【摘要】 目的 曲美他嗪是一种新型的抗心肌缺血的药物，能够改善患者的运动耐量和心肌的直接保护作用同时并没有血流动力学效应。但目前对于严重缺血性心肌病患者的临床治疗价值还需要进一步观察。方法 19例(68±9)岁确诊为缺血性心肌病(左心室射血分数<40%)的患者在常规治疗的基础上加用每日60mg曲美他嗪治疗3个月，随诊观察患者临床情况以及超声心动图指标的变化。结果 19例患者均可耐受在常规治疗基础上加用每日60mg曲美他嗪的治疗，随诊发现患者心绞痛发作明显减少，运动耐量(NYHA分级)明显改善。同时患者心率、收缩压、心率血压乘积、左心室射血分数、左心室容量以及整体室壁运动指数无明显改变。结论 缺血性心肌病的患者在常规治疗基础上加用曲美他嗪是安全的，同时其能明显改善患者的临床状态，而这种作用并不改变心肌氧的供求比值。

    关键词 曲美他嗪 缺血性心肌病 心绞痛

    Therapeutic value of trimetazidine in patients with severe ischemic cardiomyopathy

    Gao Junwu，Lu Qiang

    Department of Internal Medicine，The People’s Hospital of Xinglong，Hebei067300

    【Abstract】 Objective Trimetazidine has shown anti-ischemic properties to improve exercise tolerance without haemodynamic effects and direct cyto protective effect on the myocardium.However，it is not clear whether trimetazidine has beneficially effect on severe ischemic cardiomyopathy.Methods 19patients(68±9)years with postnecrotic left ventricular dysfunction(ejection fraction31.7%±5.4%)were studied to examine the benefit of adding60mg a day of trimetazidine for3months to the classical therapy.The assessment included clinical evaluation ......