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目的:研究曲美他嗪对慢性心力衰竭患者血管内皮功能的影响。方法:选择2013年1月~2015年12月在我院进行诊治的慢性心力衰竭患者158例为研究对象,采用奇偶数法随机分为两组,每组79例。对照组采用利尿、平衡电解质、扩血管、营养心肌等常规抗心衰治疗,观察组联合采用曲美他嗪治疗。分别于治疗前和治疗后1个月检测两组患者的血流介导血管舒张功能、内皮素-1水平、一氧化氮水平、心率、血压、白细胞计数、血肌酐和谷丙转氨酶水平。结果:治疗后,观察组的血流介导血管舒张功能明显高于治疗前(P<0.05),且肱动脉内径和血流介导血管舒张功能均明显高于对照组(P<0.05);两组的血浆内皮素-1均较治疗前降低(P<0.05),一氧化氮升高(P<0.05),且观察组的血清内皮素-1水平明显低于对照组,血清一氧化氮水平明显高于对照组(P<0.05);两组的心率、血压、肾功能、肝功能和血常规结果相比差异均无统计学意义(P>0.05),且两组均无明显不良反应发生。结论:曲美他嗪可显著改善慢性心力衰竭患者的血管内皮功能,可能与其降低血浆内皮素-1水平、升高一氧化氮水平有关。
Objective: To study the effect of trimetazidine on vascular endothelial function in patients with chronic heart failure. Methods: A total of 158 patients with chronic heart failure who were diagnosed and treated in our hospital from January 2013 to December 2015 were selected as subjects. They were randomly divided into two groups (n = 79). Control group used diuretic, balanced electrolyte, vasodilators, nutritional heart and other conventional anti-heart failure treatment, the observation group was treated with trimetazidine. Blood flow-mediated vasodilation, endothelin-1, nitric oxide, heart rate, blood pressure, white blood cell count, serum creatinine, and alanine aminotransferase levels were measured before treatment and one month after treatment. Results: After treatment, the blood flow induced vasodilation in observation group was significantly higher than that before treatment (P <0.05), and the diameter of brachial artery and vasodilation function were significantly higher than those in control group (P <0.05). The levels of plasma endothelin-1 in both groups were lower than those before treatment (P <0.05), and the levels of nitric oxide were increased (P <0.05). The serum endothelin-1 levels in the two groups were significantly lower than those in the control group. Serum nitric oxide (P <0.05). There was no significant difference in heart rate, blood pressure, renal function, liver function and blood routine results between the two groups (P> 0.05), and no significant adverse reactions were found between the two groups occur. Conclusion: Trimetazidine can significantly improve the vascular endothelial function in patients with chronic heart failure, which may be related to the decrease of plasma endothelin - 1 and the increase of nitric oxide.