多奈哌齐对慢性心力衰竭患者心功能、心室重构的影响

目的探讨使用乙酰胆碱酯酶抑制剂-多奈哌齐对慢性心衰患者的心功能以及心室重构的影响。方法慢性心衰患者60例,随机分为治疗组(28例) 和对照组(32例)。两组均给予目前常规治疗,治疗组用加多奈哌齐5mg／d。对比观察6个月至一年后两组心功能改变情况;心脏超声检查左房内径(LA)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDd)、室间隔厚度(1VSD)、左室后壁厚度(LVPWD)、左室射血分数(EF)、短轴缩短率(FS),对比两组指标的前后差异(Δ值)有无统计学意义。结果①治疗组在使用多奈哌齐后,心功能改善明显优于对照组(心功能分别为2．14±0．71和2．62±0．77,P<0．05)。②心超检查的各项指标除了LA以外,其余指标的△值,两组间存在显著差异,多奈哌齐组均优于对照组(LVEDd为-0．28±0．198和0．055±0．154;IVSD为-0．0214±0．0778和 0．0447±0．0119,P<0．01);(LVESD为-0．073±0．325和0．267±0．329;LVPWD为 -0．00625±0．104和0．0564±0．0679;EF为4．836±5．65％和0．973±7．96％及FS 为3．525±3．505％和0．769±6．7％,P<0．05)。结论慢性心衰患者在常规治疗基础上加用乙酰胆碱酯酶抑制剂-多奈哌齐能改善心功能,抑制心室重构。

Acetylcholinestrase inhibition with donepezil effect on cardiac function and ventricular remodeling in patiens with chronic heart failure

Objective To explore the effects of Acetylcholinestrase inhibition with donepezil effect on cardiac function and ventricular remodeling in patiens with chronic heart failure. Methods 60 patients with chronic heart failure were randomly divided into two groups: treatment group(n= 28) and control group(n= 32) , treatment group was administered donepezil 5mg qd above regular treatment. All the patients were followed for 6 to 12 months and detected the changes of cardiac function and measured the diameter of LA, LVESD, LVEDd, IVSD, LVPWD, EF and FS before and after treatment by echocardio-gram. Results (1) After donepezil treatment, the improvement of cardiac function was greater than that in control group( P < 0.05) . (2)After donepezil treatment, the improvement of LVESD, LVEDd, IVSD, LVPWD, EF and FS were all greater than that in control group, except LA. (LVEDd and IVSD, P < 0. 01 LVESD, LVPWD, EF and FS, P < 0.05). Conclusions Patiens with chronic heart failure treated with acetylcholinestrase inhibition donepezil can improver the cardiac function and inhibit ventricular remodeling.