曲美他嗪对冠心病急性心力衰竭患者心功能、血清N末端B型利钠肽前体及心肌肌钙蛋白I水平的影响

The influence of Trimetazidine on the cardiac function and levels of serum NT-proBNP and cTn-I patients with coronary heart disease and acute heart failure

目的探讨曲美他嗪对冠心病急性心力衰竭患者心功能、血清N末端B型利钠肽前体及心肌肌钙蛋白I水平的影响。方法回顾性分析四川省德阳市第二人民医院重症医学科2014年2月~2017年3月收治的96例冠心病急性心力衰竭患者的临床资料,依据治疗方式不同分为对照组和观察组。对照组46例给予利尿剂呋塞米+血管扩张剂硝酸甘油治疗,观察组50例给予利尿剂呋塞米+血管扩张剂硝酸甘油+曲美他嗪治疗。两组患者均连续治疗7 d。观察两组患者治疗前后心功能分级、血清N末端B型利钠肽前体、心肌肌钙蛋白I水平及临床疗效。结果两组患者治疗前心功能分级、血清N末端B型利钠肽前体、心肌肌钙蛋白I水平比较差异无统计学意义(P>0.05)。治疗后两组心功能分级均优于治疗前,血清N末端B型利钠肽前体、心肌肌钙蛋白I水平均低于治疗前,且观察组治疗后心功能分级均优于对照组,血清N末端B型利钠肽前体、心肌肌钙蛋白I水平均低于对照组,差异有统计学意义(P<0.05)。观察组总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论曲美他嗪治疗冠心病急性心力衰竭患者能明显改善心功能,降低血清N末端B型利钠肽前体、心肌肌钙蛋白I水平,疗效良好,值得临床推广应用。

Objective To investigate the influence of Trimetazidine on the cardiac function and levels of serum N-terminal pro-B-type natriuretie peptide （NT-proBNP） and cardiac troponin I （eTn-I） in patients with coronary heart dis ease and acute heart failure. Methods The clinical data of 96 cases of patients with coronary heart disease and acute heart failure admitted to ICU of the Second People＇s Hospital of Deyang City from February 2014 to March 2017 was analyzed retrospectively, and they were divided into control group and observation group by different treatment methods. 46 cases of control group were given diuretic Furosemide and vasodilator Nitroglycerin, and 50 cases of observation group were given diuretic Furosemide and vasodilator Nitroglycerin and Trimetazidine. Both groups were treated continuously for 7 d. Before and after treatment, the cardiac functional grading, the levels of NT-proBNP and cTn-I, and the clinical effects of two groups were observed. Results There were no statistically significant differences of cardiac functional grading, the levels of NT-proBNP and cTn-I between the two groups before treatment （P 〉 0.05）. After treatment, the cardiac functional grading of the two groups was better than that before treatment, and the levels of NT-proBNP and cTn-I in the two groups were lower than those before treatment, and the cardiac functional grading of observation group was better than that of control group, the levels of NT-proBNP and cTn-I in the observation group were lower than those of control group, the differences were statistically significant （P 〈 0.05）. The total effective rate of observation group was higher than that of the control group, the difference was statistically significant （P 〈 0.05）. Conclusion Trimetazidine in the treatment of patients with coronary heart disease and acute heart failure can significantly improve cardiac function, decrease the levels of serum NT-proBNP and cTn-I, with good curative effect, which is worthy of clinical promotion and application.