曲美他嗪治疗充血性心力衰竭伴室性心律失常临床观察

Clinical study on effects of trimetazidine in patients with congestive heart failure and ventricular arrhythmia

下载PDF

导出

摘要目的　研究曲美他嗪 (TMZ)治疗慢性充血性心力衰竭 (CHF)并发室性心律失常 (VA)的临床疗效及安全性。方法　选择CHF并VA患者 67例 ,随机分为对照组 (31例 )和治疗组 (36例 )。对照组采用常规综合疗法。治疗组在上述基础上加用TMZ 2 0mg ,每日 3餐后口服。在治疗前及治疗后 8周分别进行 2 4小时动态心电图、超声心动图及临床检查 ,观察加用TMZ后VA及心功能临床征象的变化。结果　治疗 8周后 ,治疗组心功能改善有效率和VA的总有效率分别为 52 .8%和 55 .6 % ,对照组分别为 9.7%和 6 .5 % ,治疗组明显高于对照组 ,均P <0 .0 1 ;治疗组室性期前收缩 (个 /2 4h)由 3 0 68± 466减至 1 387± 93 ,短阵室速 (次 /2 4h)由 1 30± 2 3减至 61± 1 9,而对照组基本无变化。两组比较差异具有统计学意义 ,均P <0 .0 0 1。未发现与药物相关的不良反应。结论　TMZ能改善CHF并VA患者的心功能 ,对VA亦有很好疗效 ,无副作用。 Objective To investigate the clinical effect and safety of trimetazidine in patients with congestive heart failure(CHF)and ventricular arrhythmia(VA).Methods Sixty seven CHF and VA patients were divided into the treatment group(36 cases) and the control group(31 cases) randomly.The routine general therapy was given to the control group.The treatment group took trimetazidine 20 mg after each of the three meals,besides routine general therapy.The 24 hour dynamic electrocardiogram,echocardiography and clinical examination were performed in the CHF and VA patients prior to and at the end of 8 weeks treatment,observation of the alternation of VA and the heart function was made after using trimetazidine.Results The effective rates for heart function and ventricular arrhythmias were 52.8% and 55.6% in the treatment group,but did not change significantly in the control group.The difference was significant between treatment group and control group (P< 0.01 ,respectively).Ventricular premature beat and ventricular tachyrhythmia reduced from 3068±466 and 130±23 to 1387±93 and 61±19 in 24 hours in the treatment group,but did not change significantly in the control group.The difference was significant between treatment group and control group (P< 0.001 ,respectively).No adverse reactions were found related to trimetazidine.Conclusion Trimetazidine can improve the heart function and VA in patients with CHF and VA,the use of antiarrhythmic drugs is safe,maybe as an adjutant drug for the disease.