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目的探讨曲美他嗪结合常规抗心衰疗法治疗扩张型心肌病的临床效果及对患者心功能的影响作用。方法回顾性分析雅安职业技术学院附属医院心血管内科2013年5月—2014年9月治疗的109例扩张型心肌病患者的临床资料,其中62例患者采用常规抗心衰疗法治疗(常规组),47例患者加用曲美他嗪20 mg,3次/d(曲美他嗪组),两组患者均连续治疗3个月。采用NYHA标准对两组患者治疗结束后的心功能进行评价并进行比较;对比两组患者治疗前后的超声心动图指标的变化情况;对比两组患者治疗前后的血浆N末端脑钠肽前体(NT-proBNP)的变化情况。结果治疗后曲美他嗪组患者的NYHA分级与常规组比较差异具有统计学意义,曲美他嗪组的Ⅰ级、Ⅱ级心功能患者率高于常规组(P<0.05)。治疗前,曲美他嗪组和常规组患者的LVEF%、LVEDd、EDV、ESV、FS测定值差异无统计学意义;治疗后,曲美他嗪组患者的LVEF%、LVEDd、EDV、ESV、FS测定值显著的优于常规组患者(P<0.05)。治疗前,曲美他嗪组和常规组患者的NT-pro BNP水平差异无统计学意义;治疗后,曲美他嗪组患者的NT-proBNP水平显著的低于常规组患者(P<0.05)。治疗后,曲美他嗪组患者的显效率42.55%高于常规组的27.42%、无效率4.26%低于常规值的14.52%,治疗后曲美他嗪组的疗效优于常规组(P<0.05)。结论曲美他嗪结合常规抗心衰疗法治疗扩张型心肌病能够进一步改善患者的心功能,降低NT-pro BNP水平。
Objective To investigate the clinical effect of trimetazidine combined with conventional anti-heart failure treatment on dilated cardiomyopathy and its effect on cardiac function. Methods The clinical data of 109 patients with dilated cardiomyopathy treated in Department of Cardiology, Affiliated Hospital of Ya’an Vocational and Technical College from May 2013 to September 2014 were retrospectively analyzed. Among them, 62 patients were treated with conventional anti-heart failure therapy (routine group) , 47 patients with trimetazidine 20 mg, 3 times / d (trimetazidine group), two groups of patients were treated for 3 months. The NYHA criteria were used to evaluate the cardiac function of the two groups after treatment. The changes of echocardiography before and after treatment were compared between the two groups. The changes of plasma N-terminal pro brain natriuretic peptide before and after treatment were compared NT-proBNP) changes. Results There was significant difference between the NYHA classification and the conventional group in the trimetazidine group after treatment. The patients with grade Ⅰ and Ⅱ cardiac function in the trimetazidine group were higher than those in the conventional group (P <0.05). Before treatment, the LVEF%, LVEDd, EDV, ESV and FS were not significantly different between the trimetazidine group and the conventional group. After treatment, the LVEF%, LVEDd, EDV, ESV, FS measured significantly better than the conventional group of patients (P <0.05). There was no significant difference in NT-pro BNP levels between the trimetazidine group and the conventional group before treatment. After treatment, NT-proBNP levels in the trimetazidine group were significantly lower than those in the conventional group (P <0.05) . After treatment, the effective rate of the patients in the trimetazidine group was 42.55% higher than that in the conventional group and 4.26% in the trimetazidine group, which was 14.52% lower than the conventional value. The effect of the trimetazidine group was better than that of the conventional group (P < 0.05). Conclusion Trimetazidine combined with conventional anti-heart failure treatment of dilated cardiomyopathy can further improve the patient’s cardiac function and reduce the level of NT-pro BNP.