曲美他嗪治疗冠心病心力衰竭近期疗效评价

目的探讨曲美他嗪治疗冠心病心力衰竭的临床疗效．方法根据治疗方案将114例冠心病心力衰竭患者分为两组，57例患者实施常规治疗为对照组，57例患者在常规治疗基础上加用曲美他嗪治疗为观察组，疗程6个月，比较两组患者的临床指标改变情况、治疗效果、药物不良反应情况．结果治疗后，两组患者左室射血分数、心输出量、左室短轴缩短率、6min步行距离、每搏输出量均显著增加，两组患者左室舒张末期内径、左室收缩末期内径、血浆B型钠尿肽均显著减小；观察组患者左室射血分数、心输出量、左室短轴缩短率、6min步行距离、每搏输出量均明显大于对照组；观察组患者左室舒张末期内径、左室收缩末期内径、血浆B型钠尿肽均明显小于对照组；观察组患者治疗总有效率明显高于对照组，差异均具有统计学意义（P〈0．05）；观察组患者药物不良反应发生率高于对照组，但差异无统计学意义（P〉0．05）．结论曲美他嗪是治疗冠心病心力衰竭的有效药物，可明显改善患者的临床指标，提高治愈率，药物不良反应少，且安全性高，值得临床推广使用．

Evaluation on the Short-Term Curative Effect of Trimetazidine in the Treatment of Heart Failure Secondary to Coronary Heart Disease

Objective To investigate the clinical effect of trimetazidine in the treatment of heart failure secondary to coronary heart disease. Method 114 patients with heart failure secondary to coronary heart disease were divided into two groups. 57 patients receiving the routine treatment were taken as control group and 57 patients treated with trimetazidine were taken as observation group. The course of treatment was 6 months. Clinical index changes ,therapeutic effects and drug adverse reaction were compared between two groups. Results After the treatment,left ventricular injection fraction, cardiac output, left ventricular fractional shortening, 6-minute walk test distance and stroke volume increased significantly in both groups. Left ventricular end-diastolic dimension, left ventrieular-end systolic diameter and brain natriuretic peptide decreased significantly in both groups. Left ventlicular ejection fraction, cardiac output, left ventricular fractional shortening and 6-minute walk test distance and stroke volume in the observation group were significantly larger than those in the control group. Left ventricular end-diastolic dimension, left ventricular-end systolic diameter and brain natriuretic peptide in the observation group were significantly smaller than that in the control group. The total effective rate in the observation group was significantly higher than those in the control group and the difference was statistically significant（P 〈0.05）. The incidence of drug adverse reactions in the observation group was higher than that in the control group, but the difference was not statistically significant （ P 〉 0.05 ）. Conclusion Trimetazidine is an effective drug in the treatment of heart failure secondary to coronary heart disease, and can significantly improve the clinical indexes and the cure rate. Trimetazidine can induce few adverse reaction, it has high safety and is worthy of clinical use.