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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,electrocardiography and echocardiography.results after adding60mg a day of trimetazidine for3months,attack of angina was relieved and dyspnea was improved(p.05).but heart rate,systolic blood pressure,rate pressure product,ejection fraction,left ventricular volume and global wall motion index were not changed.conclusion trimetazidine seems to improve clinical status while can not change oxygen supply-to-demand ratio without adverse effects in patients on severe ischemic carˉdiomyopathy.

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0%)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。

Among all persons who finished questionnaire 21.68% were resident physician,36.95% were attending physician, 25.65% were vice chief physician/chief physician; the most common cardiovascular disease in the investigated persons hospitals were angina (55.42%),stroke(38.17%), myocardial infarction(28.70%), heart failure (28.24%), hypertension (28.24%); as for early vascular disease detection methods,57.40% of investigated persons thought artery endothelial function examination,46.72% thought angiography, pulse wave velocity measurement and carotid intima-media thickness measurement were 40.61% and 31.76%;76.49% and 53.89% of the investigated persons thought angiotension converting enzyme inhibitor and statins could revert early vascular disease;96.79% of the investigated persons thought promotion early vascular disease detection strategy could help for reducing total burden of cardiovascular disease in our country;78.47% of the investigated persons thought early vascular disease detection methods should be easily used and non-invasive.

被调查者所在医院最常见心血管疾病顺序分别心绞痛55.42%,脑卒中38.17%,心肌梗死28.70%,心力衰竭28.24%,高血压28.24%;关于血管病变早期检测57.40%的被调查者认为通过动脉内皮功能测定,认为通过血管造影者占46.72%,认为通过脉搏波速度和颈动脉内膜中层厚度测定者分别占40.61%和31.76%;分别有76.49%和53.89%的被调查人群认为血管紧张素转换酶抑制剂和他汀类药物能够逆转早期血管病变;96.79%的被调查者认为推广血管病变早期检测技术有利于降低我国心脑血管疾病总体负担;78.47%的被调查者认为用于推广的早期血管病变检测技术应该是操作方便和无创伤。

Among all persons who finished questionnaire 21.68% were resident physician,36.95% were attending physician, 25.65% were vice chief physician/chief physician;the most common cardiovascular disease in the investigated persons hospitals were angina (55.42%),stroke(38.17%),myocardial infarction(28.70%),heart failure(28.24%), hypertension(28.24%);as for early vascular disease detection methods,57.40% of investigated persons thought artery endothelial function examination,46.72% thought angiography,pulse wave velocity measurement and carotid intima-media thickness measurement were 40.61% and 31.76%;76.49% and 53.89% of the investigated persons thought angiotension converting enzyme inhibitor and statins could revert early vascular disease;96.79% of the investigated persons thought promotion early vascular disease detection strategy could help for reducing total burden of cardiovascular disease in our country;78.47% of the investigated persons thought early vascular disease detection methods should be easily used and non-invasive.

被调查者所在医院最常见心血管疾病顺序分别为心绞痛55.42%,脑卒中38.17%,心肌梗死28.70%,心力衰竭28.24%,高血压28.24%;关于血管病变早期检测57.40%的被调查者认为通过动脉内皮功能测定,认为通过血管造影者占46.72%,认为通过脉搏波速度和颈动脉内膜中层厚度测定者分别占40.61%和31.76%;分别有76.49%和53.89%的被调查人群认为血管紧张素转换酶抑制剂和他汀类药物能够逆转早期血管病变;96.79%的被调查者认为推广血管病变早期检测技术有利于降低我国心脑血管疾病总体负担;78.47%的被调查者认为用于推广的早期血管病变检测技术应该是操作方便和无创伤。

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