曲美他嗪对心力衰竭心功能分级及左室射血分数的影响

Effect of Trimetazidine on cardiac functional grading and left ventricular ejection fraction in heart failure

目的探究曲美他嗪对心力衰竭患者心功能分级及左室射血分数的影响。方法 本研究选取2015年1月~2016年1月于中山市小榄人民医院心血管内科进行治疗的慢性心力衰竭患者90例,运用分层随机化分组方法将其分为观察组和对照组,各45例。对照组患者行常规抗慢性心力衰竭治疗（强心、利尿、扩血管）,观察组患者在对照组的基础上加用曲美他嗪,比较两组患者治疗后临床疗效、心功能分级、左室射血分数、左室舒张末内径的差异。结果 观察组临床有效率（95.56%）明显高于对照组（77.78%）,差异有统计学意义（P〈0.05）。治疗后,两组患者纽约心脏病协会（NYHA）心功能分级中Ⅲ、Ⅳ级的比例均降低,Ⅰ、Ⅱ级的比例均增高,与治疗前比较差异有统计学意义（P〈0.05）,观察组与对照组治疗后NYHA分级比较,差异有统计学意义（P〈0.05）。两组患者治疗前左室射血分数、左室舒张末内径比较差异无统计学意义（P〉0.05）,治疗后两组患者左室射血分数均上升,左室舒张末内径均降低,差异有高度统计学意义（P〈0.01）,治疗后观察组患者左室射血分数高于对照组,左室舒张末内径低于对照组,差异有高度统计学意义（P〈0.01）。结论 曲美他嗪可改善慢性心力衰竭患者的心功能,疗效确切。

Objective To explore the effects of Trimetazidine on cardiac funetional grading and lefl vcntricular ejection fraction in patients with heart failure. Methods Ninety patienls with chronic heart failure Ireated in Department of Cardiovasology, Xiaolan People＇s Hospital of Zhongshan City from January 2015 to January 2016 were selected and di- vided into observation group and control group by stratified randomized grouping method, with 45 cases in each group. The control group was treated by conventional treatment （cardiac, diuresis and vasodilator drug therapy）, on basis of control group, the observation group was added with Trimetazidine. The differences of clinical curative effect, cardiac functional grading, left ventricular ejection fraction, left ventrieular end diastolic diameter in the two groups after treatment were compared. Results The clinical eft）ctive rate of observation group （95.56%） was higher than that of control group （77.78%）, the difference was statistically significant （P 〈 0.05）. After treatment, the proportion of gradeⅢ arid Ⅳ of cardiac functional grading of New York Heart Association （NYHA） in the two groups were all decreased, the pro- porlion of grade Ⅰ and Ⅱ in the two groups were all increased, compared with before treatment, the differences were statistically significant （P 〈 0.05）, the difference of NYHA classification after treatment between observation group and control group was statistically significant （P 〈 0.05）. There were no significant differences of left ventrieular ejection fraction and left ventricular end diastolic diameter before treatment hetween the two groups （P 〉 0.05）, after treatment, the levels of left ventricular ejection fraction in the two groups were all increased, and the levels of left ventricular end diastolic diameter were all decreased, compared with before treatment, the differences were highly statistically significant （P 〈 0.01）, after treatment, the left ventricular ejection fraction in the observation gruup was higher than that of the control group, and the left ventricular end diastolic diameter was lower than that of the control group, the differenees were highly statistically significant （P 〈 0.01）. Conclusion Trimetazidine can improve the cardiac function of patients with chronic heart failure, which has an exact curative effect.