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目的观察曲美他嗪对老年心肌梗死后心力衰竭的保护作用,探讨防治心力衰竭的途径。方法 100例既往心肌梗死合并心力衰竭的老年患者(年龄>60岁),随机分为药物组(n=55)和对照组(n=45),对照组常规治疗,治疗组在对照组治疗基础上加服盐酸曲美他嗪片。观察治疗后心源性死亡、心衰入院、需要行冠脉介入术或搭桥术等复合终点事件、心超指标、心功能分级(NYHA)及6min步行距离的改善情况。结果和对照组相比,12月后曲美他嗪能明显减少复合终点事件(P<0.01),增加左心室射血分数(43.1±6.3%VS39.7±4.8%,P<0.05),提高了6min步行距离(455±56mVS422±43m,P<0.01)。结论曲美他嗪对老年心肌梗死后心力衰竭有保护作用。
Objective To observe the protective effect of trimetazidine on heart failure after myocardial infarction in elderly patients and to explore ways to prevent and treat heart failure. Methods Elderly patients (> 60 years old) with previous myocardial infarction complicated with heart failure were randomly divided into two groups: the drug group (n = 55) and the control group (n = 45). The control group received routine treatment. Trimetazidine hydrochloride tablets on the clothes. Cardiac death after treatment and hospitalization for heart failure were observed, and composite end points such as coronary intervention or bypass surgery were required. Cardiac function, NYHA, and 6-minute walking distance were assessed. Results Compared with the control group, trimetazidine could significantly reduce the composite end point (P <0.01) and increase the left ventricular ejection fraction (43.1 ± 6.3% vs 39.7 ± 4.8%, P <0.05) after 12 months 6min walk distance (455 ± 56mVS422 ± 43m, P <0.01). Conclusion Trimetazidine has a protective effect on heart failure after myocardial infarction in the elderly.