曲美他嗪与单硝酸异山梨酯治疗老年慢性心力衰竭效果比较

Effects difference of trimetazidine and isosorbide mononitrate in the treatment of elderly patients with chronic heart failure

目的:比较曲美他嗪与单硝酸异山梨酯治疗老年慢性心力衰竭的临床疗效。方法:选取56例老年慢性心力衰竭患者,随机分为甲组和乙组,每组各28例。两组患者均接受常规治疗,甲组加用曲美他嗪治疗,乙组加用单硝酸异山梨酯治疗,比较其临床疗效。结果:治疗后,与治疗前比较,两组患者的LVEDD、NT-pro BNP明显降低,LVEF明显升高,差异均有统计学意义(P<0.01)。组间比较,乙组的LVEDD降低更明显,差异均有统计学意义(P<0.01),甲组的LVEF升高更显著,差异均有统计学意义(P<0.01),两组的NT-pro BNP比较,差异无统计学意义(P>0.05)。结论:采用曲美他嗪与单硝酸异山梨酯治疗老年慢性心力衰竭患者均可显著改善患者的心功能,但二者在治疗机制上有所区别,单硝酸异山梨酯减轻心脏前后负荷、改善心肌重构效果更好,而曲美他嗪增加心肌能量代谢效果更好。

Objective To compare the clinical efficacy of trimetazidine and isosorbide mononitr in the treatment of elderly patients with chronic heart failure. Method 56 elderly patients with chronic heart failure were randomly divided into group A and group B,28 cases in each group. Two groups were treated with conventional therapy,group A plus trimetazidine treatment,group B plus isosorbide mononitr treatment. The clinical efficacy was compared. Results After treatment,compared with before treatment,the LVEDD and NT-pro BNP of the two groups decreased significantly（P〈0. 01）,and LVEF increased significantly（P〈0. 01）. Comparison between groups,group B LVEDD decreased significantly（P〈0. 01）,group A LVEF were significantly higher（P〈0. 01）,no significant difference between the two groups of NT-pro BNP（P〈0. 05）. Conclusion The use of trimetazidine and isosorbide mononitr in elderly patients with chronic heart failure both can significantly improve the patient＇s cardiac function,but the difference in the treatment mechanism,isosorbide mononitr lessen the preload and afterload of hearim and prove myocardial remodeling better,and trimetazidine increases myocardial energy metabolism better.