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目的观察曲美他嗪(TMZ,商品名万爽力)对慢性心力衰竭(简称心衰)患者心功能和运动耐量的影响,分析其产生作用的可能机制。方法本实验为随机、开放、对照临床研究,选取39例因缺血性心肌病和扩张性心肌病而导致的慢性心衰患者(NYHAII、III级),随机分为对照组和TMZ组。用药观察期为3个月。全部入选患者在用药前和用药3个月时行超声心动图(用LVEF、EDD、ESD、FS、SV等指标)评价心脏收缩功能的改善情况,6min步行实验评价患者运动能力的改善情况。结果入选时两组资料有可比性。用药12周后,TMZ组的6min步行距离、FS、SV和EF值与对照组相比增高。两组患者血生化检查、血压、心率在组间和组内比较均无显著性差异。本研究无严重不良事件者。结论在常规心衰治疗的基础上加用曲美他嗪可以改善慢性心衰患者的心脏收缩功能,提高慢性心衰患者的运动耐量,并具有较好的耐受性。
Objective To investigate the effect of trimetazidine (TMZ) on heart function and exercise tolerance in patients with chronic heart failure (CHF) and to analyze the possible mechanism of the effect. Methods This randomized open-controlled clinical trial included 39 patients with chronic heart failure (NYHAII, III) due to ischemic cardiomyopathy and dilated cardiomyopathy, and were randomly divided into control group and TMZ group. Medication observation period of 3 months. All patients were selected for echocardiography (using LVEF, EDD, ESD, FS, SV and other indicators) to evaluate the improvement of systolic function before medication and 3 months of medication. The 6-minute walk test was used to evaluate the improvement of motor function. Results When selected, the two groups of data were comparable. Twelve weeks after treatment, the 6-minute walking distance, FS, SV and EF in the TMZ group increased compared with the control group. Two groups of patients with blood biochemical tests, blood pressure, heart rate in the groups and groups were no significant differences. There were no serious adverse events in this study. Conclusion Trimetazidine combined with trimetazidine can improve cardiac contractile function, improve exercise tolerance of patients with chronic heart failure, and have better tolerability.