曲美他嗪、替米沙坦联合低分子肝素治疗慢性肺心病急性加重期的临床研究

目的 探讨曲美他嗪、替米沙坦联合低分子肝素对改善慢性肺心病急性加重期患者心肺功能、血液流变学和临床症状的作用.方法 将96例慢性肺心病急性加重期患者按照随机数字表法分为常规治疗组40例和试验治疗组56例.常规治疗组采用常规治疗,试验治疗组采用常规治疗+曲美他嗪、替米沙坦联合低分子肝素.治疗3周后,分别测定两组患者心肺功能、血液流变学指标,并观察临床疗效.结果 试验治疗组患者治疗后左室射血分数(LVEF)、第1秒用力呼气容积占用力肺活量百分比(FEV_1/FVC)较治疗前均有明显改善,差异有统计学意义(P<0.05),与常规治疗组治疗后比较差异也有统计学意义(P<0.05);常规治疗组患者临床总有效率67.5%(27/40),试验治疗组为92.9%(52/56),两组总有效率比较差异有统计学意义(P<0.05).结论 慢性肺心病急性加重期患者应用曲美他嗪、替米沙坦联合低分子肝素治疗对改善患者心肺功能、血液流变学和临床症状具有较好的作用.

Clinical study of trimetazidine,telmisrtan and low molecular weight heparin in treatment of chronic pulmonary heart disease in acute exacerbation

Objective To explore the effect of trimetazidine, telmisartan and low molecular weight heparin (LMWH) on improving cardiopulmonary function, hemorheology and clinical symptom of chronic pulmonary heart disease in acute exacerbation. Methods A total of 96 patients with chronic pulmonary heart disease in acute exacerbation were randomly divided into group A (40 cases) and group B (56 cases ).The group A was treated with general method and the group B was treated with trimetazidine, telmisartan and LMWH besides general method. After 3 weeks' treatment, ca_rdiopulmonary functional parameters,hemorbeology parameters and clinical symptoms were observed. Results After treatment, the left ventricular ejection fraction (LVEF), and the ratio of forced expiratory volume in one second and forced vital capacity (FEV_1/FVC ) improved in group B (P<0.05 ), and there were significant difference in LVEF, FEV_1/FVC after treatment between two groups (P<0.05). The clinical total effective rate in group B (92.9%, 52/56 ) was significantly higher than that in group A (67.5%, 27/40 ) ( P<0.05 ). Conclusion Trimetazidine, telmisartan and LMWH is effective to improve patients' cardiopulmonary function, hemorheology parameters and clinical symptoms in the treatment of chronic pulmonary heart disease in acute exacerbation.