乌拉地尔与曲美他嗪合用对慢性心力衰竭患者的疗效观察

目的 观察乌拉地尔联合曲美他嗪治疗慢性心力衰竭(CHF)的临床疗效.方法 将100例心功能(NYHA) Ⅲ-Ⅳ级的CHF患者随机分为乌拉地尔治疗组、曲美他嗪治疗组、乌拉地尔联合曲美他嗪治疗组和对照组,各25例,常规给予血管紧张素转换酶抑制剂、强心、利尿剂等治疗.乌拉地尔治疗组在此基础上连续5d静脉泵人乌拉地尔100～300 μg/min.曲美他嗪治疗组持续加用曲美他嗪20 mg次,3次/d,连续3个月.乌拉地尔联合曲美他嗪治疗组除了静脉泵入乌拉地尔100～300 μg/min达5d外,还同时加用曲美他嗪20 mg/次,3次/d,连续3个月.对照组仅为常规治疗.于治疗前、治疗后5d及治疗后3个月采用超声心动图、6min步行实验(6-MWT)等方法观察4组患者心功能情况,同时检测脑钠肽(BNP)、C反应蛋白(CRP).结果 3个治疗组心功能改善情况优于对照组,超声心动图指标、6-MWT距离均明显改善,BNP、CRP均降低,两药合用效果更佳.4组均未见明显不良反应.结论 乌拉地尔及曲美他嗪均能有效改善CHF患者心功能,降低BNP及CRP,两者合用效果更佳且安全.

Clinical Study of Urapidil Combined with Trimetazidine for Treatment of the Chronic Congestive Heart Failure

Objective To observe the clinical curative effect of Urapidil combined with Trimetazidine on chronic heart failure （CHF）. Methods 100 cases of patients with CHF whose cardiac function were III-IV degree（NYHA） were randomly divided into three treatment groups and a control group, 25 cases in each group. Four groups were given conventional treatment, including angiotensin-converting enzyme inhibitors, diuretics and digoxin by oral use. Patients in Urapidil treatment group were treated with Urapidil 100-300 μg/min by venous pump for five days, patients in Trimetazidine treatment group were treated with Trimetazidine 20 mg, 3 times/d, continuous treatment for 3 months, patients in Urapidil combined with Trimetazidine treatment group （the combined treatment group） were treated with both drugs, and those in control group were given conventional treatment. Heart function of all patients were observed by echocardiography, and their exercise endurance were evaluated by 6-minutes walking test （6-MWT） before and after the treatment. The plasma levels of brain natriuretic peptide（BNP） and C-reactive protein （CRP） were detected at the same time. Results The plasma levels of BNP and CRP, heart functin and the distance of 6-MWT were significantly improved after therapy in three treatment groups than in the control group（P0.01）, and the improvements in the combined treatment group were better. No obvious side effect was found in four groups. Conclusions Urapidil and Trimetazidine can both significantly decrease the plasma BNP and CRP levels of CHF patients and improve their cardiac function as a safe and reliable treatment. Urapidil combined with Trimetazidine treatment was better.