曲美他嗪治疗慢性收缩性心力衰竭的临床研究

目的观察曲美他嗪治疗慢性收缩性心力衰竭的临床疗效及安全性。方法采用随机数字表法将120例确诊为慢性收缩性心力衰竭的患者分为两组：对照组（60例）给予常规抗心力衰竭药物治疗；曲美他嗪组（60例）在常规药物治疗的基础上加用曲美他嗪（20mg、3次／d）治疗。治疗前后观察记录患者的一0力衰竭症状和体征，记录NYHA分级，检测患者B型脑钠肽（BNP）浓度，6min步行试验（6rainWT），超声心动图测定左心室舒张末内径（LVEDD）、LVEF，并记录不良反应及临床事件。结果曲美他嗪组显效率及总有效率均高于对照组，差异均有统计学意义（P〈0．05）。与治疗前比较，两组患者治疗后LVEDD、LVEF均有明显改善，6min聊距离明显延长，BNP水平明显下降，差异均有统计学意义（P〈0．05）。曲美他嗪组治疗后LVEDD、LVEF较对照组明显改善，6minWT距离明显延长，BNP下降更显著，差异均有统计学意义（p〈0．05）。随访期间曲美他嗪组再入院率（5．0％）与对照组再人院率（18．3％）比较，差异有统计学意义（P=0．043）。治疗期间两组均未观察到严重不良反应。结论在慢性心力衰竭常规治疗的基础上加用曲美他嗪能进一步改善心功能、提高患者的运动耐量及改善心室重构。

Clinical study on trimetazidine in patients with chronic congestive heart failure

Objective To investigate effect and safety of trimetazidine in chronic congestive heart failure. Methods One hundred and twenty patients with chronic congestive heart failure were randomly divided into two groups：control group （n=60） was received routine treatment of heart failure only,trimetazidine group （n=60） was receive routine treatment of heart failure plus trimetazidine.Left ventricular end-diastolic diameter （LVEDD）,LVEF were detected by echocardiogram,and NYHA functional class,six-minute walking test（6 min WT） and B-brain natriuretic peptide were recorded before and after treatment. Results The effective rate and total effective rate in trimetazidine group were higher than those in the control group,the differences were statistically significant （all P〈0.05）.LVEDD,LVEF in trimetazidine group after treatment improved significantly than the control group,B-brain natriuretic peptide levels decreased significantly,6 min WT distance was extended,the differences were statistically significant（all P〈0.OS）.The readmission rate of trimetazidine group （5.0%） was relatively lower than that of the control group （18.3%）,the difference was statistically significant （P=0.043）. During treatment,120 patients had not any serious uncomfortable complain about this drug and nobody stopped using this capsule. Conclusion On the basis of routine treatment of combined trimetazidine can further improve cardiac function,improve exercises tolerance and myocardial remodeling.