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目的观察乌拉地尔联合曲美他嗪治疗慢性心力衰竭(CHF)的临床疗效。方法将100例心功能(NYHA)III-IV级的CHF患者随机分为乌拉地尔治疗组、曲美他嗪治疗组、乌拉地尔联合曲美他嗪治疗组和对照组,各25例,常规给予血管紧张素转换酶抑制剂、强心、利尿剂等治疗。乌拉地尔治疗组在此基础上连续5d静脉泵入乌拉地尔100～300μg/min。曲美他嗪治疗组持续加用曲美他嗪20mg/次,3次/d,连续3个月。乌拉地尔联合曲美他嗪治疗组除了静脉泵入乌拉地尔100～300μg/min达5d外,还同时加用曲美他嗪20mg/次,3次/d,连续3个月。对照组仅为常规治疗。于治疗前、治疗后5d及治疗后3个月采用超声心动图、6min步行实验(6-MWT)等方法观察4组患者心功能情况,同时检测脑钠肽(BNP)、C反应蛋白(CRP)。结果 3个治疗组心功能改善情况优于对照组,超声心动图指标、6-MWT距离均明显改善,BNP、CRP均降低,两药合用效果更佳。4组均未见明显不良反应。结论乌拉地尔及曲美他嗪均能有效改善CHF患者心功能,降低BNP及CRP,两者合用效果更佳且安全。
Objective To observe the clinical efficacy of urapidil combined with trimetazidine in the treatment of chronic heart failure (CHF). Methods One hundred patients with NYHA class III-IV CHF were randomly divided into Urapidil group, trimetazidine treatment group, Urapidil combined trimetazidine treatment group and control group, with 25 cases in each group. Routine administration of angiotensin converting enzyme inhibitors, cardiac, diuretic and other treatment. On the basis of this, urapidil group received continuous intravenous infusion of urapidil 100 ~ 300μg / min for 5 days. Trimetazidine treatment group continued with trimetazidine 20mg / times, 3 times / d, for 3 months. Urapidil combined trimetazidine treatment group in addition to intravenous urapidil 100 ~ 300μg / min up to 5d, but also with trimetazidine plus 20mg / times, 3 times / d, for 3 months. Control group was only routine treatment. The cardiac function of the four groups was observed before treatment, 5 days after treatment and 3 months after treatment by echocardiography and 6-minute walking test (6-MWT). The levels of BNP and CRP ). Results The improvement of cardiac function in the three treatment groups was better than that in the control group. The indexes of echocardiography and the distance of 6-MWT were all significantly improved, and the BNP and CRP were both decreased. No obvious adverse reactions were found in 4 groups. Conclusion Both urapidil and trimetazidine can effectively improve the cardiac function, reduce BNP and CRP in patients with CHF, and their combined effect is better and safer.