加用曲美他嗪治疗慢性心力衰竭的疗效观察

目的:观察加用曲美他嗪治疗慢性心力衰竭患者的临床疗效及不良反应.方法:将90例慢性心力衰竭(NYHA心功能Ⅲ～Ⅳ级及左室射血分数LVEF≤45％)患者随机分为观察组和对照组.对照组(n=46)用常规抗心衰药物治疗,观察组(n=44)在对照组治疗的基础上加用曲美他嗪,治疗8周,观察治疗前后NYHA心功能分级、LVEF、左室短轴缩短分数(FS)、N末端B型利钠肽( NT - proBNP)及6分钟步行试验.结果:2组治疗后心功能各项指标均较治疗前改善(P＜0.01).与对照组相比,观察组能更明显改善NYHA心功能分级(P＜0.05),提高EF值、FS值及6分钟步行距离(6 - MWD)(P＜0.01),降低NT - proBNP(P＜0.05),均有统计学意义,且无严重不良反应出现.结论:慢性心力衰竭患者在常规治疗基础上,加用曲美他嗪可进一步改善心功能,提高运动耐量,安全有效,值得推广.

The Effects of Trimetazidine in Patients with Chronic Heart Failure

Objective:To observe clinical effects and adverse response of trimetazidine(TMZ) in patients with chronic heart failure(CHF).Methods:90 patients with CHF New York Heart Association(NYHA) 3 or 4] and reduced left ventricular ejection fraction(LVEF) ≤45%),were randomized into 2 groups,contrast group(n=46) receiving conventional therapy and TMZ group(n=44) with conventional therapy plus TMZ for 8 weeks.Patients were evaluated at baseline and after 8 months with NYHA functional class,LVEF,fractional shortening(FS) of left ventricular short axis,N-terminal pro-brain natriuretic peptide(NT-proBNP) and 6-minute walk test.Results:All indicators of cardiac function had statistically significantly after 8-weeks’ treatment(P<0.01).However,compared with contrast group,TMZ group had better NYHA functional status(P <0.05),increased significantly EF,FS and 6-minute walk distance(6-MWD)(P<0.01),meanwhile apparently reduced NT-proBNP(P<0.05).The differences were statistically meaningful.In addition,no severely adverse events were observed.Conclusion:In patients with CHF,TMZ plus conventional therapy can be better to improve cardiac function and exercise duration in contrast with conventional therapy,which is safe and effective and therefore deserves being widely used.