当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
1期
1-2,3
,共3页
黄宇%魏群英%李波%陈观荣%冼巧飞
黃宇%魏群英%李波%陳觀榮%冼巧飛
황우%위군영%리파%진관영%승교비
曲美他嗪%给药和剂量%心率%心力衰竭
麯美他嗪%給藥和劑量%心率%心力衰竭
곡미타진%급약화제량%심솔%심력쇠갈
Trimetazidine%Administration and dosage%Heart rate%Heart failure
目的：评估曲美他嗪对已应用最佳治疗方案治疗的缺血性心力衰竭患者的心率变异性（HRV）的影响。方法选取2012年1月-2012年12月在吴川市人民医院心内科住院的30例应用血管紧张素转化酶抑制剂或血管紧张素受体阻断剂、卡维地洛、螺内酯、洋地黄和速尿治疗的心力衰竭患者，增加应用曲美他嗪，20 mg/次，3次/d。所有患者心力衰竭的原因都是冠状动脉疾病。在实验开始前和加用曲美他嗪3个月后，分别通过超声心动图和24 h心率变异性分析，对患者进行评估。结果加入曲美他嗪后，平均左心室射血分数（LVEF）显著提高[从（33.5±5.1）%到（42.5±5.8）%， P＜0.001]。HRV参数中SDNN[从（97.3±40.1）m s到（110.5±29.2）ms，P=0.049]和SDANN[从（80.5±29.0）m s到（98.3±30.5）ms]显著提高。基线SDNN与基线LVEF显著相关（r=0.445，P=0.023，P=0.008），而SDNN的增量与LVEF的增加相关（r=0.518，P=0.007）。结论对缺血性病因引起的心力衰竭患者的最佳治疗方案中增加曲美他嗪，可提高心率变异性并改善左心室射血分数。
目的：評估麯美他嗪對已應用最佳治療方案治療的缺血性心力衰竭患者的心率變異性（HRV）的影響。方法選取2012年1月-2012年12月在吳川市人民醫院心內科住院的30例應用血管緊張素轉化酶抑製劑或血管緊張素受體阻斷劑、卡維地洛、螺內酯、洋地黃和速尿治療的心力衰竭患者，增加應用麯美他嗪，20 mg/次，3次/d。所有患者心力衰竭的原因都是冠狀動脈疾病。在實驗開始前和加用麯美他嗪3箇月後，分彆通過超聲心動圖和24 h心率變異性分析，對患者進行評估。結果加入麯美他嗪後，平均左心室射血分數（LVEF）顯著提高[從（33.5±5.1）%到（42.5±5.8）%， P＜0.001]。HRV參數中SDNN[從（97.3±40.1）m s到（110.5±29.2）ms，P=0.049]和SDANN[從（80.5±29.0）m s到（98.3±30.5）ms]顯著提高。基線SDNN與基線LVEF顯著相關（r=0.445，P=0.023，P=0.008），而SDNN的增量與LVEF的增加相關（r=0.518，P=0.007）。結論對缺血性病因引起的心力衰竭患者的最佳治療方案中增加麯美他嗪，可提高心率變異性併改善左心室射血分數。
목적：평고곡미타진대이응용최가치료방안치료적결혈성심력쇠갈환자적심솔변이성（HRV）적영향。방법선취2012년1월-2012년12월재오천시인민의원심내과주원적30례응용혈관긴장소전화매억제제혹혈관긴장소수체조단제、잡유지락、라내지、양지황화속뇨치료적심력쇠갈환자，증가응용곡미타진，20 mg/차，3차/d。소유환자심력쇠갈적원인도시관상동맥질병。재실험개시전화가용곡미타진3개월후，분별통과초성심동도화24 h심솔변이성분석，대환자진행평고。결과가입곡미타진후，평균좌심실사혈분수（LVEF）현저제고[종（33.5±5.1）%도（42.5±5.8）%， P＜0.001]。HRV삼수중SDNN[종（97.3±40.1）m s도（110.5±29.2）ms，P=0.049]화SDANN[종（80.5±29.0）m s도（98.3±30.5）ms]현저제고。기선SDNN여기선LVEF현저상관（r=0.445，P=0.023，P=0.008），이SDNN적증량여LVEF적증가상관（r=0.518，P=0.007）。결론대결혈성병인인기적심력쇠갈환자적최가치료방안중증가곡미타진，가제고심솔변이성병개선좌심실사혈분수。
Objective To assess the effects of trimetazidine on HRV in optimally treated patients with heart failure of ischemic origin. Methods Trimetazidine 20 mg three times/day was added to therapy of 30 patients with heart failure being treated with angiotensinogen converting enzyme inhibitors or angiotensin receptor blockers, carvedilol, spironolactone, digitalis and furosemide. The etiology of heart failure was coronary artery disease in all patients. Patients were evaluated with echocardiography and 24-hour heart rate variability analysis before and 3 months after addition of trimetazidine.Results Mean left ventricular ejection fraction (LVEF) significantly increased after the addition of trimetazidine[(33.5±5.1)%to (42.5±5.8)%,P<0.001]. Of the HRV parameters,SDNN[(97.3±40.1)ms to(110.5±29.2)ms, P=0.049]and SDANN[(80.5±29.0)ms to(98.3±30.5)ms] were significantly increased after trimetazidine treatment. Baseline SDNN was significantly correlated with baseline LVEF (r=0.445,P=0.023,P=0.008) and the increment in SDNN was correlated with increase in LVEF (r=0.518, P=0.007).Conclusion Adding trimetazidine to optimal medical therapy in patients with heart failure of ischemic origin may improve heart rate variability in association with improved left ventricular ejection fraction.
