中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
4期
374-377
,共4页
曲美他嗪%原发性扩张型心肌病%心力衰竭
麯美他嗪%原髮性擴張型心肌病%心力衰竭
곡미타진%원발성확장형심기병%심력쇠갈
Trimetazidine%Dilated cardiomyopathy%Heart failure
目的 观察曲美他嗪短期治疗扩张型心肌病(DCM)心力衰竭的疗效.方法 将67例DCM患者随机分为对照组33例,治疗组34例.2组均给予常规抗心力衰竭治疗,治疗组在常规抗心力衰竭基础上加用曲美他嗪20 mg,3 次/d口服,3个月为1个疗程.结果 2组心功能均明显好转,治疗组总有效率为88.2%(30/34),对照组为69.7%(23/33),2组比较差异有统计学意义(P＜0.05).治疗组治疗前左心室射血分数(LVEF)、每搏量(SV)、每分排血量(CO)、6 min步行距离,分别为(28.7±13.6)%、(31.0±8.7)ml、(3.10±0.49)L/min、(138.0±30.4)m,治疗后分别为(38.5±9.7)%、(48.5±6.8)ml、(4.90±0.98)L/win、(350.0±20.4)m,治疗后明显增加(P均＜0.05);治疗组治疗前左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)及脑钠肽(BNP)分别为(68.0±8.0)、(70.0±7.8)mm、(669.0±71.4)μg/L,治疗后分别为(59.0±6.7)、(68.0±7.9)mnn,(340.0±56.0)μg/L,治疗后明显减小(P均＜0.05);对照组治疗前LVEF、SV、CO、6 min步行距离分别为(28.5±13.9)%、(30.0±9.9)ml、(3.00±0.48)L/min、(130.0±28.6)m,治疗后分别为(34.0±8.5)%、(34.0±11.0)ml、(3.90±0.56)L/min、(254.0±30.0)m,治疗后明显增加(P均＜0.05);对照组治疗前LVESD、LVEDD及BNP分别为(67.0±9.0)、(70.0±8.0)mm,(666.0±70.8)μg/L,治疗后分别为(60.0±5.5)、(66.0±5.7)mm,(350.0±55.3)μg/L,治疗后明显减小(P均＜0.05).且治疗组优于对照组(P均＜0.05).结论 常规抗心力衰竭基础上加用曲美他嗪可提高疗效,改善心肌的收缩功能.
目的 觀察麯美他嗪短期治療擴張型心肌病(DCM)心力衰竭的療效.方法 將67例DCM患者隨機分為對照組33例,治療組34例.2組均給予常規抗心力衰竭治療,治療組在常規抗心力衰竭基礎上加用麯美他嗪20 mg,3 次/d口服,3箇月為1箇療程.結果 2組心功能均明顯好轉,治療組總有效率為88.2%(30/34),對照組為69.7%(23/33),2組比較差異有統計學意義(P＜0.05).治療組治療前左心室射血分數(LVEF)、每搏量(SV)、每分排血量(CO)、6 min步行距離,分彆為(28.7±13.6)%、(31.0±8.7)ml、(3.10±0.49)L/min、(138.0±30.4)m,治療後分彆為(38.5±9.7)%、(48.5±6.8)ml、(4.90±0.98)L/win、(350.0±20.4)m,治療後明顯增加(P均＜0.05);治療組治療前左心室收縮末期內徑(LVESD)、左心室舒張末期內徑(LVEDD)及腦鈉肽(BNP)分彆為(68.0±8.0)、(70.0±7.8)mm、(669.0±71.4)μg/L,治療後分彆為(59.0±6.7)、(68.0±7.9)mnn,(340.0±56.0)μg/L,治療後明顯減小(P均＜0.05);對照組治療前LVEF、SV、CO、6 min步行距離分彆為(28.5±13.9)%、(30.0±9.9)ml、(3.00±0.48)L/min、(130.0±28.6)m,治療後分彆為(34.0±8.5)%、(34.0±11.0)ml、(3.90±0.56)L/min、(254.0±30.0)m,治療後明顯增加(P均＜0.05);對照組治療前LVESD、LVEDD及BNP分彆為(67.0±9.0)、(70.0±8.0)mm,(666.0±70.8)μg/L,治療後分彆為(60.0±5.5)、(66.0±5.7)mm,(350.0±55.3)μg/L,治療後明顯減小(P均＜0.05).且治療組優于對照組(P均＜0.05).結論 常規抗心力衰竭基礎上加用麯美他嗪可提高療效,改善心肌的收縮功能.
