曲美他嗪联合左卡尼汀对缺血性心肌病伴心力衰竭患者心功能的影响

目的探讨曲美他嗪联合左卡尼汀对缺血性心肌病伴心力衰竭患者心功能的影响。方法选取2017年5月—2020年5月南阳市某医院心内科收治的86例缺血性心肌病伴心力衰竭患者为研究对象,根据不同的治疗方式分为对照组(43例)和观察组(43例)。对照组患者予以左卡尼汀治疗,观察组患者予以曲美他嗪联合左卡尼汀治疗,2组患者均持续治疗3个月。比较2组患者临床疗效和治疗前后的心输出量(CO)、每搏输出量(SV)及左室射血分数(LVEF),QT离散度(QTd)、校正QT离散度(QTcd)及QRS。结果对照组患者治疗总有效率为83.72%,低于观察组的97.67%,差异有统计学意义(χ²=5.075,P=0.024)。治疗前,2组患者心功能各项指标比较,差异均无统计学意义(P>0.05)。治疗后,观察组患者CO、SV及LVEF高于治疗前,且高于对照组,差异均有统计学意义(P<0.05);QTd、QTcd及QRS均低于治疗前,且低于对照组,差异均有统计学意义(P<0.05)。结论曲美他嗪联合左卡尼汀对缺血性心肌病伴心力衰竭患者心功能改善明显,值得临床推广使用。

Effect of trimetazidine combined with levocanidine on the hear function of patients with ischemic cardiomyopathy with heart failure

Objective To investigate the effect of trimetazidine combined with levocanidine on the heart function of patients with ischemic cardiomyopathy with heart failure.Methods Eighty-six patients with ischemic cardiomyopathy with heart failure admitted to the cardiology department of a hospital in Nanyang from May 2017 to May 2020 were selected for the study and divided into a control group(43 cases)and an observation group(43 cases)according to different treatment modalities.The control group was treated with levocanidine,and the observation group was treated with trimetazidine combined with levocanidine,and both groups were treated for 3 months.The clinical efficacy,cardiac output(CO),stroke volume(SV)and left ventricular ejection fraction(LVEF),QT dispersion(QTd),corrected QT dispersion(QTcd)and QRS of the patients in the two groups were compared before and after treatment.Results The total effective rate of treatment for patients in the control group was 83.72%,which was lower than 97.67%in the observation group,and the difference was statistically significant(χ²=5.075,P=0.024).Before treatment,there was no statistically significant difference between the indices of heart function in the 2 groups of patients(P>0.05).After treatment,CO,SV and LVEF of patients in the observation group were higher than those before treatment and significantly higher than those in the control group,and the differences were all statistically significant(P<0.05);QTd,QTcd and QRS were all lower than before treatment and significantly lower in the observation group than in the control group,and the differences were all statistically significant(P<0.05).Conclusion The improvement of heart function in patients with ischemic cardiomyopathy with heart failure by trimetazidine combined with levocanidine is obvious,and the therapy is worthy of clinical promotion.