曲美他嗪治疗冠心病心力衰竭临床评价(1)
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【摘要】目的评价曲美他嗪治疗冠心病心力衰竭的临床疗效及安全性。方法选择114例冠心病心力衰竭患者随机分为治疗组50例和对照组64例。对照组给予常规抗心力衰竭治疗;治疗组在对照组常规治疗基础上加服曲美他嗪20 mg,3次/d。2组疗程均为6个月。观察两组治疗前后临床疗效、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、血清B型尿钠肽(BNP)、6 min步行试验及药物不良反应等。结果治疗6个月后,治疗组的总有效率显著高于对照组(P<0.05);在LVEDd、LVEF、6 min步行距离及BNP等方面改善的程度,治疗组均优于对照组(P<0.05);治疗组发生药物不良反应少而轻微。结论冠心病心力衰竭患者长期服用曲美他嗪可使心功能改善,安全有效。
【关键词】
冠心病;心力衰竭;曲美他嗪
Clinical evaluation of trimetazidine in patients with coronary heart disease and chronic heart failure
DING Yan.Department of Cardiology,the People’s Hospital of Runan County,Henan Runan 463300,China
【Abstract】ObjectiveTo evaluate the clinical therapeutic effects and safety of trimetazidine(TMZ)in patients with coronary heart disease(CHD)and chronic heart failure(CHF).Methods114 patients with CHD and CHF were randomly divided into treatment group 50 cases and the control group 64 cases.The control group was given conventional antiheart failure therapy; The treatment group were given 20 mg trimetazidine(3 times per day)on the basis of conventional therapy of the control group.The course of treatment all were 6 months in 2 Groups.Clinical efficacy,left ventricular enddiastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),serum Btype natriuretic peptide(BNP),6 min walk test,and adverse drug reactions were observed before and 6 months after therapy.ResultsAfter treatment for 6 months,the total effective rate of the treatment group was significantly higher than that of the control group(P<0.05); The LVEDd,LVEF,6minute walking distance and the level of BNP in the treatment group improved significantly better than that of the control group(P<0.05); the treatment group occurred few and mild adverse drug reactions.ConclusionLongterm use trimetazidine treating in patients with with CHD and CHF can improve cardiac function,safe and effective.
【Key words】
Coronary heart disease;Chronic heart failure;Trimetazidine
冠心病是导致慢性充血性心力衰竭(chronic heart failure,CHF)的常见原因。关于CHF的治疗,尽管传统的药物,如血管紧张素转换酶抑制剂、β受体阻滞剂和利尿剂,能减轻心衰症状,增加运动耐量,提高生存率[1]。但CHF的预后仍较差,CHF患者的预后及生活质量仍需进一步改善。随着对心肌缺血代谢过程的进一步研究和认识,目前人们提出了干预心肌能量的代谢环节,完善线粒体能量代谢而治疗缺血性心脏病的新概念。近年发现曲美他嗪有改善心功能的作用[2],曲美他嗪作为一种优化心肌代谢的药物,抑制自由基的生成,抑制体内炎症反应[3],对心衰有改善作用,与β受体阻滞剂、钙通道拮抗剂和ACEI有协同作用,而且不引起血流动力学的改变。近年来,我院应用曲美他嗪治疗冠心病心力衰竭患者50例,并设64例冠心病心力衰竭患者接受常规治疗作为对照组进行比较,现报告如下。
1资料与方法
1.1一般资料选择2007年1月至2009年2月在我院住院的冠心病CHF患者58例,均符合WHO关于冠心病的命名和CHF诊断标准 ......
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