利心丸、曲美他嗪联合依那普利治疗老年风湿性心脏病合并慢性心力衰竭临床疗效及安全性观察

Clinical efficacy of lixinwan,trimetazidine combined with enalapril in the treatment of rheumatic heart disease complicated with chronic heart failure in elderly patients

目的探讨利心丸、曲美他嗪联合依那普利治疗老年风湿性心脏病合并慢性心力衰竭的临床疗效。方法选择2015年2月至2016年2月于我院接受治疗的80例老年风湿性心脏病合并慢性心力衰竭病人作为研究对象,利用随机数字表法将其分为观察组和对照组,每组40例。对照组给予曲美他嗪联合依那普利治疗;观察组在对照组治疗基础上另给予利心丸治疗,各组的治疗时间均为3月。治疗后评价各组疗效;治疗前后分别检测各组病人心脏功能[左室收缩末内径(LVESD)、左房内径(LADD)、左室舒张末内径(LVEDD)和左室射血分数(LVEF)],一般心血管指标[心胸比、纽约心脏学会(NYHA)分级、舒张压及心率]。观察病人治疗期间出现的不良反应。结果观察组显效率及总有效率分别为40.0%及95.0%,均明显高于对照组(P<0.05)。观察组病人治疗后LVESD、LADD、LVEDD、心胸比、NYHA分级、舒张压、心率均明显低于对照组,而LVEF明显高于对照组(P<0.05);各组病人治疗期间均未出现严重不良反应。结论利心丸、曲美他嗪联合依那普利治疗老年风湿性心脏病合并慢性心力衰竭具有较好的临床疗效,值得开展深入研究。

Objective To study the clinical efficacy of lixinwan, trimetazidine combined with enalapril in the treatment of rheumatic heart disease complicated with chronic heart failure in elderly patients. Methods Eighty elderly patients with rheumatic heart disease and chronic heart failure from Feb 2015 to Feb 2016 were randomly divided into observation group （40 cases） and control group （40 cases）. The control group was treated with trimetazidine combined with enalapril; the observation group was given lixinwan on the base of control group. They were treated for 3 months. The clinical effects were observed and the levels of cardiac function indexes such as left ventricular end-systolic diameter （LVESD）, left atrial diameter （LADD）, left ventricular end-diastolic diameter （LVEDD） and left ventricular ejection fraction（ LVEF）, general cardiovascular indexes such as cardiothoracic ratio, NYHA classification, diastolic blood pressure and heart rate before and after treatment were detected. Results The obvious effective rate and total effective rate of observation group were 40.0% and 95.0% respectively, significantly higher than those of control group. After the treatment, the levels of cardiacfunction indexes, general cardiovascular indexes were improved in the two groups and especially in the observation group. Conclusions The treatment of lixinwan, trimetazidine combined with enalapril is effective for rheumatic heart disease complicated with chronic heart failure in elderly patients which is worthy to the next study.