曲美他嗪对慢性心力衰竭患者血浆脑钠肽及心功能的影响

目的探讨曲美他嗪对慢性心力衰竭(CHF)患者血浆脑钠肽(BNP)及心功能的影响。方法选择新乡市第四人民医院2011年1月至2013年8月收治的68例CHF患者分为常规治疗组和曲美他嗪组,每组34例。2组患者均常规给予血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体阻滞剂、β-受体阻滞剂、血管扩张剂、洋地黄制剂、利尿剂等药物治疗。曲美他嗪组患者在此基础上加用曲美他嗪治疗。观察治疗前后2组患者血浆BNP水平及心功能变化。结果曲美他嗪组患者临床治疗总有效率和心功能分级改善总有效率均高于常规治疗组,差异有统计学意义(Z=-2.030,P=0.042;Z=-3.260,P=0.001)。曲美他嗪组与常规治疗组患者治疗后血浆BNP、左心室收缩末期容积、左心室舒张末期容积均降低,2组间治疗前后差值比较差异均有统计学意义(t=14.975,6.295,7.084;P=0.000);而左心室射血分数治疗后明显提高,2组间治疗前后差值比较差异有统计学意义(t=-4.742,P<0.01)。结论应用曲美他嗪治疗CHF能显著降低血浆BNP水平,提高临床疗效,改善心功能。

Effect of trimetazidine on B-type natriuretic peptide and heart function in patients with chronic heart failure

Objective To explore the effect of trimetazidine on B-type natriuretic peptide（ BNP） and heart function in patients with chronic heart failure（ CHF）. Methods Sixty-eight patients with CHF of the Fourth People＇s Hospital of Xinxiang in January,2011 to August,2013 were selected and divided into two groups（ conventional therapy group and trimetazidine group）,with 34 patients in each group. They were treated with angiotensin converting enzyme inhibitor /angiotension Ⅱ receptor blocker,β-acceptor blocker,vasodilator agent,asystin,diuretics. Based on these,patients in trimetazidine group were treated with trimetazidine. The changes of plasma BNP and heart function were observed before and after treatment. Results The NYHA grade＇ s total effective rate and the total effective rate of clinical efficacy in trimetazidine group were higher than those in conventional therapy group,the differences were statistically significant（ Z =- 2. 030,P = 0. 042; Z =- 3. 260,P = 0. 001）. After treatment,the level of plasma BNP,left end systolic volume and left end diastolic volume all decreased（ t = 14. 975,6. 295,7. 084; P = 0. 000）,while the left ventricular ejection fraction increased,the differences were statistically significant in the changes before and after treatment（ t =- 4. 742,P 0. 01）. Conclusion The application of trimetazidine on CHF can decrease the level of plasma BNP significantly and has important effect on increasing of clinical efficacy and the improvement of heart function.