盐酸曲美他嗪对老年急性心肌病患者的疗效及对血清细胞因子、心功能的影响

Therapeutic effect of trimetazidine hydrochloride on aged patients with acute cardiomyopathy in acute phase and its influence on serum cytokine levels and cardiac function

目的:探讨盐酸曲美他嗪对老年急性缺血性心肌病患者的疗效及对急性期血清细胞因子水平、心功能的影响。方法:选择2014年12月至2016年12月我院收治的90例老年急性心肌病患者。患者被随机均分为常规治疗组和曲美他嗪组(在常规治疗基础上接受曲美他嗪),疗程12周。测量比较两组治疗前后左室射血分数(LVEF)、左室收缩末期内径(LVESd)、左室舒张末期内径(LVEDd)、临床疗效、血清肿瘤坏死因子(TNF)-α、白介素(IL)-6水平。结果:曲美他嗪组临床总有效率显著高于常规治疗组(97.78%比77.77%),P=0.004。与治疗前比较,两组治疗后血清TNF-α、IL-6水平显著降低;曲美他嗪组LVEF显著升高,LVEDd和LVESd显著降低,P<0.05或<0.01。与常规治疗组比较,曲美他嗪组治疗后LVEF[(60.89±5.22)%比(65.01±6.01)%]升高更显著,LVESd[(34.02±5.00)mm比(30.27±4.80)mm]、LVEDd[(51.22±7.02)mm比(46.21±5.44)mm]、血清TNF-α[(282.97±59.44)pg/ml比(248.89±45.33)pg/ml]和IL-6[(721.02±165.00)pg/ml比(630.89±102.80)pg/ml]水平降低更显著,P均<0.01。结论:老年急性心肌病患者使用盐酸曲美他嗪治疗可以发挥一定的抗炎作用,能显著改善心功能,提高疗效,值得推广。

Objective:To explore therapeutic effect of trimetazidine hydrochloride on aged patients with acute ischemic cardiomyopathy in acute phase and its influence on serum cytokine levels and cardiac function. Methods:A total of 90 aged patients with acute cardiomyopathy, who were treated in our hospital from Dec 2014 to Dec 2016, were selected. Patients were randomly and equally divided into routine treatment group and trimetazidine group (received trimetazidine based on routine treatment), both groups were treated for 12 weeks. Left ventricular ejection fraction (LVEF), left ventricular end-systolic dimension (LVESd), left ventricular end-diastolic dimension (LVEDd), serum levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 before and after treatment, and therapeutic effect were measured and compared between two groups. Results:Total effective rate of trimetazidine group was significantly higher than that of routine treatment group (97.78% vs. 77.77%), P =0.004. Compared with before treatment, there were significant reductions in serum levels of TNF-α and IL-6 in two groups;significant rise in LVEF, and significant reductions in LVEDd and LVESd in trimetazidine group after treatment, P <0.05 or <0.01. Compared with routine treatment group after treatment, there was significant rise in LVEF[(60.89±5.22)% vs.(65.01±6.01)%], and significant reductions in LVESd[(34.02±5.00)mm vs.(30.27±4.80)mm], LVEDd [(51.22±7.02) mm vs.(46.21±5.44)mm], serum levels of TNF-α[(282.97±59.44)pg/ml vs.(248.89±45.33)pg/ml]and IL-6 [(721.02± 165.00)pg/ml vs.(630.89±102.80)pg/ml]in trimetazidine group, P <0.01 all. Conclusion:Trimetazidine hydrochloride possesses certain anti-inflammation effect, can significantly improve cardiac function and therapeutic effect in aged patients with acute cardiomyopathy, which is worth extending.