曲美他嗪联合福辛普利钠治疗慢性充血性心力衰竭的临床观察(1)
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[摘要] 目的：观察曲美他嗪联合福辛普利钠(TMZ)治疗充血性心力衰竭(CHF)患者的临床疗效。方法：将96例CHF患者随机分为研究组和对照组，均给予内科常规抗心力衰竭治疗。对照组加服福辛普利钠，初始剂量为5 mg，每日1次，逐渐加至靶剂量10 mg，每日1次；研究组在对照组的基础上接受曲美他嗪20 mg/次，3次/d。疗程12周。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)及6 min步行试验等。结果：治疗12周后，两组心功能较治疗前均有明显改善，研究组临床总有效率为81.3%，较对照组(64.6%)显著提高(P<0.05)；在LVESD、LVEF、6 min步行试验及BNP等方面，两组治疗后均较治疗前有明显改善(P<0.05)，且研究组较对照组改善更为显著(P<0.05)。两组均未发现有明显的不良反应。结论：曲美他嗪联合福辛普利钠治疗CHF优于单用福辛普利钠，是一种安全有效的方法。
[关键词] 慢性充血性心力衰竭；曲美他嗪；福辛普利钠；临床观察
[中图分类号] R972 [文献标识码]B[文章编号]1674-4721(2011)06(a)-063-02
Clinical observation of trimetazidine combined fosinopril in treatment for chronic congestive heart failure
ZHANG Xiaolu
Fengtian Hospital of Shenyang Medical College, Liaoning Province, Shenyang 110024, China
[Abstract] Objective: To observe the curative effect of fosinopril combined with trimetazidine (TMZ) to treat chronic congestive heart failure (CHF). Methods: 96 patients with CHF were randomly divided into experimental group and control group. All patients were given conventional medical treatment. Fosinopril was added to the control group, the initial dose of 5 mg/d, gradually increased to target dose of 10 mg/d; Besides fosinopril, trimetazidine was added to the experimental group, 20 mg, tid. 12 weeks later, the curative effect was evaluated. Results: The cardiac function in two groups were significantly improved. The clinical total effective rate was 81.3% in the experimental group, higher than that in the control group (64.6%) (P<0.05). After treatment, LVESD, LVEF, 6 min-walking distance and BNP were significantly improved than before (P<0.05), with much more improvement in the treatment group (P<0.05). Side effects were neither found in the two groups. Conclusion: Combination of trimetazidine and fosinopril for CHF is more effective than fosinopril used alone.
[Key words] Chronic congestive heart failure; Trimetazidine; Fosinopril; Clinical observation
充血性心力衰竭(congestive heart failure，CHF)是临床各种病因心脏病发展的终末阶段，是内科常见的疑难危重病，终末期住院率、病死率高，严重影响患者的生活质量和预后。目前常规的抗心力衰竭药物治疗患者病死率仍然较高。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 ......
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