曲美他嗪对改善原发性扩张性心肌病患者心功能的疗效观察.docVIP

曲美他嗪对改善原发性扩张性心肌病患者心功能的疗效观察 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：曲美他嗪对改善原发性扩张性心肌病患者心功能的疗效观察 1 1 资料与方法 3 13 统计学方法 3 2 结果 3 3 讨论 4 文2：曲美他嗪改善缺血性心肌病患者心功能的临床研究 5 1 对象与方法 5 2 结果 6 参考文摘引言： 7 原创性声明（模板） 8 文章致谢（模板） 9 正文 曲美他嗪对改善原发性扩张性心肌病患者心功能的疗效观察 文1：曲美他嗪对改善原发性扩张性心肌病患者心功能的疗效观察 Effect of Trimetazidine on Improving Heart Function in Patients with Dilated Cardiomyopathy Abstract： Objective To evaluate the effect of trimetazidine on the patients with dilated cardiomyopathy (DCM). Methods Fortysix patients with DCM who were randomized into conventional therapy group and trimetazidine therapy group (23 patients per group), were involved in this study. In the trimetazidine group, trimetazidine (20mg, three times daily) were given in addition to conventional therapy. Their treatment duratio were both 16 weeks. The improvement of clinical symptoms and left ventricular ejection fraction (LVEF) measured with echocardiography were observed before and after the treatment. Results Compared with that of the conventional therapy group, not only the cardiac function of the trimetazidine group improved markedly (P), but the improvement of LVEF was more significant as well (P). Conclusion Combined therapy of trimetazidine and conventional drugs improved the cardiac function in the patients with DCM more effectively, and trimetazidine may acts as an adjuvant drug for the disease. Key words： trimetazidine; dilated cardiomyopathy; heart function 原发性扩张性心肌病是一组以弥漫性心肌损害、纤维组织增生，引起心肌收缩期泵血功能障碍、心脏进行性扩大为特征的疾病。患者常需反复住院治疗，且治疗效果不明显。曲美他嗪（1[2，3，4三甲基苯唑]哌嗪二氢盐酸盐），是一种新的具有独特作用机制的抗心肌缺血药物，其细胞保护作用是通过直接抑制线粒体长链3酮酰辅酶A硫解酶（3KAT）获得，使心肌能量代谢由脂肪酸代谢转移为葡萄糖氧化。在心肌缺血情况下葡萄糖裂解ATP的再合成中需要的氧减少，因此能够改善心肌的能量代谢，并且不影响血流动力学，直接针对心肌细胞提供保护作用[1]，对以心肌病变为主的原发性扩张性心肌病可能成为一种新的治疗手段，为此，我们在常规治疗的基础上应用曲美他嗪观察了其对原发性扩张性心肌病心功能的影响和安全性，现将结果报告如下。 1 资料与方法 一般资料 本组46例均为2002年8月—2004年6月我院收治的原发性扩张性心肌病伴有心功能不全患者，全部病例均符合WHO（1995）原发性扩张性心肌病诊断标准[2]。NYHA心功能Ⅱ~Ⅳ级，均排除严重肝、肾功能不全及使用非洋地黄类正性肌力药者，将46例患者随机分为A，B两组，每组23例。A组：年龄20~45岁，平均32岁，男20例，女3