曲美他嗪对老年心衰合并贫血患者的心肾功能及血红蛋白的疗效

Therapeutic effect of trimetazidine on cardiac and renal function,hemoglobin level in aged patients with chronic heart failure complicated anemia

目的:探讨曲美他嗪对老年慢性心力衰竭(CHF)合并贫血患者的心功能、肾功能及血红蛋白(Hb)水平的疗效。方法:选择我院CHF合并贫血的老年患者98例,患者被随机均分为硫酸亚铁组(在常规治疗基础上加用硫酸亚铁)和曲美他嗪组(在常规治疗基础上加用曲美他嗪),疗程均为4周。观察比较两组治疗前后NYHA心功能分级、血浆N末端脑钠肽前体(NT-proBNP)、血清肌酐(Scr)、肌酐清除率(Ccr)及Hb水平。结果:与治疗前相比,治疗后曲美他嗪组NYHA心功能分级、血浆NT-proBNP和Scr水平明显降低,Ccr和Hb水平显著升高,P均<0.01;且与硫酸亚铁组比较,曲美他嗪组治疗后NYHA心功能分级[(3.2±0.6)级比(2.2±0.5)级],血浆NT-proBNP[(1980.6±820.3)ng/L比(1300.5±433.8)ng/L]和Scr[(186.4±36.0)μmol/L比(160.7±35.1)μmol/L]水平显著降低;Ccr[(38.3±7.4)ml/min比(43.1±7.2)ml/min]和Hb[(98.6±5.9)g/L比(119.3±6.9)g/L]水平显著升高,P均<0.01;总有效率(61.2%比85.7%)亦显著升高,P=0.006。结论:曲美他嗪治疗老年慢性心力衰竭合并贫血患者可明显改善心、肾功能,降低血浆N末端脑钠肽前体水平,纠正贫血,值得临床推广。

Objective： To explore therapentic effect of trimetazidine on cardiac and renal function,hemoglobin （Hb） level in aged patients with chronic heart failure （CHF） complicat^ed anemia. Methods： Atotal of 98agedpatients withCHF complicated anemiawere selected from our hospital. Patients were randomly and equally divided introus sulfate group （received ferrous sulfate based on routine treatment） and trimetazidine group （received trimetazdine based on routine treatment）,both groups were treated for fourweeks. NYHAcardiac function class,levels of plasmaN terminal pro brain natriuretic peptide （NT-proBNP）,serum creatinine （Scr）,creatinine clearance rate （Ccr） and Hb level were observed and compared between two groups before and after treatment. Results： Compared with before treatment,there were significant reductions in NYHA cardiac function class,plasma NT-proBNP and Scr level,and significant rise in Ccr and Hb level in trimetazidine group after treatment,P〈0. 01 all. Comparedwith ferrous sulfate group after treatment,there were significant reductions in NY± 0. 6） classes vs. （2. 2 ± 0. 5） classes], plasmaNT-proBNP level [ （1980. 6 ± 820. 3） n g/L vs. L] and Scr level [ （186. 4 ± 36. 0）μmol/L vs. （160. 7 ± 35. 1 ）μmol/L ] ,and significant rise in Ccr [ （38. 3 ± 7. 4） ml/ min vs. （43. 1 ± 7. 2） ml/min] andHb level [ （98. 6 ± 5. 9） g/L vs. （119. 3 ± 6. 9） g /L ],P 〈 0 . 01 all; and significant rise in total effective rate （61. 2% vs. 85. 7% ） in trimetazidine group,P = 0. 006. Conclusion： significantly improve cardiac and renal function,reduce plasma NT-proBNP level,correct anemia in aged patients with CHF complicated anemia,which is worthy of clinical extending.