目的 觀察曲美他嗪治療冠心病心功能不全的臨床療效.方法 選取2011年2月—2014年1月攀枝花市第二人民醫(yī)院收治的冠心病心功能不全患者92例,隨機分為對照組(46例)和治療組(46例).對照組給予常規(guī)治療方案,治療組在對照組基礎上口服鹽酸曲美他嗪片,20 mg/次,3次/d.兩組均治療4個月.治療后,評價兩組的臨床療效,同時比較兩組患者心肌酶譜和心功能指標的變化.結果 治療組和對照組的顯效率分別為58.70%、34.78%,兩組比較差異有統(tǒng)計學意義(P<0.05).治療3 d后,兩組患者肌鈣蛋白I(cTnI)、肌鈣蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)及肌紅蛋白(Mb)均較同組治療前顯著下降,同組治療前后差異有統(tǒng)計學意義(P<0.05);治療后治療組這些指標低于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).治療后,兩組患者的左室舒張末期內徑(LVEDD)、左室收縮末期內徑(LVESD)、平均動脈壓(MAP)均較治療前顯著降低,左室射血分數(shù)(LVEF)較治療前升高,同組治療前后差異有統(tǒng)計學意義(P<0.05),治療后治療組這些指標的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).結論 曲美他嗪治療冠心病心功能不全具有較好的臨床療效,可改善患者心肌損害狀況,促進心功能恢復,建議臨床推廣應用.

Objective To explore the efficacy of trimetazidine in treatment of coronary heart disease complicated with cardiac insufficiency. Methods Patients (92 cases) with coronary heart disease complicated with cardiac insufficiency from February 2011 to January 2014 were randomly divided into treatment (46 cases) and control (46 cases) groups. The patients in the control group were given conventional treatment. The patients in the treatment group were po administered with Trimetazidine Tablets, 20 mg/time, three times daily. The patients in the two groups were treated for 4 months. After the treatment, the treatment efficacy was evaluated, while the changes of myocardial enzyme spectrum and indexes of cardiac function were compared. Results The significant efficiency in the treatment and control groups were 58.70% and 34.78%, respectively, and there were differences between the two groups (P < 0.05). After treatment, cTnI, cTnT, CK-MB, and Mb were decreased significantly in two groups on day 3 of treatment, and the difference was statistically significant in the same group (P < 0.05). After treatment, these indexes in treatment group were lower than those in the control group, with the significant difference between two groups (P < 0.05). After treatment, LVEDD, LVESD, and MAP in two groups were decreased significantly, and LVEF was elevated, and the differences were statistically significant in the same group (P < 0.05). After treatment, these indicators in the treatment group improved better than those of control group, with the significant difference between two groups (P < 0.05). Conclusion Trimetazidine has good clinical effect in treatment of coronary heart disease complicated with cardiac insufficiency, and can improve situation of myocardial damage and promote recovery of heart function, which is worthy of clinical application.

國家自然科學基金資助項目(30900626)