【摘要】 目的探讨曲美他嗪联合法舒地尔治疗慢性心力衰竭(CHF)的疗效和可能作用机制。方法 CHF患者88例,随机分为两组。对照组43例,采用常规治疗加法舒地尔(30 mg,静脉滴注,bid,10 d为一疗程,共6个疗程)治疗,试验组45例在上述基础上加用曲美他嗪(20 mg,口服,tid,共6个月)。比较两组疗效和治疗前后血清和肽素(CPP)、半乳糖凝集素3(Gal-3)浓度、左室射血分数(LVEF)、左室舒张末径(LVEDD)和二尖瓣血流最大流速E峰和A峰比值(E/A)的变化。另选健康体检者30例设为正常对照组。结果试验组总有效率高于对照组(93%vs.72%,P<0.05)。治疗前CHF患者的血清CPP、Gal-3浓度明显高于正常对照组(均P<0.05),Pearson相关分析显示,血清CPP、Gal-3浓度与LVEF、E/A成显著负相关(均P<0.05),与LVEDD成显著正相关(均P<0.05)。治疗后两组血清CPP、Gal-3浓度和LVEDD均下降(P>0.05),试验组下降幅度大于对照组(P<0.05);LVEF和E/A值均升高(P<0.05),试验组上升幅度大于对照组(P<0.05)。两组均无明显不良反应发生。结论曲美他嗪联合法舒地尔能够显著降低CHF患者血清CPP和Gal-3浓度,改善心功能,从而对CHF患者起到治疗作用。更多还原

【Abstract】 AIM To study the effects and possible mechanism of trimetazidine and fasudil in the treatment of patients with chronic heart failure( CHF). METHODS By using randomized controlled trail, 88 patients with CHF were divided into control group( n = 43) and trial group( n = 45). The patients in the control group were given the routine therapy and fasudil(30 mg, ivgtt, bid, 10 d as a course, for 6 courses),whereas the patients in the trial group were given trimetazidine( 20 mg, po, tid, for 6 months) besides the aforesaid therapy. The difference of the clinical efficacy was compared between two groups. The levels of serum copeptin( CPP) and galectin 3( Gal- 3), left ventricular ejection fraction( LVEF), left ventricular end-diastolic dimension( LVEDD) and E and A peak of maximum peak of mitral velocity( E/A) were observed before and after the treatment. In addition, 30 healthy age-, gender-, body mass index- matched healthy subjects were selected as normal control group. RESULTS The total effective rate in the trial group were higher than that in the control group(93% vs. 72%, P < 0.05). The levels of CCP and Gal- 3 in CHF patients before the treatment were higher than those in the normal control group( all P < 0.05). Pearson correlation analysis displayed that the levels of CCP and Gal- 3 were negatively concerned with LVEF and E/A( all P < 0.05),whereas those were positively concerned with LVEDD(all P < 0.05). After treatment, the levels of CPP, Gal-3 and LVEDD decreased significantly, and LVEF, E/A increased in both groups significantly(all P > 0.05).Compared with those in the control group, the levels of CCP, Gal- 3 and LVEDD in the trial group were significantly lower after the therapy(all P < 0.05), and LVEF, E/A were significantly higher(all P < 0.05).NO obvious adverse reactions occurred in both groups. CONCLUSION Trimetazidine and fasudil can create the significant therapeutic action in patients with CHF by reducing the levels of serum CCP and Gal- 3, and amelioration heart function.更多还原