摘要
目的 研究伊伐布雷定用于慢性心力衰竭治疗中的效果.方法 收集2020年7月至2021年7月就诊于福建省莆田涵江医院心血管内科的慢性心力衰竭患者80例,其中40例为对照组,给予标准化抗心衰治疗,包括酒石酸美托洛尔缓释片、螺内酯、呋塞米、雷米普利等药物治疗.另外40例患者为观察组,因在接受循证剂量β受体阻滞剂治疗基础上心率仍持续≥70次/min而加用伊伐布雷定治疗.比较两组的氨基末端脑钠肽前体(N terminal pro B type natriuretic peptide,NT-proBNP)水平、心率、心功能指标、不良反应及生活质量评分、疗效评价.结果 观察组肌酸激酶(CK)和左室舒张末内径(LVEDD)均低于对照组,差异有统计学意义(P＜0.05).观察组左心室射血分数(LVEF)和心输出量(CO)均高于对照组,差异有统计学意义(P＜0.05).观察组、对照组治疗前NT-proBNP水平、心率差异无统计学意义(P＞0.05),治疗后观察组NT-proBNP水平和心率均低于对照组,差异有统计学意义(P＜0.05).观察组、对照组不良反应发生率差异无统计学意义(P＞0.05).观察组、对照组生活质量比较差异有统计学意义(P＜0.05).观察组治疗有效率97.50％(39/40)与对照组[80.00％(32/40)]比较差异有统计学意义(P＜0.05).结论 在慢性心力衰竭治疗期间,通过加用伊伐布雷定改善临床症状的同时有助于降低不良反应发生率,患者的心功能改善,NT-proBNP水平降低,各项体征比较稳定.
Abstract
Objective To study the efficacy of Ivabradine in the treatment of chronic heart failure.Methods 80 patients with chronic heart failure who visited the Cardiovascular Department of Hanjiang Hospital in Putian,Fujian Province from July 2020 to July 2021 were collected.40 of them were served as the control group and received standardized anti heart failure treatment,including metoprolol tartrate sustained-release tablets,spironolactone,furosemide,and ramipril.The other 40 patients were selected to the observation group.On the base of the treatment of the control group,the observation group received Ivabradine if the heart rate still persisted at ≥70 beats/min when received evidence-based dosages of[3-blocker therapy.We compared the levels of N-terminal pro B type natriuretic peptide(NT proBNP),heart rate,cardiac function indicators,adverse reactions,quality of life scores,and efficacy evaluation between two groups.Results The observation showed that the creatine kinase(CK)and the left ventricular end diastolic diameter(LVEDD)in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The left ventricular ejection fraction(LVEF)and cardiac output(CO)in the observation group were higher than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in NT proBNP levels and heart rate between the observation group and the control group before treatment(P＞0.05).After treatment,the NT proBNP levels and heart rate in the observation group were lower than those in the control group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group(P＞0.05).The difference in quality of life between the observation group and the control group was statistically significant(P＜0.05).The effective rate of treatment in the observation group was 97.50％(39/40),and there was a statistically significant difference compared to that of the control group(80.00％(32/40))(P＜0.05).Conclusion During the treatment of chronic heart failure,the addition of Ivabradine can improve clinical symptoms while reducing the incidence of adverse reactions,improve cardiac function,lower NT proBNP levels,and stabilize various physical signs.
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