曲美他嗪对慢性心力衰竭患者心功能及血清基质金属蛋白酶-9、基质金属蛋白酶抑制剂-1 的影响

目的探讨曲美他嗪对慢性心力衰竭患者心功能和血清基质金属蛋白酶-9（MMP-9）、基质金属蛋白酶抑制剂-1（TIMP-1）的影响。方法将2010年1月～2012年1月桂林医学院附属医院老年科80例慢性心力衰竭患者分为治疗组（41例）和对照组（39例），两组均接受血管紧张素转换酶抑制剂、β-受体阻滞剂、安体舒通、地高辛等常规治疗，治疗组在此基础上口服盐酸曲美他嗪，治疗前及治疗后6个月均测6min步行距离、心率、MMP-9、左室射血分数（LVEF）、TIMP-1。结果治疗结束后，治疗组、对照组与治疗前比较，血清MMP-9浓度、心率降低，TIMP-1、LVEF升高（P〈0．05）；与对照组比较，治疗组TIMP-1、LVEF升高更明显，血清基MMP-9浓度更低（P〈0．05）。血清MMP-9浓度与LVEF呈负相关（r=-0．63，P〈0．01）；血清TIMP-1浓度与LVEF呈正相关（r=0．56，P〈0．01）。结论盐酸曲美他嗪可以改善慢性心力衰竭患者的心功能，同时可降低患者血清MMP-9的浓度，升高TIMP-1的浓度。

Effects of Trimetazidine on cardiac function and serum level of MMP-9, TIMP-1 in patients with chronic heart failure

Objective To investigate the effects of trimetazidine on cardiac function and serum level of MMP-9, TIMP-1 in patients with chronic heart failure. Methods 80 patients with chronic heart failure from January 2010 to January 2012 in Department of Geriatrics, the Affiliated Hospital of Guilin Medical College were divided into two groups ： treat- ment group （41 cases） and control group （39 Cases）. All the patients were treated for 6 months besides conventional therapy including ACEI, β-receptor blocker, Spironolactone, Digoxin. The treatment group were given the Trimetazidine oral in addition. The heart rates, 6 min walking distance, left ventricular ejection fraction （LVEF） and serum MMP-9, TIMP-1 were evaluated before and 6 months after therapy. Results Both treatment and control group significantly in- creased the LVEF, TIMP-1, decreased the heart rates and serum MMP-9 （P 〈 0.05）, what＇s more, treatment group had much lower serum MMP-9 and higher LVEF, TIMP-1 than those of the control group after 6 months of treatment （r = 0.56, P 〈 0.01）, moreover the MMP-9 was negative correlated with LVEF （r = -0.63, P 〈 0.01）. TIMP-1 was positive correlated with LVEF. Conclusion Trimetazidine can improve cardiac function, TIMP-1 can decrease the serum MMP-9.