CAJ | 학술논문

目的观察在常规治疗基础上加用曲美他嗪对酒精性心肌病(ACM)的治疗效果及其对血浆脑钠肽(BNP)的影响.方法 86例ACM患者按随机数字表法分为对照组和观察组,每组43例.对照组采用常规治疗,观察组联合使用曲美他嗪治疗,治疗3个月,观察比较两组左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、6 min步行距离、BNP及临床疗效.结果治疗前对照组LVEF、LVEDD、6 min步行距离、BNP分别为(37.2±7.4)％、(57.6±7.4)mm、(312.8±21.6)m、(846.2±63.7) μg/L,观察组分别为(38.5±8.1)％、(57.1±6.8)mm、(316.5 ±23.9)m、(857.6±61.4)μg/L,两组比较差异无统计学意义(P＞0.05).对照组治疗后LVEF、LVEDD、6 min步行距离、BNP分别为(43.5±8.6)％、(54.3 ±6.4) mm、(511.6±26.7)m、(679.4±51.3) μg/L,与治疗前比较差异有统计学意义(P＜0.05).观察组治疗后LVEF、LVEDD、6min步行距离、BNP分别为(51.6±9.2)％、(51.2±6.3)mm、(579.3±25.1)m、(536.5±50.6) μg/L,与治疗前比较差异有统计学意义(P＜0.05).两组治疗后LVEF、LVEDD、6 min步行距离、BNP比较差异有统计学意义(P＜0.05).观察组的治疗总有效率为90.7％(39/43),显著高于对照组的72.1％(31/43),两组比较差异有统计学意义(x2=4.914,P＜ 0.05).结论在常规治疗基础上联合使用曲美他嗪可更好地改善ACM患者的心功能及心肌重塑,提高临床疗效.
목적 관찰재상규치료기출상가용곡미타진대주정성심기병(ACM)적치료효과급기대혈장뇌납태(BNP)적영향.방법 86례ACM환자안수궤수자표법분위대조조화관찰조,매조43례.대조조채용상규치료,관찰조연합사용곡미타진치료,치료3개월,관찰비교량조좌실사혈분수(LVEF)、좌실서장말기내경(LVEDD)、6 min보행거리、BNP급림상료효.결과 치료전대조조LVEF、LVEDD、6 min보행거리、BNP분별위(37.2±7.4)％、(57.6±7.4)mm、(312.8±21.6)m、(846.2±63.7) μg/L,관찰조분별위(38.5±8.1)％、(57.1±6.8)mm、(316.5 ±23.9)m、(857.6±61.4)μg/L,량조비교차이무통계학의의(P＞0.05).대조조치료후LVEF、LVEDD、6 min보행거리、BNP분별위(43.5±8.6)％、(54.3 ±6.4) mm、(511.6±26.7)m、(679.4±51.3) μg/L,여치료전비교차이유통계학의의(P＜0.05).관찰조치료후LVEF、LVEDD、6min보행거리、BNP분별위(51.6±9.2)％、(51.2±6.3)mm、(579.3±25.1)m、(536.5±50.6) μg/L,여치료전비교차이유통계학의의(P＜0.05).량조치료후LVEF、LVEDD、6 min보행거리、BNP비교차이유통계학의의(P＜0.05).관찰조적치료총유효솔위90.7％(39/43),현저고우대조조적72.1％(31/43),량조비교차이유통계학의의(x2=4.914,P＜ 0.05).결론 재상규치료기출상연합사용곡미타진가경호지개선ACM환자적심공능급심기중소,제고림상료효.
Objective To observe the effect of conventional therapy plus trimetazidine on alcoholic cardiomyopathy (ACM) and plasma brain natriuretic peptide (BNP).Methods Eighty-six cases of ACM patients were divided into control group and observation group by random digits table method with 43 cases each.Control group was treated with conventional therapy,while observation group was added trimetazidine.Course of treatment was 3 months.The left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),6 min walk distance,plasma BNP before and after treatment and the efficiency in two groups was observed and compared.Results LVEF,LVEDD,6 min walk distance,BNP before treatment in control group were respectively (37.2 ±7.4)％,(57.6 ±7.4) mm,(312.8 ±21.6) m,(846.2 ±63.7)μg/L,and the indicators in observation group were respectively (38.5 ±8.1)％,(57.1 ±6.8) mm,(316.5 ± 23.9) m,(857.6 ± 61.4) μ g/L.All indicators between two groups was no statistically different (P＞0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in control group were respectively (43.5 ±8.6)％,(54.3 ± 6.4) mm,(511.6 ± 26.7) m,(679.4 ± 51.3) μg/L,and there were significant difference compared with those before treatment (P ＜ 0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in observation group were respectively (51.6 ± 9.2)％,(51.2 ± 6.3) mm,(579.3 ± 25.1) m,(536.5 ± 50.6)μ g/L,and there were significant difference compared with those before treatment (P ＜ 0.05).There were significant difference in LVEF,LVEDD,6 min walk distance and BNP after treatment between two groups (P ＜ 0.05).The total effective rate in observation group was 90.7％ (39/43),which was significantly higher than that in control group [72.1％ (31/43)] (x2 =4.914,P ＜ 0.05).Conclusion Adding trimetazidine on the basis of conventional therapy can improve the cardiac function and myocardial remodeling of ACM patients and improve clinical efficacy.