缬沙坦联合曲美他嗪与单用缬沙坦治疗冠心病心力衰竭患者的疗效比较

Investigation on Curative Effect of Valsartan Combined with Trimetazidine for Heart Failure Patients

目的比较缬沙坦联合曲美他嗪与单用缬沙坦治疗冠心病心力衰竭的临床疗效。方法选取2014年1月至2015年6月枣庄矿业集团中心医院收治的冠心病心力衰竭患者96例,按抽签法随机分为对照组(47例)和观察组(49例)。对照组采用包括缬沙坦(80 mg/次,每日1次)在内的常规治疗,观察组在此基础上加用曲美他嗪(20 mg/次,每日3次)治疗。比较两组患者治疗前后的心功能脑钠肽等指标及不良反应发生情况。结果治疗后观察组左心室射血分数、E/A显著高于对照组[(50±9)%比(45±8)%,(1.23±0.19)比(1.02±0.20),P<0.01],E/e'显著低于对照组[(7.7±3.1)比(10.5±2.3),P<0.01];两组冠心病心力衰竭患者治疗第15、30、60日脑钠肽水平均较治疗前呈下降趋势,观察组下降速度更快,治疗后第60日观察组脑钠肽测量值显著低于对照组[(2.5±0.6)μg/L比(3.2±0.9)μg/L](P<0.05);两组均无相关不良反应发生。结论缬沙坦联合曲美他嗪与单用缬沙坦治疗冠心病心力衰竭患者均安全有效,但前者疗效更确切。

Objective To compare the clinical efficacy of simple valsartan and valsartan combined with trimetazidine for the treatment of coronary heart disease patients complicated with heart failure. Methods From Jan. 2014 to Jun. 2015,96 coronary heart disease patients complicated with heart failure diagnosed in Central Hospital of Zaozhuang Mining Group were included in the study. Sortition method was adopted to divide them into two groups： control group（ 47 cases） and observation group（ 49 cases）. Both groups were given usual treatment including valsartan（ 80 mg / d,po,qd）. Based on this,extra trimetazidine（ 20 mg,po,tid） was given to the observation group. The heart function,level of serum brain natriuretic peptide and adverse reaction of the two groups were compared before and after treatment. Results After treatment,the left ventricular ejection fraction and E / A of coronary heart disease in the observation group were significantly higher than the control group [（ 50 ± 9） % vs（ 45 ± 8） %,（ 1. 23 ± 0. 19） vs（ 1. 02 ± 0. 20）,（ P〈0. 01） ]. E / e＇ was significantly lower than the control group[（ 7. 7 ± 3. 1） vs（ 10. 5 ± 2. 3）,P〈0. 01]. The serum brain natriuretic peptide of both groups decreased on the 15 th,30th,60 th day,The observation group decreased faster than the control group. The serum brain natriuretic peptide level of the observation group after 60 days of treatment was significantly lower than the control group [（ 2. 5 ± 0. 6） μg / L vs（ 3. 2 ±0. 9） μg / L]（ P〈0. 05）. There was no relational adverse reaction observed in both groups. Conclusion Simple valsartan and valsartan combined with trimetazidine are both safe and effective for coronary heart failure patients and the effect of the combined usage is more affirmative.