목적 관찰곡미타진단기치료확장형심기병(DCM)심력쇠갈적료효.방법 장67례DCM환자수궤분위대조조33례,치료조34례.2조균급여상규항심력쇠갈치료,치료조재상규항심력쇠갈기출상가용곡미타진20 mg,3 차/d구복,3개월위1개료정.결과 2조심공능균명현호전,치료조총유효솔위88.2%(30/34),대조조위69.7%(23/33),2조비교차이유통계학의의(P＜0.05).치료조치료전좌심실사혈분수(LVEF)、매박량(SV)、매분배혈량(CO)、6 min보행거리,분별위(28.7±13.6)%、(31.0±8.7)ml、(3.10±0.49)L/min、(138.0±30.4)m,치료후분별위(38.5±9.7)%、(48.5±6.8)ml、(4.90±0.98)L/win、(350.0±20.4)m,치료후명현증가(P균＜0.05);치료조치료전좌심실수축말기내경(LVESD)、좌심실서장말기내경(LVEDD)급뇌납태(BNP)분별위(68.0±8.0)、(70.0±7.8)mm、(669.0±71.4)μg/L,치료후분별위(59.0±6.7)、(68.0±7.9)mnn,(340.0±56.0)μg/L,치료후명현감소(P균＜0.05);대조조치료전LVEF、SV、CO、6 min보행거리분별위(28.5±13.9)%、(30.0±9.9)ml、(3.00±0.48)L/min、(130.0±28.6)m,치료후분별위(34.0±8.5)%、(34.0±11.0)ml、(3.90±0.56)L/min、(254.0±30.0)m,치료후명현증가(P균＜0.05);대조조치료전LVESD、LVEDD급BNP분별위(67.0±9.0)、(70.0±8.0)mm,(666.0±70.8)μg/L,치료후분별위(60.0±5.5)、(66.0±5.7)mm,(350.0±55.3)μg/L,치료후명현감소(P균＜0.05).차치료조우우대조조(P균＜0.05).결론 상규항심력쇠갈기출상가용곡미타진가제고료효,개선심기적수축공능.
Objective To analyze the clinical efficacy of trimetazidine in short-term treatment for dilated cardiomyopathy accompanied by heart failure. Methods Sixty seven cases of dilated cardiomyopathy patients with heart failure were recruited and divided into two groups randomly,the control group(n = 33) had conventional therapy and the treatment group (n = 34) had conventional therapy plus oral tid 20 mg trimetazidine administration for 3 months. Results The heart function improved significantly in both groups. The overall effective rate was significantly lower in the control group than the treatment group(69. 7% vs. 88.2%,P ＜ 0. 05). In the treatment group, before treating the left ventricular ejection fraction(LVEF), stroke volume (SV), cardiac output per minute (CO), 6 min walk test(6-MWT), were(28.7 ± 13. 6) %,(31.0 ± 8. 7) ml,(3. 10 ± 0. 49) L/min,(138.0 ± 30. 4) m respectively, and after treazing these indices were(38. 5 ± 9. 7) %,(48. 5 ± 6. 8) ml, (4. 90 ± 0. 98) L/min,(350. 0 ± 20. 4) m respectively, which increased significantly after treatment(Ps ＜0. 05). However,in the treatment group ,before treatment left ventricular. End-systolic dimension (LVESD), left ventricular end-diastolic dimension (LVEDD) and brain natriuretic peptide (BNP) were (68. 0 ± 8. 0)mm,(70. 0 ± 7. 8) mm,(669. 0 ± 71.4) μg/L respectively, whereas after treatment these indices were(59. 0 ± 6. 7) mm,(68.0 ± 7. 9) μg/L,(340. 0 ± 56. 0) μg/L respectively, which decreased significantly after treatment(Ps ＜ 0. 05). In the control group, before treatment LVEF, SV, CO, 6-M WT were(28. 5 ±13.9) %,(30. 0 ± 9. 9) ml,(3.00 ± 0. 48) L/min,(130. 0 ± 28. 6) m respectively, whereas after treating these indices were(34. 0 ± 8. 5) %,(34. 0±11.0) ml,(3. 90 ± 0. 56) L/min,(254. 0 ± 30. 0) m, respectively,which increased significantly after treatment(Ps ＜ 0. 05). While in the control group, before treatment LVESD,LVEDD and BNP were (67.0 ± 9. 0) mm, (70. 0 ± 8.0) mm,(666. 0 ± 70. 8) μg/L respectively, whereas after treatment these indices were(60. 0 ± 5. 5) mm,(66. 0 ± 5.7) mm,(350. 0 ± 55.3) μg/L respectively, which decreased significantly after treatment (Ps ＜ 0. 05). Moreever, the improvement of these indices in the treatment group were significantly higher than those in the control group (Ps ＜ 0. 05). Conclusion The additional administration of trimetazidine to conventional anti-failure treatment can significantly improve the heart function in patients with dilated cardiomyopathy,which is worth to be generalized clinically.
