医学论文-曲美他嗪对改善冠心病合并糖尿病患者左室功能的疗效研究.docVIP

医学论文-曲美他嗪对改善冠心病合并糖尿病患者左室功能的疗效研究 【摘要】? 目的 探讨曲美他嗪对改善冠心病合并糖尿病患者左室功能的作用。方法 41例合并冠心病和糖尿病的心功能不全患者随机分为两组，对照组21例给予常规治疗，治疗组20例在常规治疗基础上加用口服曲美他嗪20mg，3次/d。12周后观察NYHA心功能分级及超声心动图指标的变化。结果 与对照组相比，治疗组心功能分级明显改善（P0.05)，左室射血分数（LVEF）有明显提高（P0.05)，左室舒张末期内径（LVEDD）明显缩小（P0.05)。结论 合并糖尿病的冠心病左心衰患者治疗上加用曲美他嗪能明显改善患者的左心功能。 【关键词】? 冠心病 糖尿病 心功能 曲美他嗪 ??? Research on the effect of trimetazidine on the left ventricular function in patients with coronary heart disease complicated with diabetes ??? QIAO Rui,JIA Yuan-sheng.Department of Cardiology,Anqing Municipal Hospital,Anhui,246003,China ??? 【Abstract】? Objective? To explore the effects of trimetazidine on improving the left ventricular function in patients with coronary heart disease complicated with diabetes.Methods? 41 cardiac insufficiency patients with coronary heart disease complicated with diabetes were divided into two groups randomly.The control group (n=21) accepted? routine therapy,in addition to routine treatment,the therapy group was? given trimetazidine 20mg PO,tid.The? cardiac function and echocardiography indexes were observed after 12 weeks.Results? Compare with the control group,the grade of cardiac function in patients of the? group was greatly improved after the trimetazidine treatment(P0.05).The left ventricular ejection fraction(LVEF)? increased dramatically(P0.05) and the left ventricular end-diastolic diameter(LVEDD) reduced significantly(P0.05).Conclusion? Trimetazidine has? good therapeutic effects on the left ventricular function in patients with coronary heart disease complicated with diabetes. ??? 【Key words】? coronary heart disease;diabetes;ventricular function;trimetazidine ??? 糖尿病（DM）作为冠心病的独立危险因素，DM患者冠心病的患病率为非DM病人的3倍，合并DM的冠心病的病理变化特点常是累及多支冠脉，病变弥漫，狭窄程度重，易发生心肌梗死。与非DM组相比，有心力衰竭者也较多，且一旦发??心衰提示预后不良。本研究通过观察合并糖尿病的冠心病患者在常规药物治疗的基础上加用曲美他嗪12周对左心功能的影响，以了解曲美他嗪在治疗伴有DM的冠心病患者左心衰中的作用。 ??? 1? 资料与方法 ??? 1.1? 一般资料? 选择2005年1月～2007年12月在我科住院治疗的合并冠心病和DM的左心衰竭的患者41例，男24例，女17例;年龄48～76岁，平均（61.8±8.2)岁，所有入选患者均经冠脉造影确诊或有明确的心肌梗死病史，DM诊断符合WHO1999年诊断标准。除外无法