曲美他嗪治疗糖尿病合并慢性心功能不全患者的临床疗效观察

目的 观察并比较常规治疗与常规联合曲美他嗪(TMZ)治疗10年以上2型糖尿病(T2DM)合并慢性心功能不全患者的临床疗效.方法 将收治的160例T2DM(病程≥10年)合并慢性心功能不全患者分为对照组和观察组各80例,对照组给予常规治疗,观察组在常规治疗基础上给予TMZ(20 mg,3次/天).观察并比较两组患者的美国纽约心脏病学会(NYHA)心功能分级、左室射血分数(LVEF)、6分钟步行距离(6MWD)、左室舒张末期容积(LVEDD)、左室收缩末期容积(LVESD)、血浆脑钠肽(BNP)水平、空腹血糖(FBG)、糖化血红蛋白(HbA1 C).结果 治疗后心功能疗效观察组总有效率高于对照组(P<0.05);6MWD和LVEF较治疗前提高(均P<0.05),BNP、LVEDD、LVESD较治疗前下降(均P<0.05),且观察组较对照组明显(均P<0.05),均差异有统计学意义;治疗后两组间FBG和HbA1 C比较差异有统计学意义(均P<0.05).结论 曲美他嗪治疗糖尿病(病程≥10年)合并慢性心力衰竭患者,可改善患者的心功能和血糖代谢,疗效安全,值得在临床推广.

The clinical efficacy of Trimetazidine in diabetic patients with chronic heart failure

Objective To investigate the clinical effects of trimetazidine(TMZ)in patients with chronic heart failurand type 2 diabetes mellitus(T2DM)that the course is over 10 years on the basis of conventional treatment.Methods The 160 cases of patients with T2DM (course of the disease is greater than or equal to 10 year)and chronic heart failure were divided into observation group and the control group,with 80 cases in each.The observation group were treated with TMZ(20 mg 3 times/day)on the basis of conventional treatmentgiving,while r with,the control giving routine treatment.NYHA classification,left ventricular ejection fraction (LVEF),6 mi-nutes walking distance (6MWD),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter(LVESD),B-type natriuretic peptide level (BNP),fasting blood glucose (FBG)and HbA1 C of two group were observed and compared.Results The total effective of observation group is significantly higher than the control group(P <0.01 ).There was significant increase in 6MWD and LVEF (P <0.05),and significant decrease in BNP,LVEDD and LVESD after treatment (P <0.05),while the tendency is significant in observation group.There were significant difference of fasting blood glucose and HbA1 C between two groups after treatment (P <0.05).Conclusion Trimetazidine can improve the cardiac function and the metabolism of blood glucose in the diabetes mellitus (course of the disease is greater than or equal to 10 year)complicated with chronic heart failure patients,the efficacy is safe,it is worth to widely applied in clinical.