曲美他嗪辅助治疗糖尿病心肌病156例临床分析  

Trimetazidine Treatment of 156 Patients with Diabetic Cardiomyopathy

作　　者：郑焱玲[1] 陈刘[1] 刘颖[1] 唐能华 欧敏[2] 雷小添 程立庆[1] 龙崇荣[2] 

机构地区：[1]第三军医大学西南医院内分泌科,重庆400038 [2]重庆市沙坪坝区人民医院内分泌科,重庆400030

出　　处：《贵州医科大学学报》2017年第12期1465-1468,1477,共5页Journal of Guizhou Medical University

基　　金：中华医学会临床医学科研专项资金(13040630448);中华国际医学交流基金会青年医生糖尿病研究项目(2015-N-08)

摘　　要：目的:观察曲美他嗪辅助治疗糖尿病心肌病(DC)的临床疗效。方法:将156例DC患者按随机数字法分为治疗组(81例)与对照组(75例),采用常规内科治疗;治疗组在常规内科治疗基础上口服曲美他嗪,测定治疗前后各组的空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、E/A比值、心电图Q-T离散度(Q-Td),超敏C反应蛋白(HsCRP)和肿瘤坏死因子(TNF-α)。结果:与治疗前比较,两组患者治疗后血糖、总胆固醇、甘油三酯、LDL、HDL均较治疗前有所改善(P<0.05),其中治疗组总胆固醇、甘油三酯、LDL、HDL改善幅度较对照组大(P<0.05);Q-Td均较治疗前有所降低(P<0.05),其中治疗组降低幅度较对照组幅度大(P<0.05);E/A比值均较治疗前有显著增高(P<0.05),其中治疗组改善幅度较对照组显著(P<0.05);HsCRP和TNF-α均较治疗前下降明显(P<0.05),其中治疗组HsCRP和TNF-α改善幅度与对照组相比更为明显(P<0.05)。结论:曲美他嗪对临床糖尿病心肌病有一定辅助治疗效果。Objective： To investigate the efficacy of Trimetazidine in 156 patients with diabetic cardiomyopathy. Methods： 156 patients were randomly divided into Trimetazidine treatment group（ n =81） and the control group（ n = 75）,both received conventional medical treatment. Treatment group received further Trimetazidine treatment. Blood glucose,HbA1C,blood lipids（ total cholesterol,triglycerides,LDL,HDL）,E/A ratio,ECG QT dispersion,High-sensitive C-reactive protein（ HsCRP）and TNF-αwere tested before and after treatment. Results： Compared with before treatment,blood glucose,total cholesterol,triglycerides,LDL,HDL were improved significantly in both group after treatment（ P〈0. 05）; in treatment group,total cholesterol,triglycerides,LDL,HDL improved much more than control group（ P〈0. 05）; QT dispersion decreased compared with before treatment（ P〈0.05）,of which treatment decreased much more tan control group（ P〈0. 05）; E/A ratio improved compared with before treatment（ P〈0. 05）,of which treatment group improved much more than control group（ P〈0. 05）; HsCRP and TNF-αdecreased compared with before treatment（ P〈0. 05）,of which HsCRP and TNF-α improvement were more obvious compared with control group（ P〈0. 05）. Conclusion： Trimetazidine can assist the treatment of diabetic cardiomyopathy.

关 键 词：曲美他嗪 糖尿病 心肌病 治疗效果 心功能 超敏C反应蛋白 肿瘤坏死因子 

分 类 号：R587.1[医药卫生—内分泌] R542.2[医药卫生—内科学]