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目的:探讨用盐酸曲美他嗪治疗左心室舒张功能不全的临床疗效。方法:将我院2010年1月～2011年3月收治的52例老年左心室舒张功能不全患者随机分为两组。其中一组为常规治疗组(25例),常规治疗组患者接受心衰标准治疗,另外一组为盐酸曲美他嗪组(27例),盐酸曲美他嗪组患者在常规治疗组患者治疗的基础上加用盐酸曲美他嗪(每次服20mg,每天服3次)进行治疗。治疗3个月后,比较两组患者治疗前后的NYHA分级、LVEF(左室射血分数)、E/A(舒张早晚期血流峰值比值)和E/e(’二尖瓣口舒张早期的血流峰值速度E与二尖瓣环舒张早期峰值速度e’的比值)。结果:①两组患者的基线指标无显著性差异。②治疗后,两组患者的症状和体征均有明显的改善,但盐酸曲美他嗪组患者治疗的有效率明显高于常规治疗组患者(85%vs64%,p<0.05)。③与治疗前相比,两组患者的LVEF和E/A均显著增加、E/e’均显著降低,但盐酸曲美他嗪组患者上述三项指标的改善程度较常规治疗组患者更明显。结论:应用盐酸曲美他嗪治疗老年左心室舒张功能不全可以在不影响患者血流动力学变化的前提下显著改善患者的左心舒张功能。
Objective: To investigate the clinical efficacy of trimetazidine hydrochloride in the treatment of left ventricular diastolic dysfunction. Methods: 52 cases of senile patients with left ventricular diastolic dysfunction admitted to our hospital from January 2010 to March 2011 were randomly divided into two groups. One group was treated with conventional therapy (n = 25). Patients in the conventional treatment group received standard therapy of heart failure. The other was trimetazidine hydrochloride group (n = 27). Patients in trimetazidine hydrochloride treatment group Based on the use of trimetazidine hydrochloride (each serving 20mg, serving three times a day) for treatment. After 3 months of treatment, NYHA classification, LVEF, E / A ratio of early and late diastolic flow and E / e of early and late mitral valve were compared between two groups before and after treatment The ratio of peak blood flow velocity E to mitral annulus early peak velocity e ’). Results: ① There was no significant difference in baseline indexes between the two groups. ② After treatment, the symptoms and signs of both groups were significantly improved, but the effective rate of trimetazidine hydrochloride treatment group was significantly higher than that of the conventional treatment group (85% vs64%, p <0.05). ③Compared with pretreatment, LVEF and E / A in both groups increased significantly and E / e ’decreased significantly, but the above three indexes of trimetazidine hydrochloride group improved more significantly than those in the conventional treatment group . Conclusion: The application of trimetazidine hydrochloride in elderly patients with left ventricular diastolic dysfunction can significantly improve left ventricular diastolic function in patients without affecting hemodynamic changes.