【摘要】 目的观察曲美他嗪片治疗冠心病伴心力衰竭合并心房颤动的临床疗效及安全性。方法将226例冠心病伴心力衰竭合并心房颤动患者随机分为对照组113例和试验组113例。对照组予以阿司匹林、氯吡格雷、他汀类药物、血管紧张素转化酶抑制药等常规治疗;试验组在对照组治疗的基础上,予以曲美他嗪每次20 mg,tid,口服。2组患者均治疗6个月。比较2组患者的临床疗效、6 min步行试验、代谢综合征（Mets）评分、脂蛋白相关磷脂酶A2（Lp-PLA2）、N端前脑钠肽（NT-proBNP）和肿瘤坏死因子（TNF-α）的水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为84.07%（95例/113例）和65.49%（74例/113例）,差异有统计学意义（P<0.05）。治疗后,试验组和对照组的6 min步行距离分别为（378.45±82.31）和（352.14±63.23）m,Mets评分分别为（2.14±0.50）和（1.82±0.28）分,Lp-PLA2分别为（397.24±135.98）和（481.20±139.15）U·L^-1,NT-proBNP分别为（2084.35±1074.47）和（4611.25±1299.74）pg·mL^-1,TNF-α分别为（12.94±6.03）和（23.10±6.78）ng·mL^-1,差异均有统计学意义（均P<0.05）。治疗期间,2组患者均未发现明显的药物不良反应。结论曲美他嗪片能够改善冠心病伴心力衰竭合并心房颤动患者的临床疗效确切,且安全性好。更多还原

【Abstract】 Objective To observe the clinical efficacy and safety of trimetazidine tablets in the treatment of coronary heart disease with heart failure and atrial fibrillation. Methods A total of 226 patients of coronary heart disease with heart failure and atrial fibrillation were randomly divided into control and treatment groups with 113 cases per group. Control group was treated with aspirin,clopidogrel,statins,angiotensin converting enzyme inhibitor and other conventional therapy. Treatment group was given trimetazidine 20 mg per time,tid,orally,on the basis of control group. Two groups were treated for 6 months. The clinical efficacy,6 min walk test,metabolic syndrome（ Mets） score,lipoprotein associated phospholipase A2（ Lp-PLA2）, NT-brain natriuretic peptide（ NT-proBNP）,tumor necrosis factor-α（ TNF-α） and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 84. 07%（ 95 cases/113 cases） and 65. 49%（ 74 cases/113 cases） with significantdifference（ P < 0. 05）. After treatment,the main indexes in treatment and control groups were compared: the distance of 6 min walking test were（ 378. 45 ± 82. 31） and（ 352. 14 ± 63. 23） m,Mets score were（ 2. 14 ± 0. 50） and（ 1. 82 ± 0. 28） points,Lp-PLA2 were（ 397. 24 ± 135. 98） and（ 481. 20 ± 139. 15） U·L^-1,NT-proBNP were（ 2084. 35 ± 1074. 47） and（ 4611. 25 ± 1299. 74） pg·mL^-1,TNF-α were（ 12. 94 ± 6. 03） and（ 23. 10 ± 6. 78）ng·mL^-1,the differences were statistically significant（ all P < 0. 05）. There were no adverse drug reactions in two groups during the treatment. Conclusion Trimetazidine tablets have a definitive clinical efficacy and safety in the treatment of coronary heart disease with heart failure and atrial fibrillation更多还原