曲美他嗪联合辅酶Q10治疗高龄慢性心力衰竭患者的效果观察  

Clinical study of combination of trimetazidine/coenzyme as a adjunctive treatment in the elderly patients with chronic heart failure

作　　者：刘立新[1] 毕磊[1] 崔振双[1] 姚依群[1] 

机构地区：[1]北京军区总医院干一科,100700

出　　处：《中国综合临床》2016年第3期224-227,共4页Clinical Medicine of China

摘　　要：目的观察曲美他嗪联合辅酶Q10对高龄慢性心力衰竭患者的疗效和安全性。方法62例80岁以上慢性心力衰竭男性住院患者按抽签法随机分成治疗组和对照组，对照组给予常规抗心力衰竭治疗，治疗组在对照组治疗基础上加用曲美他嗪20mg3次／d、辅酶Q1020mg3次／d，共治疗6周。观察两组患者治疗前后的左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、血浆脑钠肽（BNP）、6min步行距离（6MWT）和NYHA心功能分级。结果治疗组、对照组治疗前NYHA分级为2．8±0．7、2．7±0．7，治疗后为2．1±0．6,2．4±0．7，治疗前、后比较差异均有统计学意义（t值分别为6．808、2．249，P〈0．01、P〈0．05）。两组治疗前BNP分别为（540±351）、（483±351）ng／L，治疗后分别为（219±172）、（316±202）ng/L，治疗前、后比较差异均有统计学意义（Z值分别为-4．927、-4．042，P均〈0．01）。治疗组治疗后的NYHA、血浆BNP浓度与对照组比较差异均有统计学意义（t值为-2．109，P〈0．05；z值为-2．219，P〈0．05）。治疗组治疗前LVEF、LVEDD、6MWT分别为（44．3±3．1）％、（54．0±4．7）mm、（217．0±60．9）m，治疗后分别为（46．8±3．9）％、（53．2±4．3）mm、（267．0±91．1）m，治疗前后比较差异均有统计学意义（t值分别为-8．313、2．254、-4．561，P〈0．01或0．05）。治疗组治疗后的LVEF、6MWT明显优于对照组[分别为（44．9±3．5）％、（213．2±78．1）m]（t值分别为2．000、2．186，P均〈0．05）。治疗组未发现明显的不良反应。结论常规治疗基础上联用曲美他嗪、辅酶Q10能够进一步改善高龄患者的心功能并且安全性良好。Objective To observe the efficacy and safety of trimetazidine/coenzyme QlO combination in the treatment of the elderly patients with chronic heart failure（CHF）. Methods Sixty-two male patients aged over 80 years with CHF were randomly divided into intervention group and control group. Patients in control group received optimal conventional CHF therapy according to the guideline for CHF, while patients in intervention group received trimetazidine of 20 mg,3 times per day, coenzyme Q10 20 mg,3 times per day, additionally for 6 weeks. Left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （ LVEDD ）, plasma brain natriuretie peptide （ BNP ）, 6 min walking distance （6MWT） and NYHA cardiac function classification of two groups before and after treatment were observed. Results Before treatmen, the NYHA function class of patients in intervention and control groups were 2. 8±0. 7,2. 7±0.7 respectively, after treatment were 2. 1 ± 0. 6,2.4 ±0. 7 respectively, the differences were significant before and after treatment （ t = 6. 808,2. 249; P〈0. 01, P〈 0. 05）. Before treatment, BNP of intervention and control groups were （540±351 ） ng/L, （483±351） ng/L respectively, after treatment were （ 219± 172） ng/L, （ 316±202 ） ng/L respectively, the differences were significant before and after treatment （ Z = - 4. 927, - 4. 042; P 〈 0. 01 ） . Moreover, after treatment, NYHA function class and plasma BNP in intervention group were significantly better than those in control group （ t = - 2. 109, P 〈 0. 05 ; Z = - 2. 219, P 〈 0.05 ）. Before treatment, LVEF, LVEDD and 6MWT of intervention group were （ 44. 3 ±3.1 ） %, （ 54. 0 ± 4.7 ） mm and （ 217.0±60. 9 ） m respectively, after treatment were （46. 8±3.9）%, （53.2±4. 3）mm and （267.0±91.1）m respectively, the differences were significant before and after treatment（t= -8. 313,2. 254, -4. 561 ; P〈0. 01 or P〈0. 05）. Moreover, after treatment, LVEF and 6MWT in interve

关 键 词：曲美他嗪 辅酶Q10 心力衰竭 高龄 男性 

分 类 号：R541.61[医药卫生—心血管疾病]