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目的观察曲美他嗪联合阿托伐他汀治疗充血性心力衰竭患者的疗效。方法将充血性心力衰竭患者118例采用SAS 10.0软件生成随机数字分组,分为联合组和常规组各59例。2组均采用基础治疗加阿托伐他汀治疗,联合组另予曲美他嗪治疗。检测比较2组患者治疗前后的左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、每搏心输出量(SV)、血清肌钙蛋白T(cTnT)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、P波最大宽度(Pmax)、P波最小宽度(Pmin)、P波离散度(Pd)。结果治疗后2组心功能指标水平均改善,联合组患者的LVEF%、SV测定值均高于常规组,LVEDd值均低于常规组,差异均有统计学意义(P<0.05)。治疗后,2组cTnT、CK、CK-MB水平均降低,且联合组cTnT、CK、CK-MB测定值低于常规组,差异有统计学意义(P<0.05)。治疗后,2组上述指标水平均降低,但联合组患者的Pmax、Pmin及Pd测定值均低于常规组,差异均有统计学意义(P<0.05)。治疗后2组患者的呼吸困难程度评分均低于治疗前,且联合组低于常规组,差异均有统计学意义(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05),2组症状较轻,未影响用药治疗,症状自行缓解。结论曲美他嗪联合阿托伐他汀对充血性心力衰竭患者能进一步的改善患者的心功能、延缓心肌重构、改善患者的临床症状,值得临床推广应用。
Objective To observe the efficacy of trimetazidine combined with atorvastatin in patients with congestive heart failure. Methods One hundred and fourty-eight patients with congestive heart failure were randomized to SAS 10.0 software and divided into two groups, 59 cases in each group. Both groups were treated with atorvastatin and atorvastatin in combination group. The levels of left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDd), cardiac output (SV), serum cTnT, CK, , CK-MB, Pmax, Pmin and P wave dispersion. Results After treatment, the levels of cardiac function improved in both groups. The LVEF% and SV values in the combined group were significantly higher than those in the conventional group, and the LVEDd values were lower than those in the conventional group (P <0.05). After treatment, the levels of cTnT, CK and CK-MB decreased in both groups, and the values of cTnT, CK and CK-MB in the combined group were lower than those in the conventional group (P <0.05). After treatment, the levels of these indexes decreased in both groups, but the Pmax, Pmin and Pd in the combined group were lower than those in the conventional group (P <0.05). The scores of dyspnea in two groups after treatment were lower than those before treatment, and the difference was statistically significant in the combined group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). The symptoms of the two groups were mild and did not affect the medication, and the symptoms relieved spontaneously. Conclusion Trimetazidine combined with atorvastatin can further improve cardiac function, delay myocardial remodeling and improve clinical symptoms in patients with congestive heart failure, which is worthy of clinical application.