曲美他嗪联合运动康复对慢性心力衰竭患者心肾功能及甲状旁腺素的影响  

Impact of Trimetazidine Combined with Exercise Rehabilitation on Heart-kidney Function and Parathyroid Hormone in Patients with Chronic Cardiac Failure

作　　者：王楠[1] 张双[1] 刘永政[1] 王倩[1] 刘立杰[2] 刘淑华[1] 柳东田[1] WANG Nan;ZHANG Shuang;LIU Yong-zheng;WANG-Qian;LIU Li-jie;LIU Shu-hua;LIU Dong-tian(The First Department of Cardiology, the First Hospital of Qinhuangdao, Qinhuangdao 066000, China;The First Department of Oncology, the First Hospital of Qinhuangdao, Qinhuangdao 066000, China)

机构地区：[1]河北省秦皇岛市第一医院心内一科,066000 [2]河北省秦皇岛市第一医院肿瘤一科,066000

出　　处：《实用心脑肺血管病杂志》2018年第3期104-108,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：秦皇岛市科学技术研究与发展计划项目(201703A049)

摘　　要：目的探讨曲美他嗪联合运动康复对慢性心力衰竭(CHF)患者心肾功能及甲状旁腺素(PTH)的影响。方法选取2015年8月—2016年12月秦皇岛市第一医院心内科收治的CHF患者82例,采用随机数字表法分为对照组和联合组,每组41例。在标准化抗心力衰竭治疗基础上,对照组患者给予曲美他嗪治疗,联合组患者在对照组基础上加用运动康复;两组患者均连续治疗24周。比较两组患者治疗前及治疗后12、24周心功能指标,肾功能指标,血清PTH、脑钠肽(BNP)、心肌肌钙蛋白I(c Tn I)水平,临床疗效;并观察两组患者治疗期间不良反应发生情况。结果治疗前两组患者左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)、左心室质量指数(LVMI)、美国纽约心脏病协会(NYHA)分级比较,差异无统计学意义(P>0.05);治疗后12、24周联合组患者LVESV、LVEDV、LVMI低于对照组,LVEF高于对照组,NYHA分级优于对照组(P<0.05)。治疗前两组患者尿素氮(BUN)、血肌酐(Scr)、胱抑素C(Cys-C)、估算的肾小球滤过率(e GFR)比较,差异无统计学意义(P>0.05);治疗后12、24周联合组患者BUN、Scr、Cys-C低于对照组,e GFR高于对照组(P<0.05)。治疗前两组患者血清PTH、BNP、c Tn I水平比较,差异无统计学意义(P>0.05);治疗后12、24周联合组患者血清PTH、BNP、c Tn I水平低于对照组(P<0.05)。联合组患者临床疗效优于对照组(P<0.05)。两组患者治疗期间均未出现明显不良反应。结论曲美他嗪联合运动康复可有效改善CHF患者心肾功能,降低血清PTH水平,临床疗效确切且安全性较高。Objective To investigate the impact of trimetazidine combined with exercise rehabilitation on heart-kidney function and parathyroid hormone（PTH） in patients with chronic cardiac failure（CHF）. Methods From August 2015 to December 2016, a total of 82 patients with CHF were selected in the First Department of Cardiology, the First Hospital of Qinhuangdao, and they were divided into control group and combination group according to random number table, each of 41 cases. Based on standardized anti-heart failure treatment, patients in control group received trimetazidine, while patients in combination group received trimetazidine combined with exercise rehabilitation; both groups continuously treated for 24 weeks. Index of cardiac function and renal function, serum levels of PTH, BNP and c Tn I before treatment, 12 and 24 weeks after treatment, and clinical effect were compared between the two groups, and incidence of adverse reactions was observed during treatment. Results No statistically significant differences of LVESV, LVEDV, LVEF, LVMI or NYHA grade was found between the two groups before treatment（P〉0.05）; 12 and 24 weeks after treatment, LVESV, LVEDV and LVMI in combination group were statistically significantly lower than those in control group, LVEF in combination group was statistically significantly higher than that in control group, respectively, NYHA grade in combination group was statistically significantly better than that in control group, respectively（P〈0.05）. No statistically significant differences of BUN, Scr, Cys-C or e GFR was found between the two groups before treatment（P〉0.05）; 12 and 24 weeks after treatment, BUN, Scr and Cys-C in combination group were statistically significantly lower than those in control group, while e GFR in combination group was statistically significantly higher than that in control group（P〈0.05）. No statistically significant differences of serum level of PTH, BNP or c Tn I was found between the two groups before treatment（P〉0.05）,

关 键 词：心力衰竭 曲美他嗪 运动康复 心肾功能 甲状旁腺素 

分 类 号：R541.6[医药卫生—心血管疾病]