曲美他嗪对充血性心力衰竭患者心功能、血浆BNP及Hcy水平的影响  

Influence of trimetazidine on cardiac function,plasma levels of BNP and Hcy in patients with congestive heart failure

作　　者：冯振勤[1] 周伟伟[1] 赵波[1] 

机构地区：[1]江苏大学附属昆山医院心血管内科,江苏昆山215300

出　　处：《心血管康复医学杂志》2017年第4期424-427,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨曲美他嗪对充血性心力衰竭(CHF)患者心功能、炎症因子、脑钠肽(BNP)及同型半胱氨酸(Hcy)水平的影响及其疗效。方法:选择我院心内科120例明确诊断为CHF的患者,按照随机数字表分为常规治疗组和曲美他嗪组(在常规治疗组的基础上加服曲美他嗪,20mg/次,2次/d),各60例,治疗6个月,观察两组治疗前后左心室等容舒张时间(LVRT)、E峰减速时间(EDT)、左室舒张早期峰值血流速度/舒张晚期峰值血流速度比值(E/A)、左心房内径(LAD)等心功能指标及白介素(IL)-6、肿瘤坏死因子α(TNF-α)、BNP及Hcy水平的变化。结果:治疗6个月后,曲美他嗪组总有效率明显高于常规治疗组(93.3%比80.0%,P=0.032);与常规治疗组比较,曲美他嗪组治疗后LVRT[(92.1±4.6)ms比(74.5±2.7)ms]、EDT[(165.3±5.1)ms比(139.2±3.9)ms]、LAD[(41.1±2.6)mm比(33.1±1.8)mm]均显著减小,E/A比值[(0.89±0.21)比(1.16±0.51)]显著增加(P均<0.01);血清IL-6[(16.3±2.8)ng/ml比(11.3±1.3)ng/ml]、TNF-α[(3.17±0.99)ng/ml比(2.01±1.12)ng/ml]、BNP[(311.4±27.9)pg/ml比(278.2±31.3)pg/ml]及Hcy[(15.6±4.2)pg/ml比(11.3±2.7)pg/ml]水平均明显降低(P均<0.01)。结论:曲美他嗪治疗充血性心力衰竭,可明显改善心功能,降低炎症因子水平,抑制心房重构,疗效显著。Objective： To explore influence of trimetazidine on cardiac function, levels of inflammatory factors, brain natriuretic peptide （BNP） and homocysteine （Hcy） in patients with congestive heart failure （CHF） and its therapeutic effect. Methods： A total of 120 patients diagnosed as CHF in our department were selected. According to random number table, they were randomly and equally divided into routine treatment group and trimetazidine group （received trimetazidine based on routine treatment group, 20mg/time, twice/d）, both groups were treated for six months. Left ventricular relaxation time （LVRT）, E peak decrease time （EDT）, early diastolic peak velocity/late diastolic peak velocity （E/A）, left atrial diameter （LAD）, levels of interleukin （IL） -6, tumor necrosis factor （TNF） -a, BNP and Hey were measured and compared between two groups before and after treatment. Results： Af- ter six-month treatment, total effective rate of trimetazidine group was significantly higher than that of routine treatment group （93.3% vs. 80.0%, P = 0. 032）] compared with routine treatment group after treatment, there were significant reductions in LVRT [（92.1±4.6） ms vs. （74. 5±2.7） ms], EDT [ （165.3 ＋ 5.1） ms vs. （139.2 ＋3.9） ms] and LAD[ （41.1±2.6） mmvs. （33.1±1.8） mini, and significant rise inE/A[（0.89±0.21） vs. （1.16 ±0. 51）] （P（0.01 all）] and significant reductions in serum levels of IL-6 [（16.3±2.8） ng/ml vs. （11.3 ±1.3） ng/ml], TNF-a [（3.17±0. 99） ng/ml vs. （2. 01±1.12） ng/ml], BNP [（311.4±27. 9） pg/ml vs. （278. 2±31.3） pg/ml] and Hcy [（15.6±4. 2） pg/ml vs. （11.3±2.7） pg/ml] in trimetazidine group, P（0.01 all. Conclu- sion： Trimetazidine can significantly improve heart function, reduce inflammatory factor levels and inhibit atrium remodeling in patients with congestive heart failure, and the therapeutic effect is significant.

关 键 词：心力衰竭 利钠肽 脑 高半胱氨酸 曲美他嗪 

分 类 号：R541.61[医药卫生—心血管疾病]