曲美他嗪治疗老年陈旧性心肌梗死合并慢性心力衰竭的疗效及对再住院率的影响  

Effect of trimetazidine on heart failure and the rate of rehospitalization in patients after chronic myocardial infarction

作　　者：赵霞[1] 茹静[1] 汤莉莹[1] 

机构地区：[1]北京市朝阳医院(京西院区)干部综合科,北京市100043

出　　处：《实用老年医学》2010年第3期216-218,共3页Practical Geriatrics

摘　　要：目的观察曲美他嗪治疗老年陈旧性心肌梗死合并慢性心力衰竭的疗效及对再住院率的影响。方法回顾2006年3月至2008年9月住我院的160例陈旧性心肌梗死并出现慢性心力衰竭的老年患者,分为曲美他嗪组(80例)和对照组(80例)。2组疗程均为6月。全部入选患者在用药前和用药6月时分别行B型脑钠肽、NYHA分级、超声心动图评价心脏功能的改善。随访6月内的再住院次数。结果对照组左室射血分数(LVEF)提高,但心排血量(CO)、心排血指数(CI)无显著变化;而治疗组加用曲美他嗪后能显著改善LVEF及NY-HA分级,且能显著增加CO(P<0.05)。另外对照组及曲美他嗪组B型脑钠肽水平均降低(P<0.01或P<0.05),但曲美他嗪组血浆B型脑钠肽水平降低及心功能改善更显著(P<0.05)。曲美他嗪组再住院次数较对照组明显减少,差异显著(P<0.05)。用药6月后患者心率、血压、平均动脉压在组间比较均无显著差异。结论在常规治疗陈旧性心肌梗死合并慢性心力衰竭基础上加用曲美他嗪可以明显改善心脏功能,降低再住院率。Objective To observe the effects of trimetazidine on post-infarction chronic heart failure in aged patients and analyse the rate of rehospitalization. Methods The clinical data of 160 cases of chronic heart failure after myocardial infarction were reviewed,and those cases were divided into control group（80 cases）and trimetazidine group（80 cases）. The observation lasted for 6 months. The measurement of echocardiography NYHA functional class and BNP were performed prior to and after the study to evaluate the improvement of cardiac function. The rate of rehospitalization was also analysed. Results The level of LVEF was improved in control group. The levels of LVEF,CO,CI were significantly improved in trimetazidine group. The level of BNP was significantly lower in trimetazidine group than that in control group（P〈0.05）.The trimetazidine group had lower rate of rehospitalization（P〈0.05）.There was no singnificant difference in heart rate,blood pressure,biochemical tests between the two groups after 6 months. Conclusions Trimetazidine can improve cardiac function and decrease the rate of rehopitalization in the patients with heart failure after myocardial infarction.

关 键 词：曲美他嗪 陈旧性心肌梗死合并心力衰竭 再住院率 老年人 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]