曲美他嗪对老年高血压性心脏病慢性心力衰竭患者心功能及预后的影响

目的研究曲美他嗪对老年高血压性心脏病慢性心力衰竭患者心功能及预后的影响并探讨相关机制。方法纳入云南省第三人民医院老年病科2008～2009年收治的高血压性心脏病慢性充血性心力衰竭患者62例,随机分为对照组和治疗组。对照组给予标准药物治疗,治疗组给予曲美他嗪联合标准药物治疗。对比研究两组患者治疗前及治疗后3个月、6个月、1年、2年的纽约心脏病学会（NYHA）心功能分级,左室射血分数（LVEF）,6 min步行距离（6MWD）,血浆脑利钠肽（BNP）。随访2年内两组心衰再住院例次及心血管死亡例数。结果两组治疗后3个月、6个月、1年、2年的心功能分级均较治疗前有不同程度改善,差异有统计学意义（P〈0.05）;LVEF、6MWD较治疗前升高,差异有统计学意义（P〈0.05）;BNP较治疗前降低,差异有统计学意义（P〈0.05）;治疗组差异更显著。两组治疗后心衰再住院例次治疗组低于对照组,差异有统计学意义（P〈0.05）。心血管死亡百分率两组相比,差异无统计学意义（P〉0.05）。结论曲美他嗪能改善老年高血压性心脏病慢性心力衰竭患者心功能及预后。

Effect of Rimetazidine on the cardiac function and prognosis of aged patients with chronic heart failure due to hypertensive heart disease

Objective To observe the effect of Rimetazidine on the cardiac function and prognosis of aged patients with chronic heart failure due to hypertensive heart disease,and to investigate its action mechanism.Methods Total 62 patients with chronic congestive heart failure due to hypertensive heart disease were enrolled from those who were hospitalized in the department of geriatrics,the third people＇s hospital of Yunnan Province from 2008 to 2009.All enrolled patients were randomly divided into control group and treatment group.Classic drug therapy was given to patients in control group,Trimetazidine was applied to patients in treatment group besides classic drug therapy.NYHA classification,left ventricular ejection（LVEF）,6-minutes walking distance（6MWD） and brain natriuretic peptide（BNP） was measured in both groups before treatment and 3 months,6 months,1 year and 2 years after treatment,and the rehospitalized date and cardiovascular death date within the 2-year follow-up was investigated.Results The cardiac function,LVEF and 6MWD of patients were improved after treatment in both groups（P 0.05）.BNP was decreased after treatment in both groups（P 0.05）.The therapeutic effect in treatment group was better than control group（P 0.05）.The rehospitalisation date of treatment group was lower than control group（P 0.05）.However the cardiovascular death date was not statistically significant between the two groups（P 0.05）.Conclusion Trimetazidine can improve the cardiac function and prognosis of aged patients with chronic heart failure due to hypertensive heart disease.