曲美他嗪对老年糖尿病心肌病慢性心力衰竭患者心功能的影响

摘要

目的 研究曲美他嗪对老年糖尿病心肌病(diabetic cardiomyopathy,DCM)慢性心力衰竭患者心功能的影响.方法 DCM慢性充血性心力衰竭患者41例,其中男21例,女20例,年龄65 ～ 75岁,平均年龄(71.3+4.7)岁,随机分为对照组和治疗组.对照组给予标准药物治疗,治疗组在标准药物治疗基础上给予曲美他嗪治疗.观察两组治疗前、治疗后1年的纽约心脏病学会(NYHA)心功能分级、左室射血分数(LVEF)、6分钟步行距离(6MWD)和血浆脑利钠肽(BNP).结果 两组治疗后NYHA心功能分级、LVEF、6MWD、BNP均较治疗前有明显改善,差异有统计学意义(P＜0.05).治疗组NYHA心功能分级(2.1+0.3),对照组(2.5+0.3),P＜0.05差异有统计学意义.治疗组LVEF为(51.1±4.5)％,对照组LVEF为(43.1+5.5)％,P＜0.05差异有统计学意义.治疗组6MWD为(364.1 +21.6)m,对照组6MWD为(280.0+22.4)m,P＜0.05差异有统计学意义.治疗组BNP为(113.0±22.4)ng/mL,对照组BNP为(221.6+26.4)ng/mL,P＜0.05差异有统计学意义.结论 曲美他嗪能改善老年DCM慢性心力衰竭患者心功能.%Objective To observe the effect of trimetazidine on the Cardiac function in aged Patients with chronic Heart Failure due to diabetic cardiomyopathy (DCM).Methods Forty-one aged patients with chronic congestive heart failure due to DCM (21mates and 20 females) were randomly divided into control and treatment group.Standard therapy was given to the patients in control group,but trimetazidine was added in treatment group.NYHA classification,left ventricular ejection (LVEF),6-minute walking distance (6MWD) and brain natriuretic peptide (BNP) were measured in both groups before and after 1 year treatment.Results NYHA classification,LVEF,6MWD BNP were improved after treatment in both groups (P ＜ 0.05).NYHA classification were (2.1 +0.3) in treatment group but (2.5 +0.3) in control group (P＜0.05).[LVEF％ was (51.1+4.5) ％ in treatment group but (43.1±5.5) ％ m control group.(P＜0.05).6MWD were (364.1+21.6) meters in treatment group but (280.0+22.4) meters in control group (P＜0.05).BNP were (113.0+22.4) ng/mL in treatment group but (221.6+26.4) ng/mL in control group (P＜0.05).Conclusion Trimetazidine can improve the Cardiac function in aged Patients with chronic Heart Failure due to DCM.