联合曲美他嗪治疗对左室射血分数正常的老年心力衰竭患者心功能的影响

目的探讨联合曲美他嗪（TMZ）治疗对左室射血分数正常的老年心力衰竭（HFNEF）患者心功能的影响。方法随机入选96例HFNEF老年患者,分为对照组（52例）与曲美他嗪组（TMZ组,44例）;对照组接受常规治疗,TMZ组在使用常规治疗的基础上同时使用曲美他嗪20mg口服,3次/d。所有患者均于治疗前及治疗后3月及6月行心脏彩超检查,测定超敏C-反应蛋白（hsCRP）及NT-前端B型钠尿肽（NT-proBNP）。结果与治疗前相比,治疗后两组的左房舒张末期内径（LAEDD）、hsCRP、NT-proBNP明显降低,LVEF、VE/VA明显升高（P〈0.05）;与对照组相比,TMZ组3个月及6个月后hsCRP、NT-proBNP、LAEDD明显降低,LVEF、VE/VA升高明显（P〈0.05）;左室舒张末期内径（LVEDD）在TMZ组有降低趋势,但两组间差异无统计学意义。结论联合TMZ治疗可能通过改善心肌能量代谢、抗炎等机制提高老年患者心功能,可能有改善左室重构作用。

Effect of combination therapy of trimetazidine on elder patients of heart failure with normal ejection fraction

【Objective】To explore the effects of combination therapy of trimetazidine on elder patients of heart failure with normal ejection fraction.【Methods】A total of 96 elder patients of heart failure with normal ejection fraction were devided into control group（52） and TMZ group（44）,control group received conventional drug while TMZ group received trimetazidine 20mg tid additionally,cardiac color doppler、hsCRP and NT-proBNP were measured before and 3 and 6 months after therapy.【Resluts】 LAEDD、hsCRP and NT-proBNP decreased dramatically while LVEF and VE/VA increased significantly after therapy（P0.05）;hsCRP、NT-proBNP and LAEDD decreased dramatically while LVEF and VE/VA increased significantly in TMZ group Compared to control group（P0.05）;There was no statistically difference between two group in the measurement of LVEDD while the TMZ group has the tendency to decrease.【Conclusion】 Combination therapy of trimetazidine can improve cardiac function by enhancing myocardial energy metabolism and Antiinflammatory effect,and can improve left ventricular remodeling.