目的 探討曲美他嗪結(jié)合常規(guī)抗心衰療法治療擴(kuò)張型心肌病的臨床效果及對(duì)患者心功能的影響作用。方法 回顧性分析雅安職業(yè)技術(shù)學(xué)院附屬醫(yī)院心血管內(nèi)科2013年5月-2014年9月治療的109例擴(kuò)張型心肌病患者的臨床資料，其中62例患者采用常規(guī)抗心衰療法治療（常規(guī)組），47例患者加用曲美他嗪20 mg，3次/d（曲美他嗪組），兩組患者均連續(xù)治療3個(gè)月。采用NYHA標(biāo)準(zhǔn)對(duì)兩組患者治療結(jié)束后的心功能進(jìn)行評(píng)價(jià)并進(jìn)行比較；對(duì)比兩組患者治療前后的超聲心動(dòng)圖指標(biāo)的變化情況；對(duì)比兩組患者治療前后的血漿N末端腦鈉肽前體（NT-proBNP）的變化情況。結(jié)果 治療后曲美他嗪組患者的NYHA分級(jí)與常規(guī)組比較差異具有統(tǒng)計(jì)學(xué)意義，曲美他嗪組的Ⅰ級(jí)、Ⅱ級(jí)心功能患者率高于常規(guī)組（P<0.05）。治療前，曲美他嗪組和常規(guī)組患者的LVEF%、LVEDd、EDV、ESV、FS測(cè)定值差異無(wú)統(tǒng)計(jì)學(xué)意義；治療后，曲美他嗪組患者的LVEF%、LVEDd、EDV、ESV、FS測(cè)定值顯著的優(yōu)于常規(guī)組患者（P<0.05）。治療前，曲美他嗪組和常規(guī)組患者的NT-proBNP水平差異無(wú)統(tǒng)計(jì)學(xué)意義；治療后，曲美他嗪組患者的NT-proBNP水平顯著的低于常規(guī)組患者（P<0.05）。治療后，曲美他嗪組患者的顯效率42.55%高于常規(guī)組的27.42%、無(wú)效率4.26%低于常規(guī)值的14.52%，治療后曲美他嗪組的療效優(yōu)于常規(guī)組（P<0.05）。結(jié)論 曲美他嗪結(jié)合常規(guī)抗心衰療法治療擴(kuò)張型心肌病能夠進(jìn)一步改善患者的心功能，降低NT-proBNP水平。

Objective To discuss the clinical effect and influence of Sibutramine trimetazidine combined with routine anti heart failure therapy on the cardiac function of the patients with dilated cardiomyopathy. Methods A retrospective analysis of dilated cardiomyopathy patients (109 cases) in Vasculocardiology Deparment of Affiliated Hospital of Ya'an Vocational College from May 2013 to September 2014, in which 62 patients were treated with conventional anti-heart failure therapy (conventional group), 47 patients plus song TMZ 20 mg, 3 times/d (trimetazidine group), patients were treated for 3 consecutive months, and the clinical effects were compared. Results After treatment, the NYHA classification of Sibutramine trimetazidine group was statistically significant compared with conventional treatment group (P<0.05). Before treatment, LVEF%, LVEDd, EDV, ESV, and FS of patients in Sibutramine trimetazidine group and conventional group had no significant difference; After treatment, LVEF%, LVEDd, EDV, ESV, and FS of patients in Sibutramine trimetazidine group were significantly superior to the patients in conventional group (P<0.05). Before treatment, the difference of NT-proBNP level between Sibutramine trimetazidine group and conventional group was not statistically significant; After treatment, the NT-proBNP level in Sibutramine trimetazidine group was significantly lower than conventional group (P<0.05). After treatment, the significant efficiency in Sibutramine trimetazidine group (42.55%) was higher than that (27.42%) in conventional group, and the inefficiency in Sibutramine trimetazidine group was 4.26%, lower than conventional group of 14.52%. After treatment the efficacy of in Sibutramine trimetazidine group was better than the conventional group (P<0.05). Conclusion Sibutramine trimetazidine combined with conventional anti-heart failure therapy for dilated cardiomyopathy can further improve cardiac function and reduce the level of NT-proBNP.