曲美他嗪治疗冠心病合并慢性充血性心力衰竭的疗效

Therapeutic efficacy of trimetazidine in coronary heart disease complicated with chronic congestive heart failure

目的研究曲美他嗪应用在冠心病(Coronary heart disease,CHD)合并慢性充血性心力衰竭(chronic congestive heart failure,CHF)中的疗效。方法以我院2018年3月~2019年3月收治的88例CHD合并CHF患者作为本研究观察对象,依据随机数字表法分为对照组44例,进行常规抗心衰治疗,实验组44例,加用曲美他嗪,比较两组的心功能指标、临床疗效、再住院率、病死率。结果 (1)治疗前,两组左室舒张末容积指数(Left ventricular end-diastolic volume index,LVEDVI)、左室收缩末容积指数(Left ventricular end systolic volume index,LVESVI)、左室射血分数(Left ventricular ejection fraction,LVEF)水平比较,无明显差异(P>0.05);治疗后,实验组LVEDVI、LVESVI均低于对照组(P<0.05),且实验组LVEF高于对照组(P<0.05);(2)实验组无效5例(11.36%)、有效16例(36.36%)、显效23例(52.28%),总有效率88.64%,对照组无效14例(31.82%)、有效14例(31.82%)、显效16例(36.36%),总有效率68.18%,差异有统计学意义(P<0.05);(3)实验组再住院率(18.18%)、病死率(2.27%)均低于对照组(40.91%)、(15.91%),差异有统计学意义(P<0.05)。结论曲美他嗪治疗CHD合并CHF疗效显著,且可降低病死率,减少再住院率,所以值得推广。

Objective To investigate the therapeutic efficacy of trimetazidine in coronary heart disease(CHD) complicated with chronic congestive heart failure(CHF). Methods In this study, 88 patients with CHD complicated with chronic CHF admitted in our hospital from March 2018 to March 2019 were selected as subjects. They were divided into the control group(n=44, with a routine treatment of heart failure) and the research group(n=44, additionally with trimetazidine) using the random number table method. Indices of cardiac function, therapeutic efficacy, rehospitalization rate and case-fatality rate were compared between the two groups. Results(1)There were no significant differences in left ventricular end-diastolic volume index(LVEDVI), left ventricular end systolic volume index(LVESVI) and left ventricular ejection fraction(LVEF) before treatment between the two groups(P >0.05). After treatment, values of LVEDVI and LVESVI were significantly lower and the value of LVEF was significantly higher in the research group than the control group(P<0.05).(2)In the research group, 5 cases showed no efficacy(11.36%), 16 significant efficacy(36.36%) and 23 satisfactory efficacy(52.28%) with the total effective rate of 88.64%. In the control group, 14 presented no efficacy(31.82%), 14 significant efficacy(31.82%) and 16 satisfactory efficacy(36.36%), with the total effective rate of 68.18%,the difference was significant(P<0.05).(3)The rehospitalization rate and case-fatality rate in the research group were18.18% and 2.27%, significantly lower than those of 40.91% and 15.91% in the control group,the difference was significant(P<0.05). Conclusion The addition of trimetazidine to the routine treatment for CHD complicated with chronic CHF can improve the therapeutic efficacy with ameliorated cardiac function and a reduced rehospitalization rate and case-fatality rate. Therefore, it is worth promoting in clinical practices.