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目的探讨曲美他嗪(TMZ)对冠心病心力衰竭(CHF)患者的治疗作用及其对血管内皮依赖性舒张功能的影响。方法80例冠心病CHF患者随机分为治疗组和对照组,每组40例,对照组给予洋地黄类、利尿剂、血管扩张剂、血管紧张素转化酶抑制剂、β受体阻滞剂常规治疗;治疗组在常规治疗基础上加用TMZ治疗,两组均连续用药6个月。治疗前后进行多普勒超声心动图检查,评定心功能及血管内皮依赖性舒张功能的变化。结果治疗组心功能改善的临床显效率(45.0%)和总有效率(92.5%)均较对照组(25.0%和67.5%)显著提高(P<0.01),且无不良反应发生。治疗后治疗组患者左室射血分数、左室舒张末期容积、左室收缩末期容积、心排血量与血管内皮依赖性舒张功能指标均明显改善(P<0.01或<0.05),与对照组比较差异有统计学意义(P<0.01或<0.05)。结论TMZ有改善左心功能及血管内皮依赖性舒张功能的作用,是辅助治疗CHF的一种有效安全的药物。
Objective To investigate the therapeutic effect of trimetazidine (TMZ) on patients with coronary heart disease and heart failure (CHF) and its effect on endothelium-dependent vasodilatation. Methods Eighty patients with coronary heart disease and CHF were randomly divided into treatment group and control group, 40 cases in each group. The control group was given digitalis, diuretic, vasodilator, angiotensin converting enzyme inhibitor and beta blocker The treatment group was treated with TMZ on the basis of routine treatment, both groups were treated for 6 months continuously. Doppler echocardiography was performed before and after treatment to assess changes in cardiac function and endothelium-dependent vasodilation. Results The clinical effective rate (45.0%) and total effective rate (92.5%) in the treatment group were significantly higher than those in the control group (25.0% and 67.5%, P <0.01), and no adverse reactions occurred. After treatment, the left ventricular ejection fraction, left ventricular end-diastolic volume, left ventricular end-systolic volume, cardiac output and endothelium-dependent vasodilation were all significantly improved in the treatment group (P <0.01 or <0.05) The difference was statistically significant (P <0.01 or <0.05). Conclusion TMZ has the effect of improving left ventricular function and endothelium-dependent vasodilatation, and is an effective and safe adjuvant therapy for CHF.