曲美他嗪对心力衰竭患者血清中白细胞介素-6影响的研究(1)
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[摘要] 目的 观察曲美他嗪辅助治疗冠心病心力衰竭患者的疗效，并观察治疗前及治疗后血清中白细胞介素-6(IL-6)的改变，以期为临床工作提供理论支持。方法 收集134例临床确诊为冠心病心力衰竭的患者，按患者的入院顺序分为两组，观察组共67例，在常规治疗中加用曲美他嗪，对照组共67例，应用常规治疗。于治疗前、治疗后观察两组患者血清中IL-6的表达差别。结果 治疗3个月后观察疗效，观察组患者的总有效率明显高于对照组，观察组与对照组患者在左心室舒张末期内径及左室射血分数的变化比较中差异有统计学意义。两组患者治疗后血清中IL-6的表达均下降，但是观察组的下降值明显高于对照组。结论 在常规治疗基础上加用曲美他嗪治疗冠心病心力衰竭的患者，临床疗效明显，且能有效下调血清中IL-6的表达，进而有效调节机体的内环境，临床治疗中可以积极应用。
[关键词] 冠心病；心力衰竭；曲美他嗪；白细胞介素-6
[中图分类号] R541.4；R541.6 [文献标识码] B [文章编号] 1673-9701(2011)23-46-02
The Effect of Trimetazidine on Expression of IL-6 in Patients with Coronary Heart Disease Complicated Heart Failure
HE Lingyun
Department of Internal Medicine, the Second People's Hospital of Zhuji City in Zhejiang Province, Zhuji 311811, China
[Abstract] Objective To observe the curative effect and IL-6 change by trimetazidine in patients with coronary heart disease complicated heart failure, for accumulating clinical experience and directing clinical treatment. Methods One hundred thirty four patients with coronary heart disease complicated heart failure were divided into two groups. The control group (67 cases) was treated by normal treatment and the observation group (67 cases) was treated by normal and trimetazidine treatment. We observed the efficacy and the change of IL-6 in the two groups. Results The total effective rate was obviously higher in the observation group than in the control group. The change value of IL-6 was obviously higher in the observation group than in the control group. Conclusion The treatment of trimetazidine can improve the curative effect, downregulate the expression of IL-6 in patients with coronary heart disease complicated heart failure, is worth of application in clinical treatment.
[Key words] Coronary heart disease; Heart failure; Trimetazidine; Interleukin-6
冠心病心力衰竭是指心脏病发展到一定程度，心肌收缩力减弱，心排血量减少，因而不能满足机体组织细胞代谢的需要，同时静脉回流受阻，静脉系统瘀血，并出现一系列症状和体征[1]。有观点认为白细胞介素-6(IL-6)在冠心病心力衰竭患者血清中的表达增高，并能促进疾病的发展[2]。曲美他嗪是一种优化心肌能量代谢的抗心肌缺血药物，可以促进葡萄糖氧化、产生更多的ATP，提高氧的利用率，增加心脏的收缩功能[3]。本文对冠心病心力衰竭患者在常规治疗基础上加用曲美他嗪进行治疗，并关注治疗前、后血清中IL-6的表达，同时进行临床对照观察，旨在为临床治疗提供有效的依据。
1 资料与方法
1.1 一般资料
收集我院2007年6月～2010年12月确诊为冠心病心力衰竭患者共134例，其中男72例，女62例；年龄40～79岁，平均(58.97±7 ......
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