心脉隆联合曲美他嗪治疗慢性心力衰竭的疗效

Therapeutic effect of Xinmailong combined trimetazidine on chronic heart failure

目的:探讨心脉隆联合曲美他嗪治疗慢性心力衰竭(CHF)患者的疗效。方法:选择2013年10月～2016年4月于我科住院的155例CHF患者。患者被随机分为常规治疗组(50例)、心脉隆组(52例,在常规治疗组基础上使用心脉隆注射液)和联合治疗组(53例,在心脉隆组基础上使用曲美他嗪),三组均治疗8周。治疗前后测量比较三组每博量(SV)、心排血量(CO)、心脏指数(CI)、左室射血分数(LVEF)、二尖瓣舒张早期峰值流速/舒张晚期峰值流速(E/A)、6min步行距离(6MWD)以及治疗总有效率。结果:联合治疗组总有效率显著高于常规治疗组(88.7%比66.0%,P=0.006),但联合治疗组与心脉隆组间总有效率无显著差异(P=0.171)。与治疗前比较,治疗8周后三组SV、CO、CI、LVEF和E/A均显著升高,6MWD均显著增加,P均=0.001。治疗8周后,与常规治疗组比较,心脉隆组SV、CI和LVEF升高更显著,6MWD增加更显著(P均<0.01);与常规治疗组和心脉隆组比较,联合治疗组SV [(48.6±8.9)ml比(53.6±8.5)ml比(60.2±8.4)ml]、CO [(4.4±0.5)L/min比(4.5±0.6)L/min比(5.7±0.6)L/min]、CI[(3.1±0.9)L·min^(-1)·m-2比(3.7±0.3)L·min^(-1)·m-2比(4.3±0.4)L·min^(-1)·m-2]、LVEF [(42.3±8.4)%比(46.6±7.9)%比(53.2±7.3)%]和E/A[(1.0±0.3)比(1.1±0.3)比(1.4±0.2)]均升高更显著,6MWD [(342.88±52.44)m比(420.90±36.86)m比(443.55±25.30)m]增加更显著,P均=0.001。结论:心脉隆联合曲美他嗪可促进慢性心力衰竭患者心功能和血液动力学改善及心室重塑,提高临床疗效。

Objective:To explore therapeutic effect of Xinmailong combined trimetazidine on patients with chronic heart failure(CHF).Methods:A total of155CHF inpatients hospitalized in our department from Oct2013to Apr2016were selected.According to therapeutic method,patients were divided into routine treatment group(n=50),Xinmailong group(n=52,received Xinmailong injection based on routine treatment group)and combined treatment group(n=53,received trimetazidine based on Xinmailong group),all groups were treated for eight weeks.Stroke volume(SV),cardiac output(CO),cardiac index(CI),left ventricular ejection fraction(LVEF),transmitral early diastolic peak flow velocity/late diastolic peak flow velocity(E/A),6min walking distance(6MWD)and total effective rate were measured and compared among three groups before and after treatment.Results:Total effective rate of combined treatment group was significantly higher than that of routine treatment group(88.7%vs.66.0%,P=0.006),but there were no significant difference between combined treatment group and Xinmailong group(P=0.171).Compared with before treatment,after eight-week treatment,there were significant rise in SV,CO,CI,LVEF,E/A and6MWD in three groups,P=0.001all.Compared with routine treatment group after eight-week treatment,there were significant rise in SV,CI,LVEF and6MWD in Xinmailong group,P<0.01all;compared with routine treatment group and Xinmailong group,there were significant rise in SV[(48.6±8.9)ml vs.(53.6±8.5)ml vs.(60.2±8.4)ml],CO[(4.4±0.5)L/min vs.(4.5±0.6)L/min vs.(5.7±0.6)L/min],CI[(3.1±0.9)L·min-1·m-2vs.(3.7±0.3)L·min-1·m-2vs.(4.3±0.4)L·min-1·m-2],LVEF[(42.3±8.4)%vs.(46.6±7.9)%vs.(53.2±7.3)%],E/A[(1.0±0.3)vs.(1.1±0.3)vs.(1.4±0.2)]and6MWD[(342.88±52.44)m vs.(420.90±36.86)m vs.(443.55±25.30)m]in combined treatment group,P=0.001all.Conclusion:Xinmailong combined trimetazidine can improve cardiac function,hemodynamics,ventricular remodeling and therapeutic effect in patients with chronic heart failure.