曲美他嗪对冠心病急性心力衰竭患者心功能、血清N末端B型利钠肽前[摘要]目的探?曲美他嗪对冠心病急性心力衰竭患者心功能、血清N末端B型利钠肽前体及心肌肌钙蛋白I水平的影响。方法回顾性分析四川省德阳市第二人民医院重症医学科2014年2月～2017年3月收治的96例冠心病急性心力衰竭患者的临床资料，依据治疗方式不同分为对照组和观察组。对照组46例给予利尿剂呋塞米+血管扩张剂硝酸甘油治疗，观察组50例给予利尿剂呋塞米+血管扩张剂硝酸甘油+曲美他嗪治疗。两组患者均连续治疗7d。观察两组患者治疗前后心功能分级、血清N末端B型利钠肽前体、心肌肌钙蛋白I水平及临床疗效。结果两组患者治疗前心功能分级、血清N末端B型利钠肽前体、心肌肌钙蛋白I水平比较差异无统计学意义（P>0.05）。治疗后两组心功能分级均优于治疗前，血清N末端B型利钠肽前体、心肌肌钙蛋白I水平均低于治疗前，且观察组治疗后心功能分级均优于对照组，血清N末端B型利钠肽前体、心肌肌钙蛋白I水平均低于对照组，差异有统计学意义（P<0.05）。观察组总有效率明显高于对照组，差异有统计学意义（P<0.05）。结论曲美他嗪治疗冠心病急性心力衰竭患者能明显改善心功能，降低血清N末端B型利钠肽前体、心肌肌钙蛋白I水平，疗效良好，值得临床推广应用。[关键词]曲美他嗪；冠心病；急性心力衰竭；心功能；N末端B型利钠肽前体；心肌肌钙蛋白I[]R542.2[文献标识码]A[]1673-7210（2018）02（b）-0062-04[Abstract]ObjectiveToinvestigatetheinfluenceofTrimetazidineonthecardiacfunctionandlevelsofserumN-terminalpro-B-typenatriureticpeptide（NT-proBNP）andcardiactroponinI（cTn-I）inpatientswithcoronaryheartdiseaseandacuteheartfailure.MethodsTheclinicaldataof96casesofpatientswithcoronaryheartdiseaseandacuteheartfailureadmittedtoICUoftheSecondPeople'sHospitalofDeyangCityfromFebruary2014toMarch2017wasanalyzedretrospectively，andtheyweredividedintocontrolgroupandobservationgroupbydifferenttreatmentmethods.46casesofcontrolgroupweregivendiureticFurosemideandvasodilatorNitroglycerin，and50casesofobservationgroupweregivendiureticFurosemideandvasodilatorNitroglycerinandTrimetazidine.Bothgroupsweretreatedcontinuouslyfor7d.Beforeandaftertreatment，thecardiacfunctionalgrading，thelevelsofNT-proBNPandcTn-I，andtheclinicaleffectsoftwogroupswereobserved.ResultsTherewerenostatisticallysignificantdifferencesofcardiacfunctionalgrading，thelevelsofNT-proBNPandcTn-Ibetweenthetwogroupsbeforetreatment（P>0.05）.Aftertreatment，thecardiacfunctionalgradingofthetwogroupswasbetterthanthatbeforetreatment，andthelevelsofNT-proBNPandcTn-Iinthetwogroupswerelowerthanthosebeforetreatment，andthecardiacfunctionalgradingofobservationgroupwasbetterthanthatofcontrolgroup，thelevelsofNT-proBNPandcTn-Iintheobservationgroupwerelowerthanthoseofcontrolgroup，thedifferenceswerestatisticallysignificant（P<0.05）.Thetotaleffectiverateofobservationgroupwashigherthanthatofthecontrolgroup，thedifferencewasstatisticallysignificant（P<0.05）.ConclusionTrimetazidineinthetreatmentofpatientswithcoronaryheartdiseaseandacuteheartfailurecansignificantlyimprovecardiacfunction，decreasethelevelsofserumNT-proBNPandcTn-I，withgoodcurativeeffect，whichisworthyofclinicalpromotionandapplication.[Keywords]Trimetazidine；Coronaryheartdisease；Acuteheartfailure；Cardiacfunction；N-terminaltypeBnatriureticpeptideprecursor；CardiactroponinI急性心力衰竭是由于急性心脏病诱发的心排出量不足，造成急性瘀血综合征[1-2]。急性瘀血会造成心肌的收缩水平降低或出现心室瓣膜的反流，影响正常的心脏排血量，无法保证正常的组织器官灌注水平。有研究报道表明，急性心力衰竭患者多数呈现低血压状态，诱发突发性呼吸困难，严重者可...