【摘要】 目的　本研究探讨曲美他嗪对冠心病左室功能不全患者室壁运动积分指数 (VMI)、左室射血分数(LVEF)和血流动力学参数的影响。方法　选择心肌梗死左室功能不全患者 (LVEF为 3 3 %± 7% ) 2 4例 ,分为 2组 ,治疗组在常规治疗基础上口服曲美他嗪 60mg/d,分 3次服用 ,治疗 2个月。对照组仅使用常规治疗。治疗前后进行超声心动图检查及血流动力学参数测定。结果　曲美他嗪治疗后VMI显著下降 (治疗组下降2 0 .81% ,对照组下降 5 .71% ,P <0 .0 1) ,LVEF显著升高 (治疗组升高 18.18% ,对照组升高 2 .94% ,P <0 .0 1) ,CI显著升高 (治疗组升高 14 .2 9% ,对照组升高 1.70 % ,P <0 .0 1) ,心率 收缩压无明显变化 (治疗组下降0 .74% ,对照组下降 0 .14 % ,P >0 .0 5 ) ,周围血管阻力无明显变化 (治疗组下降 5 .5 8% ,对照组下降 6.10 % ,P >0 .0 5 )。结论　曲美他嗪可改善冠心病左室功能不全患者的VMI和LVEF ,而对血流动力学参数无明显影响更多还原

【Abstract】 Objective There is evidence that trimetazidine, an anti ischemic agent with a direct cytoprotective effect on the myocardium is effective in stable angina. However, it is not clear whether trimetazidine can improve the mechanical efficiency of chronically ischemic dysfunctional myocardium. Methods Twenty four patients (62.7±8.1 years) with infarcted left ventricular dysfunction (ejection fraction: 0.33 ± 0.07) were studied. Patients were divided into two groups. Group A received trimetazidine and the usual medications for 2 months, while group B received the usual medications only during the same period.At baseline and after 2 months, before and after the treatment, all patients underwent echocardiography. Results On initial evaluation, the ventricular wall motion score index(VMI), left ventricular ejection fraction(LVEF), cardiac index(CI),heart rate and systolic blood pressure (HR*SBP),systemic vascular resistance(SVR)were similar in both groups. However, at 2 months, group A patients had improvements in VMI and LVEF without concomitant changes in heart rate and blood pressure. Conclusion In patients with ischemic cardiomyopathy, trimetazidine improves the contractile response of chronically dysfunctional myocardium without haemodynamic changes.更多还原