曲美他嗪治疗冠状动脉粥样硬化性心脏病合并左心功能不全的疗效

目的研究冠状动脉粥样硬化性心脏病（冠心病）合并左心功能不全的患者在传统治疗基础上合用心肌代谢调节药物曲美他嗪对心功能的影响。方法84例冠心病心功能不全患者采用预制随机信封法分成两组，对照组按指南予传统的冠心病、心功能不全二级预防：治疗组在传统治疗基础上合用曲美他嗪持续口服。比较两组治疗前后纽约心脏协会心功能分级、二维超声测量的左心室射血分数。结果治疗组与对照组3个月时和6个月时纽约心脏协会心功能分级改善／不变／恶化百分构成比比较，差异无统计学意义（P〉0．05）。左心室射血分数的改善在治疗组显著优于对照组：3个月时两组比较，差异有统计学意义（4．2％±2．2％／）vs.1．9％±0．9％，P〈O．01）：6个月时两组比较，差异有统计学意义（7．1％±3．6％vs．3.3％±1．1％，P〈0.01）。两组在3个月时和6个月时血压、心率的下降比例比较，差异无统计学意义（P〉0．05）。结论在传统二级预防基础上合用曲美他嗪可进一步改善冠心病合并左心功能不全的患者心功能。

Effect of trimetazidine in patients with coronary heart disease combined with left heart insufficiency

Objetives To investigate effect of trimetazidine on heart function of patients with coronary heart disease combined with left heart insufficiency. Methods We enrolled 84 patients and randomly assigned them to treat traditionally with or without trimetazidine added. New York Heart Association heart function classification and left ventricular ejection fraction were compared between the two groups before and after treatment. Results Follow-up at the 3^rd and 6^th month suggested no significantly different alterations were observed on New York Heart Association heart function classification between the two groups （P〉0.05）. Better improvement on left ventricular ejection fraction in group treated with trimetazidine when compared with group treated traditionally at the 3^rd month（4.2%±2.2% vs. 1.9%±0.9%,P〈0.010）and at the 6^th month （7.1%±3.6% vs. 3.3%±1.1%,P〈0.01）. Similar drop in mean artery blood pressure and heart rate between the two groups（P〉0.05） at the 3^rd month at the 6^th month. Conclusions Trimetazidine on the top of traditional therapy benefits patients with coronary heart disease combine with left heart insufficiency by further improving heart function.