肌病患者63例,随机分为对照组(n=32)和治疗组(n=31),对照组患者采用传统药物治疗,包括β受体阻滞剂、血管紧张素转换酶抑制剂、利尿剂、洋地黄类药物等;治疗组患者在对照组基础上联合盐酸曲美他嗪片(20 mg,3次/天)治疗,疗程为6个月。评价两组患者治疗前后左室功能[左室射血分数(LVEF)]、6分钟步行距离和N末端脑钠肽前体(NT-pro BNP)水平变化。结果治疗6个月后,治疗组患者LVEF[(45.36±6.51)%]、6分钟步行距离[(512.44±180.10)m]、NT-pro BNP水平[(1425.0±1275.0)ng/L]均显著改善,与对照组[(41.25±5.46)%、(435.49±116.17)m、(3150.0±2525.5)ng/L]比较差异均具有显著性(P<0.05)。结论曲美他嗪联合常规药物可明显改善心房颤动致心动过速性心肌病患者的心脏结构和心功能,增加其运动耐量。

Objective To review the influence of trimetazidine on exercise tolerance of cardiac function in the patients with tachycardia cardiomyopathy. Method The randomized controlled trials were conducted involving 63 patients heart failure from tachycardia cardiomyopathy; they were randomly divided into control group（n = 32） and test group（n = 31）. Patients in control group were administered with routine treatment, such as β receptor blocker, angiotensin converting enzyme inhibitor, diuretic, digitalis. The patients in test group were administered with trimetazidine（20 mg, 3 times each day） based on the routine treatment for 6 months. Left ventricular ejection fraction（LVEF）, 6-minute walk test and N-terminal brain natriuretic peptide precursor（NT-proBNP） were conducted to evaluate the therapeutic effect of trimetazidine before and after treatment. Result After treatment, LVEF [（45.36±6.51） %], 6-minute walk test distance [（512.44±180.10） m] and the level of NT-proBNP [（1425.0±1275.0） ng/L] in test group were better than control group [（41.25±5.46） %,（435.49±116.17） m,（3150.0±2525.5） ng/L], the difference was statistical significant（P〈0.05）. Conclusion Trimetazidine combined with other conventional drugs can effectively improve the cardiac function of patients with heart failure from tachycardia cardiomyopathy, and increase their physical activity.