阿托伐他汀钙联合曲美他嗪对缺血性心肌病患者心功能的影响

目的观察阿托伐他汀联合曲美他嗪对缺血性心肌病患者心功能的影响。方法选择缺血性心肌病患者124例,随机分为3组:对照组40例,给予常规抗心力衰竭治疗;阿托伐他汀组42例,常规治疗基础上加用阿托伐他汀钙;联合治疗组42例,常规治疗基础上加用阿托伐他汀钙及曲美他嗪,所有患者在治疗前后用超声心动图检测左心室收缩末内径(LVESD)及左心室舒张末内径(LVEDD)、LVEF、左心室短轴缩短率(FS)、二尖瓣舒张早期血流峰值速度(E)/二尖瓣舒张晚期血流峰值速度(A)之比(E/A);记录心绞痛发作次数和持续时间及6 min步行试验(6MWT)。结果联合治疗组及阿托伐他汀组治疗后LVESD、LVEDD、FS、LVEF、E/A较对照组明显改善,心绞痛发作次数和发作时间较对照组明显减少,6MWT距离明显延长;与阿托伐他汀组比较,联合治疗组治疗后心绞痛发作次数和发作时间明显减少,6MWT距离明显延长(P<0.05,P<0.01)。结论在常规治疗基础上加用阿托伐他汀能改善缺血性心肌病患者心室重构,减少心绞痛发作次数并提高患者运动耐量;在常规治疗基础上联合应用阿托伐他汀及曲美他嗪治疗能进一步减少心绞痛发作次数,并提高患者运动耐量。

Effect of the combination of atorvastatin with trimetazidine on heart function of ischemic cardiomyopathy patients

Objective To observe the effect of combination of atorvastatin with trimetazidine on heart function of ischemic cardiomyopathy patients.Methods 124 patients with ischemic cardiomyopathy were divided randomly into three groups:the control group(n = 40),received routine treatment of heart failure only:the statin group(n = 42),received routine treatment plus atorvastatin: the combined group(n = 42),received routine treatment plus atorvastatin and trimetazidine. Left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter (LVEDD),LVEF,left ventricle shortening fraction(FS),and the ratio of maximal velocity of bicuspid blood flow in the early(E) and advanced(A) stages of left ventricle diastoleC E/A) were detected by echocardiogram before and after treatment.The frequency and duration of angina were also recorded,and six-minute walking test(6MWT) was conducted.Results LVESD,LVEDD, FS,LVEF,E/A apparently improved after treatment in the combined and the statin group as compared with the control group;also,the frequency and duration of angina decreased,the distance in 6MWT extended.Compared with the statin group,there were lower frequency and shorter duration of angina and longer walking distance in the combined group(P<0.05,P<0.01).Conclusion Routine treatment plus atorvastatin improves cardiac ventricle remodeling,lowers the frequency of angina,and increases exercise tolerance in patients with ischemic cardiomyopathy.Routine treatment combined with atorvastatin and trimetazidine is even better.