不同剂量曲美他嗪辅助治疗扩张型心肌病心力衰竭患者的疗效比较及血清相关细胞因子水平分析  

Comparison of Efficacy of Different Doses of Trimetazidine in Adjuvant Treatment of Heart Failure Patients with Dilated Cardiomyopathy and Analysis of Serum Related Cytoki

作　　者：李瑾[1] 刘江峰[1] 符赵鑫 LI Jin;LIU Jiangfeng;FU Zhaoxin(Xinxiang First People′s Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市第一人民医院,河南新乡453000

出　　处：《岭南心血管病杂志》2023年第2期180-183,189,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的分析不同剂量曲美他嗪辅助治疗扩张型心肌病(dilated cardiomyopathy,DCM)心力衰竭患者的疗效。方法选取新乡市第一人民医院2020年1月至2021年1月期间收治的DCM心力衰竭患者86例作为研究对象,依据随机抽签法分成研究组与对照组,分别43例。两组患者均接受常规治疗,研究组予以大剂量曲美他嗪治疗,对照组予以常规剂量曲美他嗪治疗,比较两组的临床疗效、不良反应以及治疗前、治疗后1个月、3个月的心功能[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)]、血清组织型金属蛋白酶抑制剂-4(tissue type metalloproteinase-4,TIMP-4)及游离脂肪酸(free fatty acid,FFA)浓度。结果研究组患者临床疗效总有效率显著高于对照组,差异有统计学意义(93.02%vs.74.42%,P<0.05)。两组患者的时间、组间、交互作用LVEDD、LVESD、LVEF比较,差异有统计学意义(P<0.05);治疗后1个月、3个月研究组患者的LVEDD、LVESD小于对照组,LVEF高于对照组,差异有统计学意义(P<0.05)。两组患者时间、组间、交互作用血清FFA、TIMP-4浓度比较,差异有统计学意义(P<0.05);治疗后1个月、3个月研究组患者的血清FFA浓度低于对照组,TIMP-4浓度高于对照组,差异有统计学意义(P<0.05)。研究组患者的不良反应发生率与对照组比较,差异无统计学意义(11.63%vs.6.98%,P>0.05)。结论大剂量曲美他嗪辅助治疗DCM心力衰竭患者时,可提高治疗效果,改善心功能,调节血清FFA、TIMP-4浓度,且安全性有保障。Objectives To analyze the efficacy of different doses of trimetazidine in adjuvant treatment of heart failure patients with dilated cardiomyopathy(DCM).Methods A total of 86 heart failure patients with DCM admitted to Xinxiang First People′s Hospital from January 2020 to January 2021 were selected as the research subjects.According to random drawing method,they were divided into study group and control group,with 43 cases in each group respectively.Both groups received conventional treatment,study group was treated with large dose of trimetazidine,control group was treated with conventional dose of trimetazidine.Clinical efficacy,adverse reactions,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],serum concentrations of tissue type metalloproteinase-4(TIMP-4)and free fatty acid(FFA)before treatment,1 month and 3 months after treatment were statistically compared between the two groups.Results The total clinical efficacy rate of study group was significantly higher than that of control group(93.02%vs.74.42%,P<0.05).Comparison of time,inter⁃group,interaction LVEDD,LVESD and LVEF between the two groups showed statistically significant differences(P<0.05).After 1 month and 3 months of treatment,LVEDD and LVESD in study group were significantly lower than those in control group,and LVEF in study group was higher than that in control group(P<0.05).Comparison of time,inter⁃group,interaction serum concentrations of FFA and TIMP-4 between the two groups showed statistically significant differences(P<0.05).After 1 month and 3 months of treatment,serum concentration of FFA in study group was significantly lower than that in control group,while serum concentration of TIMP-4 was significantly higher than that in control group(P<0.05).There was no significant difference in the incidence of adverse reaction rate between study group and control group(11.63%vs.6.98%,P>0.05).Conclusions In the adjuvant treatment of heart fai

关 键 词：心肌病 心力衰竭 不同剂量 曲美他嗪 心功能 血清相关细胞因子 

分 类 号：R542.2[医药卫生—心血管疾病] R541.6[医药卫生—内科学]