曲美他嗪对酒精性心肌病左心收缩功能和血浆脑钠肽的影响

Influence of trimetazidine on left cardiac systolic function and plasma brain natriuretic peptide in alcoholic cardiomyopathy

目的：探究曲美他嗪对酒精性心肌病左心收缩功能及血浆脑钠肽（BNP）的影响。方法选取2014年12月至2015年12月在威海市妇幼保健院接受治疗的60例酒精性心肌病患者为研究对象，按随机数字表法将其分为观察组和对照组，每组各30例患者。对照组给予常规药物比索洛尔联合强心、利尿等治疗，观察组在常规治疗的基础上，再给予患者曲美他嗪治疗。治疗6个月后，观察两组患者治疗前后的左心射血分数（LVEF）、左心室舒张末期内径（LVEDD）及每分排血量（CO）的变化情况，同时测定两组患者的脑钠肽（BNP）值。结果观察组患者治疗后的 LVEF 值从治疗前（34．8±5．4）％上升至（47．4±5．5）％；治疗后LVEDD 值[（49．1±6．5）min]及 CO 值[（5．6±0．7）L／min]明显优于对照组[（53．4±7．5）min、（4．9±0．7）L／min]，差异有统计学意义（t ＝2．373、3．873，均 P ＜0．05）。治疗后观察组患者的 BNP 水平显著低于对照组[（455．8±133．2）fmoL／mL 比（542．7±128．3）fmoL／mL；t ＝2．574，P ＜0.05）]。观察组总有效率（96．67％）高于对照组（80．00％）（χ^2＝13．09，P ＜0．05）。结论酒精性心肌病患者应注重日常生活的科学作息，采取相应的戒酒、戒烟措施，临床治疗过程中联合使用曲美他嗪能够有效改善患者的左心收缩功能，于降低血浆脑钠肽水平，值得临床推广应用。

Objective To explore the influence of trimetazidine on left cardiac systolic function and plasma brain natriuretic peptide（BNP）in alcoholic cardiomyopathy.Methods 60 cases of alcoholic cardiomyopathy in our hospital from December 2014 to December 2015 were chosen to research,and they were divided into observation group and control group by random number table,30 patients in each group.The control group was treated with bisoprolol combined with strengthening heart,diuretic and other treatment,the observation group was treated with trimetazidine on the basis of routine treatment.Left ventricular ejection fraction（LVEF）,left ventricular end diastolic diameter （LVEDD）,each sub output（CO）after 6 months＇treatment were compared.Results LVEF of the observation group was from pre -treatment （34.8 ±5.4）% up to （47.4 ±5.5）%,LVEDD value （49.1 ±6.5）min and CO values （5.6 ±0.7）L/min were significantly better than the control group[（53.4 ±7.5）min,（4.9 ±0.7）L/min],the differences were statistically significant（t =2.373,3.873,all P 〈0.05）.BNP level of the observation group after treatment was significantly lower than control group[（455.8 ±133.2）fmoL/mL vs （542.7 ±128.3）fmoL/mL,t =2.574,P 〈0.05）].The total effective rate of the observation group （96.67%）was higher than that of the control group （80%）,and the difference between the two groups was significant （χ^2 =13.09,P 〈0.05 ）.Conclusion Alcoholic cardiomyopathy should pay attention to the daily scientific daily routine,take measure to quit smoking and alcohol.Trimetazidine could effectively improve the left ventricular systolic function,decrease the level of BNP,thus is worthy of clinical application.