曲美他嗪对扩张型心肌病患者NT-proBNP水平及心功能的影响

Effect of Sibutramine trimetazidine on NT-proBNP level and heart function in patients with dilated cardiomyopathy

目的探讨曲美他嗪结合常规抗心衰疗法治疗扩张型心肌病的临床效果及对患者心功能的影响作用。方法回顾性分析雅安职业技术学院附属医院心血管内科2013年5月—2014年9月治疗的109例扩张型心肌病患者的临床资料,其中62例患者采用常规抗心衰疗法治疗(常规组),47例患者加用曲美他嗪20 mg,3次/d(曲美他嗪组),两组患者均连续治疗3个月。采用NYHA标准对两组患者治疗结束后的心功能进行评价并进行比较;对比两组患者治疗前后的超声心动图指标的变化情况;对比两组患者治疗前后的血浆N末端脑钠肽前体(NT-proBNP)的变化情况。结果治疗后曲美他嗪组患者的NYHA分级与常规组比较差异具有统计学意义,曲美他嗪组的Ⅰ级、Ⅱ级心功能患者率高于常规组(P<0.05)。治疗前,曲美他嗪组和常规组患者的LVEF%、LVEDd、EDV、ESV、FS测定值差异无统计学意义;治疗后,曲美他嗪组患者的LVEF%、LVEDd、EDV、ESV、FS测定值显著的优于常规组患者(P<0.05)。治疗前,曲美他嗪组和常规组患者的NT-pro BNP水平差异无统计学意义;治疗后,曲美他嗪组患者的NT-proBNP水平显著的低于常规组患者(P<0.05)。治疗后,曲美他嗪组患者的显效率42.55%高于常规组的27.42%、无效率4.26%低于常规值的14.52%,治疗后曲美他嗪组的疗效优于常规组(P<0.05)。结论曲美他嗪结合常规抗心衰疗法治疗扩张型心肌病能够进一步改善患者的心功能,降低NT-pro BNP水平。

Objective To discuss the clinical effect and influence of Sibutramine trimetazidine combined with routine anti heart failure therapy on the cardiac function of the patients with dilated cardiomyopathy. Methods A retrospective analysis of dilated cardiomyopathy patients （109 cases） in Vasculocardiology Deparment of Affiliated Hospital of Ya＇an Vocational College from May 2013 to September 2014, in which 62 patients were treated with conventional anti-heart failure therapy （conventional group）, 47 patients plus song TMZ 20 rag, 3 times/d （trimetazidine group）, patients were treated for 3 consecutive months, and the clinical effects were compared. Results After treatment, the NYHA classification of Sibutramine trimetazidine group was statistically significant compared with conventional treatment group （P 〈 0.05）. Before treatment, LVEF%, LVEDd, EDV, ESV, and FS of patients in Sibutramine trimetazidine group and conventional group had no significant difference; After treatment, LVEF%, LVEDd, EDV, ESV, and FS of patients in Sibutramine trimetazidine group were significantly superior to the patients in conventional group （P 〈 0.05）. Before treatment, the difference of NT-proBNP level between Sibutramine trimetazidine group and conventional group was not statistically significant; After treatment, the NT-proBNP level in Sibutramine trimetazidine group was significantly lower than conventional group （P 〈 0.05）. After treatment, the significant efficiency in Sibutramine trimetazidine group （42.55%） was higher than that （27.42%） in conventional group, and the inefficiency in Sibutramine trimetazidine group was 4.26%, lower than conventional group of 14.52%. After treatment the efficacy of in Sibutramine trimetazidine group was better than the conventional group （P 〈 0.05）. Conclusion Sibutramine trimetazidine combined with conventional anti-heart failure therapy for dilated cardiomyopathy can further improve cardiac function and reduce the level of NT-proBNP.