曲美他嗪辅助治疗慢性心力衰竭疗效观察及对心功能和血管内皮功能的影响

Clinical Effect of Trimetazidine on Chronic Heart Failure and Its Effect on Cardiac Function and Vascular Endothelial Function

目的研究曲美他嗪辅助治疗慢性心力衰竭临床疗效及对心功能和血管内皮功能的影响.方法选取2018年1月—2019年1月就诊的慢性心力衰竭患者88例,按照随机数表法分为对照组和研究组各44例进行回顾性分析,对照组实施常规方案治疗包括限水限盐,消除诱发因素、原发病,合理使用强心剂、利尿剂、血管紧张素转化酶抑制剂、β-受体阻断剂等措施,研究组在对照组常规方案治疗基础上给予曲美他嗪口服治疗,3个月后比较两组患者心功能指标LVEF、LVESD、LVEDd改善情况以及NT-proBNP水平,比较两组患者血管内皮因子ET-1、NO水平改善情况.结果治疗后研究组临床总有效率为93.2%,显著高于对照组临床总有效率72.7%,差异具有统计学意义(P<0.05);治疗后两组心功能指标均有显著改善,且研究组改善情况显著优于对照组,差异具有统计学意义(P<0.05);治疗后两组患者血清NT-proBNP水平、ET-1及NO水平较治疗前均有显著改善,且研究组NT-proBNP、ET-1水平显著低于对照组,NO水平显著高于对照组,差异均具有统计学意义(P<0.05).结论曲美他嗪辅助治疗慢性心力衰竭有显著疗效,可显著改善患者心功能指标以及血管内皮因子水平.

Objective To study the clinical effect of trimetazidine in the treatment of chronic heart failure and its effect on cardiac function and vascular endothelial function.Methods 88 patients with chronic heart failure who came to the Fourth Affiliated Hospital of China Medical University from January 2018 to January 2019 were selected and divided into control group and study group according to the method of random number table for retrospective analysis.In the control group,the routine treatment included water and salt restriction,elimination of induced factors and primary diseases,rational use of cardiotonic,diuretic,ACE inhibitor,p-receptor blocker,and etc.In the study group,trimetazidine was given orally on the basis of conventional treatment in the control group.After 3 months,the improvement of LVEF,LVESD,LVEDd,NT-proBNP,ET-1 and NO levels of vascular endothelial factor in the two groups were compared.Results After treatment,the total clinical effective rate of the study group was 93.2%,which was significantly higher than that of the control group(72.7%),the difference was statistically significant(P<0.05).The level of NT-proBNP and ET-1 in the study group was significantly lower than that in the control group,and the level of NO in the study group was significantly higher than that in the control group(P<0.05).Conclusion Trimetazidine has a significant effect in the treatment of chronic heart failure,which can significantly improve the cardiac function and the level of vascular endothelial factor.