曲美他嗪治疗慢性充血性心力衰竭60例疗效观察

Clinical efficacy of trimetazidine in the treatment of 60 patients with chronic congestive heart failure

目的观察曲美他嗪治疗慢性充血性心力衰竭(CHF)患者的临床疗效。方法选取2012年5月至2013年5月在我院就诊的CHF患者120例,按随机数表法分为观察组和对照组各60例。两组患者入院后均接受血管紧张素转化酶抑制剂(ACEI)、洋地黄、利尿剂、β受体阻滞剂等常规治疗,观察组在常规治疗基础上加用曲美他嗪,随访6个月后观察两组患者的治疗效果、心功能、6 min步行试验(6 m WT)等指标。结果经过6个月的治疗,观察组治疗总有效率、显效率均明显高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组左心室射血分数(LVEF)较对照组明显升高,心脏指数、6 m WT明显高于对照组,差异均有统计学意义(P<0.05);观察者治疗后左心室舒张末期容积(LVDD)及左心室收缩末期容积(LVDS)均缩小,较对照组明显改善,血浆脑钠肽前体(PNT-pro BNP)水平低于对照组,差异均有统计学意义(P<0.05)。结论在常规抗心衰治疗基础上使用曲美他嗪,可明显改善慢性充血性心力衰竭患者的左室功能,改善预后,提高生活质量。

Objective To observe the clinical efficacy of trimetazidine for treating patients with chronic congestive heart failure （CHF）. Methods A total of 120 patients with CHF treated in our hospital from May 2012 to May 2013 were divided into the observation group （n=60） and the control group （n=60） according to random num- ber table. The two groups of patients all accepted conventional treatment with angiotensin converting enzyme inhibi- tors （ACEI）, digitalis, diuretics, beta-blockers. The observation group was additionally treated with trimetazidine. Af- ter a fullow-up of 6 months, the clinical efficacy, heart function, indexes of 6 rain walk test （6 mWT） were observed. Results After six months of treatment, the total effective rate, the marked effective rate in the observation group were significantly higher than those in the control group （P〈0.05）. After treatment, left ventricular ejection fraction （LVEF）, cardiac index, 6 mWT in the observation group were significantly higher than those in the control group （P〈 0.05）; the left ventricular end-diastolic dimension （LVDd） and left ventricular end-systolic dimension （LVDs） were sig- nificantly narrower; the level of plasma brain natriuretic peptide precursor （PNT-proBNP） was significantly lower （P〈 0.05）. Conclusion Applying trimetazidine on the basis of conventional heart failure treatment can significantly im- prove left ventricular function in patients with CHF, and it can also improve prognosis and quality of life.