曲美他嗪治疗冠状动脉粥样硬化性心脏病心力衰竭的有效性及对血浆脑钠肽水平影响

目的观察曲美他嗪治疗冠状动脉粥样硬化性心脏病心力衰竭(CHD-CHF)的疗效及对血浆脑钠肽(BNP)水平的影响。方法选择CHD-CHF患者84例,按照治疗方式的不同将患者分为观察组和对照组,每组42例。对照组患者给予强心、利尿和扩血管的常规治疗,观察组患者在对照组治疗的基础上加用曲美他嗪治疗。2组患者均连续治疗1个月。对2组患者综合疗效进行评价,并观察治疗前后患者左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及6 min步行距离(6MWD),同时检测治疗前后血浆BNP水平。结果观察组有效率为92.9%,高于对照组的73.8%,差异有统计学意义(P<0.05)。治疗前2组患者LVEF、LVEDD、6MWD和BNP水平比较,差异均无统计学意义(P>0.05)。治疗后观察组患者LVEF和6MWD高于对照组,LVEDD和BNP水平低于对照组,差异均有统计学意义(P<0.05)。结论曲美他嗪治疗CHD-CHF效果显著,能迅速改善患者心功能,且能降低血浆BNP水平。

Effectiveness of trimetazidine for treatment of coronary heart disease-congestive heart failure and effect on plasma brain natriuretic peptide level

Objective To observe the efficacy of trimetazidine for treatment of coronary heart disease-congestive heart failure（CHD-CHF） and effect on plasma brain natriuretic peptide （BNP）level. Methods Eighty-four patients with CHD- CHF were selected and then were divided into observation group and control group according to the different treatment, with 42 cases in each group. The patients in control group were given conventional treatment included cardiotonie, diuretic and vasodi-lator. Based on these, the observation group were treated with trimetazidine. All patients were treated for one month. The comprehensive efficacy of two groups were evaluated, and indexes of cardiac function include left ventricular ejection fraction （LVEF） , left ventricular end-diastolic diameter（LVEDD） and 6 minutes walk distance （6MWD） were observed before and after treatment, as well as the BNP levels were detected before and after treatment. Results The effective rates were 92.9% and 73.8% in observation group and control group respectively,the difference was statistically significance（P 〈0. 05）. The difference of LVEF, LVEDD ,6MWD and BNP levels between two groups before treatment was not significant （P 〉 0. 05） ;after treatment, the LVEF and 6MWD increased, the LVEDD and BNP decreased in observation group compared with control group （P 〈 0. 05 ）. Conclusion Trimetazidine has a significant effect for the treatment of CHD-CHF,it can rapidly improve patients＇ cardiac function, as well as reduce levels of BNP.