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目的:本研究评价冠心病合并左心功能不全患者在常规治疗情况下加用国产曲美他嗪的临床疗效及安全性。方法:64例冠心病合并左心功能不全(LVEF<35%)患者,平均年龄(61±9)岁,随即分为治疗组和对照组。治疗组在常规治疗的基础上加用国产曲美他嗪每日60mg,治疗12个月,随诊观察患者临床情况、左心室射血分数(LVEF)、左室舒张末期容积、心胸比率、动态心电图(Holter)记录的心肌缺血次数以及6min步行距离的变化。结果:治疗组患者心功能明显改善,LVEF由(31.6±7.5)%升至(40.7±9.8)%(P<0.01);左室舒张末期容积由(58.5±6.8)ml/m2减到(52.1±7.7)ml/m2(P<0.01);心胸比率由(57.2±5.6)%降至(53.0±6.9)%(P<0.01);Holter记录的心肌缺血次数由(3.6±4.8)次减至(1.2±3.4)次;6min步行距离由(134.8±47.1)m增至(340.9±56.5)m(P<0.01)。结论:国产曲美他嗪联合其他治疗心功能不全的药物,能够进一步改善冠心病合并左心功能不全患者的心功能,降低左室舒张末期容积,减少心肌缺血次数,增加6min步行距离。
Objective: This study was to evaluate the clinical efficacy and safety of domestic trimetazidine in patients with coronary heart disease complicated with left ventricular dysfunction under conventional treatment. Methods: Sixty-four patients with coronary heart disease with left ventricular dysfunction (LVEF <35%), mean age (61 ± 9 years), were randomly divided into treatment group and control group. The treatment group was treated with domestic trimetazidine 60mg daily for 12 months. The clinical data, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume, cardiothoracic ratio, dynamic state The number of myocardial ischemia recorded by Holter and the change of 6min walk distance. Results: The LVEF increased from (31.6 ± 7.5)% to (40.7 ± 9.8)% (P <0.01), and the left ventricular end diastolic volume decreased from (58.5 ± 6.8) ml / m2 to ± 7.7) ml / m2 (P <0.01). The rate of myocardial ischemia decreased from (57.2 ± 5.6)% to (53.0 ± 6.9)% (P <0.01) To (1.2 ± 3.4) times; 6min walking distance increased from (134.8 ± 47.1) m to (340.9 ± 56.5) m (P <0.01). Conclusion: The domestic trimetazidine combined with other drugs for treating cardiac insufficiency can further improve the cardiac function, reduce the volume of left ventricular end-diastolic volume, reduce the number of myocardial ischemia and increase the walking distance 6min in patients with coronary heart disease complicated with left ventricular dysfunction.