CAJ | 학술논문

目的：评价盐酸曲美他嗪治疗冠心病合并左心室舒张功能不全的临床疗效。方法本研究连续入选冠心病合并左心室舒张功能不全的患者80例，并随机分为常规治疗组(40例)，给予心衰的标准治疗，以及盐酸曲美他嗪组(40例)，给予心衰的标准治疗基础上加用盐酸曲美他嗪(万爽力20mg，3次/日)。随访观察3个月，盐酸曲美他嗪治疗前后，应用心脏超声心动图评价左室射血分数(LVEF)；舒张早，晚期血流峰值E/A比值；二尖瓣口舒张早期的血流峰值速度（E）与二尖瓣环舒张早期峰值速度（e'）的比值E/e'的变化。结果治疗前两组间的临床基线指标无显著差异，但经过治疗，曲美他嗪组无论在临床症状及体征改善，还是在LVEF、E/A上升， E/e'下降等方面均显著优于常规组患者，P＜0.05。结论应用盐酸曲美他嗪的优化心肌代谢治疗可显著改善冠心病患者的左心舒张功能。
목적：평개염산곡미타진치료관심병합병좌심실서장공능불전적림상료효。방법본연구련속입선관심병합병좌심실서장공능불전적환자80례，병수궤분위상규치료조(40례)，급여심쇠적표준치료，이급염산곡미타진조(40례)，급여심쇠적표준치료기출상가용염산곡미타진(만상력20mg，3차/일)。수방관찰3개월，염산곡미타진치료전후，응용심장초성심동도평개좌실사혈분수(LVEF)；서장조，만기혈류봉치E/A비치；이첨판구서장조기적혈류봉치속도（E）여이첨판배서장조기봉치속도（e'）적비치E/e'적변화。결과치료전량조간적림상기선지표무현저차이，단경과치료，곡미타진조무론재림상증상급체정개선，환시재LVEF、E/A상승， E/e'하강등방면균현저우우상규조환자，P＜0.05。결론응용염산곡미타진적우화심기대사치료가현저개선관심병환자적좌심서장공능。
Objectives To evaluate the clinical curative effect of Trimetazidine in the treatment of coronary heart disease(CHD) combined with left ventricular diastolic dysfunction.Methods A total of 80 consecutive CHD patients with left ventricular diastolic dysfunction were enrolled and randomized to trimetazidine group(n=40) and control group(n=40). All patients received routine therapy for heart failure. Patients in trimetazidine group received trimetazidine 20mg three times daily. Three months of follow-up was conducted in all patients. Two-dimensional echocardiography and M-mode echocardiography including conventional and tissue Doppler imaging were used to evaluate left ventricular ejection fraction(LVEF), the ratio of mitral peak velocity of early filling(E) to mitral peak velocity of late filling(A)(E/A ratio) and the ratio of mitral peak velocity of early filling(E) to early diastolic mitral annular velocity(e')(E/e' ratio) before and after trimetazidine treatment.Results There were no significant differences between both groups in baseline characteristics. Total effective rate was significantly greater in trimetazidine group than that in routine treatment group(88% vs 62%,P<0.05). LVEF and E/A ratio were significantly increased and E/e' ratio were significantly deceased in the two groups. However, the changes were more significant in trimetazidine group than those in routine treatment group. Conclusion The optimizing myocardial metabolism therapy of Trimetazidine may improve the left ventricular diastolic function in CHD patients.