陈玲，吕湛，何文凤

(川北医学院附属医院心内科，四川 南充　637000)



曲美他嗪对冠心病心力衰竭患者心肌功能与相关免疫指标的影响

陈玲，吕湛，何文凤

(川北医学院附属医院心内科，四川 南充637000)

目的：探讨曲美他嗪对冠心病心力衰竭患者心肌功能与相关免疫指标的影响。方法：选择2014年2月至2015年4月在川北医学院附属医院心内科进行治疗的冠心病合并心力衰竭患者107例，按随机数字表法分为观察组54例和对照组53例。对照组使用常规治疗。观察组在常规治疗的基础上应用曲美他嗪，每日给药3次，每次给药20 mg。结果：观察组患者总有效率显著高于对照组[92.6%(50/54)vs.73.6%(39/53)，P<0.05]。治疗后，观察组患者左心室射血分数，6 min内步行距离显著高于对照组(P<0.05)；观察组左心室舒张末期内径、左心室收缩末期内径显著低于对照组(P<0.05)。观察组患者NK细胞水平显著高于对照组[(15.3±3.2)vs.(13.2±3.5)，P<0.05]，观察组患者IgG水平显著高于对照组[(4.8±0.8)vs.(3.1±1.3)，P<0.05]。结论：曲美他嗪能够显著改善冠心病心力衰竭患者的心肌功能，同时能够增强机体免疫力，改善心衰患者预后。

曲美他嗪；冠心病；心力衰竭；心肌功能；免疫指标

【Abstract】Objective：To study the effect of trimetazidine on myocardial function in patients with coronary heart disease and heart failure related immune indexes.Methods：107 patients with coronary heart disease complicated with heart failure treated in department of cardiology,Affiliated Hospital of North Sichuan Medical College,Nanchong City from February 2014 to April 2015.They were divided into observation group(54)and control group(53)according to random number table method.The control group was treated with conventional treatment.The observation group treated with trimetazidine based on conventional treatment,the dosage of trimetazidine was 20 mg each time,3 times a day.Results：The total efficiency of observation group was significantly higher than the control group [92.6%(50/54)vs.73.6%(39/53)，P<0.05].After treatment,the left ventricular ejection fraction and 6min walking distance in the observation group were significantly higher than those in the control group (P<0.05).The left ventricular end diastolic diameter and left ventricular end systolic diameter in the observation group were significantly lower than those in the control group (P<0.05).The level of NK cells in observation group was significantly higher than that in control group [(15.3±3.2)vs.(13.2±3.5)，P<0.05],and the level of IgG in observation group was significantly higher than that in control group [(4.8±0.8)vs.(3.1±1.3),P<0.05].Conclusion：Trimetazidine can significantly improved myocardial function in patients with heart failure of coronary heart disease,at the same time,to enhance immunity and improve prognosis of patients with coronary heart disease.

冠心病是一种常见的老年慢性病，该病发展至终末期可引起多种并发症，其中以心力衰竭为最为常见。心力衰竭近年来发病率逐渐增高，已成为全世界范围内的公共卫生问题[1-2]。目前对心力衰竭治疗虽取得一定疗效，但其仍是导致患者死亡的重要原因之一[3]。本研究旨在分析曲美他嗪对冠心病心力衰竭患者心肌功能与相关免疫指标的影响，了解其作用机制，为临床提供参考。

1　资料与方法

1.1一般资料

选择2014年2月至2015年4月在川北医学院附属医院心内科进行治疗的冠心病合并心力衰竭患者107例，按随机数字表法分为观察组54例和对照组53例。观察组男性29例、女性25例，年龄51～67岁，平均年龄(58.3±2.2)岁，美国纽约心脏病学会(New York Heart Association，NYHA)分级，心功能Ⅲ级37例，Ⅳ级17例；对照组男性27例，女性26例，年龄50～68岁，平均年龄(59.2±2.9)岁，NYHA心功能分级Ⅲ级38例，Ⅳ级15例。……