曲美他嗪对不同左室收缩功能稳定型心绞痛患者心脏功能的影响

Effect of trimetazidine on cardiac function in patients with stable left ventricular systolic function angina pectoris

目的观察曲美他嗪(TMZ)对稳定型心绞痛患者运动耐量、生活质量、心脏功能的影响。方法选取稳定型心绞痛患者210例,根据左室射血分数(LVEF)不同分为正常组(LVEF≥50%)、降低组(LVEF 30%~50%)及严重降低组(LVEF≤30%),每组70例。3组均按冠心病常规二级预防治疗,3组均随机分为曲美他嗪治疗组(TMZ组)和对照组35例。比较各组患者治疗8周后运动耐量(METs、30 min步行试验)、生活质量、心功能情况。结果治疗后TMZ组和对照组运动耐量、生活质量、心功能均明显提高(P<0.05),且TMZ组均优于对照组(P<0.05);随着LVEF值降低,TMZ组运动耐量、生活质量、心脏功能改善越明显,差异有统计学意义(P<0.05)。结论曲美他嗪能有效增加稳定型心绞痛患者的运动耐量,提高生活质量,改善心脏功能,尤其对于LVEF偏低的患者效果更加明显。

Objective To observe the effect of trimetazidine（ TMZ） on exercise tolerance,quality of life and cardiac function in patients with stable angina. Methods 210 patients with stable angina pectoris were selected,according to the ejection fraction of left ventricular,they were divided into three groups： the normal group（ LVEF≥50%）,the lower group（ 30% ~50% LVEF） and the severe reduction group（ LVEF≤30%）,70 cases in each group. 3 groups were routine secondary prevention and treatment of coronary heart disease,each group was randomly divided into trimetazidine treatment group（ TMZ group）and control group of 35 cases. The exercise tolerance（ METs,30-min walk test）,quality of life,and cardiac function were compared between the groups after 8 weeks of treatment. The exercise tolerance（ METs,30-min walk test）,quality of life,and cardiac function were compared between the groups after 8 weeks of treatment. Results After treatment,the exercise tolerance,quality of life and heart function of TMZ group and control group were significantly increased（ P 0. 05）,and the TMZ groups were superior to the control group（ P 0. 05）. With the decrease of LVEF,the improvement of exercise tolerance,quality of life and cardiac function were more obvious in TMZ group,with significant difference（ P 0. 05）. Conclusion Trimetazidine can effectively increase the exercise tolerance,improve the quality of life and improve the heart function in patients with stable angina pectoris,especially for patients with lower left ventricular ejection fraction.