CAJ | 학술논문

目的观察曲美他嗪联合培哚普利治疗充血性心力衰竭(CHF)的临床疗效.方法 118例CHF患者随机分为研究组和对照组各59例,均给予内科常规抗心力衰竭治疗.对照组加服培哚普利,初始剂量2 mg,每日1次,逐渐加至靶剂量4 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2组左心室射血分数、左心室舒张末期容积、左心室收缩末期容积、每搏量、心排血量以及心功能变化.结果研究组治疗后左心室射血分数(46.89±8.00)%较治疗前(29.60±11.00)%,左心室舒张末期容积(129.20±25.00)ml较治疗前(164.40±31.00)ml,左心室收缩末期容积(70.90±32.00)ml较治疗前(95.60±33.00)ml,心排血量(4.32±0.65)L/min较治疗前(2.91±0.56)L/min,每搏量(55.06±13.27)ml较治疗前(37.69±13.62)ml均有明显改善(P<0.01或P<0.05);2组治疗后研究组左心室射血分数(46.89±8.00)%较对照组(34.70±9.00)%,左心室舒张末期容积研究组(129.20±25.00)ml较对照组(148.20±29.00)ml.左心室收缩末期容积研究组(70.90±32.00)ml较对照组(81.10±31.00)ml,心排血量研究组(4.32±0.65)L/min较对照组(3.14±0.60)L/min,每搏量研究组(55.06 4±13.27)ml较对照组(49.56±14.29)ml均有明显改善(P<0.01或P<0.05);研究组总有效率为93.2%(55/59),与对照组的66.1%(39/59)比较差异有统计学意义(P<0.01).2组均未发现有明显的不良反应.结论曲美他嗪联合培哚普利治疗CHF疗效好,副作用少,是一种安全有效的方法.
목적 관찰곡미타진연합배타보리치료충혈성심력쇠갈(CHF)적림상료효.방법 118례CHF환자수궤분위연구조화대조조각59례,균급여내과상규항심력쇠갈치료.대조조가복배타보리,초시제량2 mg,매일1차,축점가지파제량4 mg,매일1차;연구조재대조조적기출상접수곡미타진20 mg/차,3차/d.료정12주.관찰2조좌심실사혈분수、좌심실서장말기용적、좌심실수축말기용적、매박량、심배혈량이급심공능변화.결과 연구조치료후좌심실사혈분수(46.89±8.00)%교치료전(29.60±11.00)%,좌심실서장말기용적(129.20±25.00)ml교치료전(164.40±31.00)ml,좌심실수축말기용적(70.90±32.00)ml교치료전(95.60±33.00)ml,심배혈량(4.32±0.65)L/min교치료전(2.91±0.56)L/min,매박량(55.06±13.27)ml교치료전(37.69±13.62)ml균유명현개선(P<0.01혹P<0.05);2조치료후연구조좌심실사혈분수(46.89±8.00)%교대조조(34.70±9.00)%,좌심실서장말기용적연구조(129.20±25.00)ml교대조조(148.20±29.00)ml.좌심실수축말기용적연구조(70.90±32.00)ml교대조조(81.10±31.00)ml,심배혈량연구조(4.32±0.65)L/min교대조조(3.14±0.60)L/min,매박량연구조(55.06 4±13.27)ml교대조조(49.56±14.29)ml균유명현개선(P<0.01혹P<0.05);연구조총유효솔위93.2%(55/59),여대조조적66.1%(39/59)비교차이유통계학의의(P<0.01).2조균미발현유명현적불량반응.결론 곡미타진연합배타보리치료CHF료효호,부작용소,시일충안전유효적방법.
Objective To study the efficacy of trimetazidine combined with perindopril in treating congestive heart failure (CHF). Methods One hundred and eighteen patients with CHF were randomly divided into experimental group and control group. All patients were given conventional medical treatment. Patients in the control group was treated with additionally with perindopril. The initial dose was 2 mg/d, and gradually increased to target dose of 4 mg/d. The experimental group was additionally treated with trimetazidine 20 mg orally 3 times a day for 12 weeks based on the regimen in the control group. The changes of left ventricular ejection fraction ( LVEF) , left ventricular end of diastolic volume ( LVEDV) , left ventricular end of systolic volume ( LVESV), stroke volume (SV),cardiac output (CO)and cardiac function (NYHA) were observed. Results In the experiment group, after treatment,LVEF,LVEDV,LVESV,CO and SV were(46. 89 ±8. 00)% ,(129. 20 ±25. 00)ml, (70.90 ±32. 00)ml, (4. 32 ±0. 65 ) L/min and (55. 06 ± 13. 27) ml, respectively, which were significantly improved compared to those before treatment (29.60 ± 11. 00)% ,(164. 40 ± 31. 00) ml, (95. 60 ± 33. 00) ml, (2.91 ±0.56) L/min and (37. 69 ± 13. 62) ml .respectively) ( P < 0.01 or P < 0. 05). After treatment, the LVEF, LVEDV, LVESV, CO and SV were (46.89 ± 8. 00)% , (34. 70 ± 9. 00)% ,( 129. 20 ± 25. 00) ml, ( 148. 20 ±29. 00) ml and (70.90 ± 32. 00)ml in the experiment group, respectively, which were significantly higher than those in the control group (81. 10 ±31.00)ml, (4. 32 ±0.65) L/min, (3. 14 ±0.60) L/min, (55. 06 ±13.27 )ml and (49. 56 ± 14. 29) ml, respectively) (P <0. 01 or P <0. 05). The overall effective rate in the experiment group was 93. 2% .which was significantly higher than that in the control group (66. 1% ) ( P < 0.01). No obvious adverse effect was observed. Conclusions The effect of trimetazidine combined with perindopril in treating congestive heart failure is satisfactory. It is safe and effective for CHF.