优甲乐联合曲美他嗪治疗扩张型心肌病致心力衰竭的疗效观察  

Clinical efficacy of euthyrox combined with trimetazidine in the treatment of heart failure caused by dilated cardiomyopathy

作　　者：罗剑[1] 王振国[1] Luo Jian;Wang Zhenguo(Department of Cardiac Surgery,the Affiliated Hospital of Chinese People's Armed Police Forces Logistics Institute,Tianjin 300162,China)

机构地区：[1]中国人民武装警察部队后勤学院附属医院心外科,天津300162

出　　处：《广西医科大学学报》2018年第3期352-355,共4页Journal of Guangxi Medical University

基　　金：武警后勤学院基础研究基金资助项目(No.WHJ2014021)

摘　　要：目的:观察优甲乐联合曲美他嗪(TMZ)治疗扩张型心肌病(DCM)致心力衰竭(HF)的疗效。方法:将本院收治的86例DCM致HF患者随机分为接受优甲乐联合TMZ治疗的观察组(43例)和接受TMZ治疗的对照组(43例),比较两组治疗前后心室重构、TH水平及HF预后指标等变化情况。结果:观察组治疗总有效率高于对照组(P<0.05);两组血清基质金属蛋白酶-1(MMP-1)、血管紧张素Ⅱ(Ang-Ⅱ)和内皮素-1(ET-1)水平均显著下降(P<0.05),观察组各心室重构指标下降幅度均大于对照组(P<0.05);两组血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和外周血淋巴细胞β受体密度均明显升高(P<0.05),血浆B型脑钠肽(BNP)、血清可溶性Sema4D(sSema4D)和促甲状腺激素(TSH)水平均显著下降,观察组TH、BNP和sSema4D水平变化幅度均大于对照组(P<0.05);两组均无严重不良反应。结论:优甲乐联合TMZ治疗DCM致HF疗效显著,可有效改善心室重构和甲状腺素水平,改善心脏舒缩功能,安全性较高。Objective:To observe the curative effect of euthyrox combined with trimetazidine(TMZ)in treatment of heart failure(HF)caused by dilated cardiomyopathy(DCM).Methods:A total of 86 patients with HF caused by DCM in our hospital were selected and randomly divided into an observation group and a control group^with 43 cases in each group.The patients in the observation group were treated with euthy-rox and TMZ,nd those in the control group were treated with TMZ only.Changes in ventricular remode-ling before and after treatment?thyroid hormones(TH)level and prognosis were observed and compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P〈0.05).Serum levels of matrix metalloproteinase-(MMP-1),angiotensin II(Ang-n),endothelin-1(ET-1),soluble Sema4D(sSema4D),and thyroid stimulating hormone(TSH)as well as the plasma level of type B brain natriuretic peptide(BNP)were markedly decreased in both groups(P〈0.05),while the levels of free triiodothyronine(FT3)and free thyroxine(FT4)in serum and peripheral blood lymphocyte p receptor density were increased(P〈0.05).The changes of above indexes were more significant in the observation group than those in the control group(P〈0.05).TNo serious adverse reaction was noted in both groups.Conclusion:Euthyrox combined with TMZ was effective in the treatment of HF caused by DCM.This combination could improve ventricular remodeling,TH level and cardiac diastolic function,and was safe.

关 键 词：扩张型心肌病 心力衰竭 优甲乐 曲美他嗪 

分 类 号：R541.6[医药卫生—心血管疾病]