美托洛尔并曲美他嗪治疗小儿扩张型心肌病心衰的疗效

目的：观察美托洛尔联合曲美他嗪对儿童扩张型心肌病（DCM）心力衰竭的疗效。方法：选择我院儿科收治的DCM心力衰竭（NYHA心功能分级Ⅱ～Ⅲ级）患儿86例，分为常规治疗组（常规药物治疗）和联合治疗组（在常规药物治疗的基础上加用美托洛尔和曲美他嗪），每组各43例。1个月后观察对比两组的临床疗效。结果：治疗后，联合治疗组的总有效率明显高于常规治疗组（93．020比76．75％）；与常规治疗组比较，联合治疗组心率r（91．2±2．6）次／min比（87．4±3．1）次／mini、血压（100．6±2．7／70．1±3．8）mmHg比（92．6±1．9／60．9±4．6）mmHg]、左心室舒张末期内径（49．5±5．3）mm比（41．2±4．9）mm]及收缩末期内径（45．7±4．9）mm．比（40．3±5．5）mm]明显降低，左室射血分数（37．6±5．7）％比（45．9±2．6）%]明显增大（P均〈0．05）。结论：使用常规药物治疗小儿扩张型心肌病心力衰竭的同时加用美托洛尔和曲美他嗪能进一步提高疗效。

Effect of metoprolol combined trimetazidine therapy in children with dilated cardiomyopathy and heart failure

Objective： To observe therapeutic effects of metoprolol combined trimetazidine in children with dilated cardiomyopathy （DCM） and heart failure. Methods： A total of 86 child patients with DCM and heart failure （NY- HA class II - III ） of our hospital were enrolled. They were randomly divided into routine treatment group （n = 43, received routine drug therapy） and combined treatment group （n = 43, received metoprolol and trimetazidine based on routine drug treatment）. Clinical therapeutic effects after one month were observed and compared between two groups. Results： After treatment, total effective rate of combined treatment group was significantly higher than that of routine treatment group （93.02% vs. 76. 75%） ; Compared with routine treatment group, there were significant decrease in heart rate （91.2 ± 2.6） times/min vs. （87.4 ± 3.1） times/mini, blood pressure （100. 6 ± 2.7/ 70.1 ± 3.8） mmHg vs. （92.6 ± 1.9/60.9 ± 4.6） mmHg], left ventricular end - diastolic dimension （49.5 ± 5.3） mm vs. （41.2±4. 9） mm] and end-systolic dimension （45.7±4. 9） mm vs. （40. 3±5. 5） mm], and significant increase in left ventricular ejection fraction （37. 6 ± 5.7） % vs. （45.9 ± 2.6） % ] in combined treatment group, P〈 0. 05 all. Conclusion： Additional use of metoprolol and trimetazidine based on routine drug therapy can further increase therapeutic effects in child patients with dilated cardiomyopathy and heart failure.