曲美他嗪对慢性心力衰竭患者血管内皮功能的影响

目的:研究曲美他嗪对慢性心力衰竭患者血管内皮功能的影响。方法:选择2013年1月~2015年12月在我院进行诊治的慢性心力衰竭患者158例为研究对象,采用奇偶数法随机分为两组,每组79例。对照组采用利尿、平衡电解质、扩血管、营养心肌等常规抗心衰治疗,观察组联合采用曲美他嗪治疗。分别于治疗前和治疗后1个月检测两组患者的血流介导血管舒张功能、内皮素-1水平、一氧化氮水平、心率、血压、白细胞计数、血肌酐和谷丙转氨酶水平。结果:治疗后,观察组的血流介导血管舒张功能明显高于治疗前(P0.05),且肱动脉内径和血流介导血管舒张功能均明显高于对照组(P0.05);两组的血浆内皮素-1均较治疗前降低(P0.05),一氧化氮升高(P0.05),且观察组的血清内皮素-1水平明显低于对照组,血清一氧化氮水平明显高于对照组(P0.05);两组的心率、血压、肾功能、肝功能和血常规结果相比差异均无统计学意义(P0.05),且两组均无明显不良反应发生。结论:曲美他嗪可显著改善慢性心力衰竭患者的血管内皮功能,可能与其降低血浆内皮素-1水平、升高一氧化氮水平有关。

Effects of Trimetazidine on the Vascular Endothelial Function of Patients with Chronic Heart Failure

ABSTRACT Objective: To investigate the effect of trimetazidine on the vascular endothelial function of patients with chronic heart failure. Methods: 158 cases of patients with chronic heart failure who were treated in our hospital from January 2013 to December 2015 were selected and randomly divided into two groups. The control group was treated with diuresis, electrolyte balance, expanding blood vessels, nutrition myocardial, while the observation group was treated with conventional heart failure treatment combined with trimetazi- dine. The blood flow mediated vasodilatation function, serum levels of endothelin-1 levels, nitric oxide, heart rate, blood pressure, white blood cell count, serum creatinine and third transaminase levels were compared before and at 1 month after treatment. Results: After treatment, the blood flow mediated vasodilatation function of observation group was obviously higher than before treatment (P<0.05), and the brachial artery diameter and blood flow mediated vasodilatation function of observation group were significantly higher than those of the control group (P<0.05); the plasma endothelin-1 levels of both groups were significantly increased(P<0.05), the nitric oxide level were significantly decreased(P<0.05), and the endothelin-1 level of observation group was obviously higher than that of the control group(P<0.05), the nitric oxide level was significantly lower than that of the control group(P<0.05); the heart rate, blood pressure, kidney function, liver function and blood routine of two groups showed no obvious difference between two groups(P>0.05), and no obvious ad- verse reaction was found in both groups. Conclusion: Trimetazidine could improve the endothelial function of patients with chronic heart failure, which might be related to the decrease of plasma levels of endothelin-1 and elevation of the plasma levels of nitric oxide.