不同剂量瑞舒伐他汀联合曲美他嗪治疗老年冠心病左心功能不全的疗效观察

Curative Effect of Rosuvastatin at Different Dosages plus Trimetazidine on Left Ventricular Dysfunction in the Elderly with Coronary Heart Disease

目的探讨不同剂量瑞舒伐他汀联合曲美他嗪治疗老年冠心病左心功能不全的疗效和安全性。方法将146例老年冠心病左心功能不全患者随机分为A组和B组,每组73例,A组在常规抗心衰治疗的基础上给予10 mg/d瑞舒伐他汀联合曲美他嗪治疗,B组在常规抗心衰治疗的基础上给予20 mg/d瑞舒伐他汀联合曲美他嗪治疗。观察2组治疗前后左室收缩末期内径(LVESD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、6 min步行距离(6MWT),统计2组有效率及不良反应发生率。结果与治疗前相比,2组治疗后LVESD和LVEDD值均显著降低(均P<0.05),且B组LVESD和LVEDD值与同期A组相比较均显著降低(均P<0.05);与治疗前相比,2组治疗后LVEF和6MWT水平均显著升高(均P<0.05),且B组LVEF和6MWT水平与同期A组相比较均显著升高(均P<0.05)。B组治疗有效率明显高于A组(P<0.05)。2组不良反应发生率差异均无统计学意义(P>0.05)。结论 20 mg/d的剂量瑞舒伐他汀联合曲美他嗪可更明显改善左心功能,提高治疗有效率,安全性良好,值得临床推广应用。

Objective To explore the curative effect of rosuvastatin at different dosages plus trimetazidine on left ventricular dysfunction in the elderly with coronary heart disease （CHD） and the safety. Methods 146 elderly CHD patients with left ventricular dysfunction were selected and randomly divided into 2 groups： group A and group B, 73 in each; routine antiheart failure treatment was applied to patients in both groups while rosuvastatin （lOmg a day） plus trimetazidine was added to patients in group A and rosuvastatin （20mg a day） plus trimetazindine to patients in group B; observation was made to the left ventricular end systolic diameter （LVESD）, left ventricular end diastolic diameter （LVEDD）, left ventricular ejection fraction （LVEF）, 6min walking distance （6MWT） of the patients in both groups, as well as the effective rate and the occurrence of side effect in the 2 groups. Results The values of LVESD and LVEDD of the patients in the 2 groups after treatment were significantly lower than those before treatment （P〈0.05）, and those in group B dropped down much more than in group A （P〈0.05）; the levels of LVEF and 6MWT of the patients in both groups after treatment were significantly higher than those before treatment, and those in group B increased much more than in group A （P 〈 0.05）; the curative effect in group B was obviously higher than that in group A （P〈0.05） while there existed no difference of statistical significance in the occurrence of side effects between the 2 groups （P〉0.05）. Conclusions Rosuvastatin at the dosage of 20mg a day plus trimetazidine leads to a better improvement of left ventricular function with better safety, it is worthy of wide application in clinic.