右佐匹克隆对慢性心衰伴失眠患者临床疗效分析

Analysis of clinical effects of Eszopiclone in treatment of insomnia combined with chronic heart failure

目的:观察右佐匹克隆对慢性心衰伴失眠患者临床疗效分析。方法:选择120例失眠伴慢性心力衰竭(NYHAⅠ~Ⅱ级)患者,随机分为治疗组和对照组,每组各60例。对照组患者间断给予阿普唑仑治疗;治疗组患者给予右佐匹克隆规范治疗。入组前,两组患者临床基础资料及失眠严重程度,差异无统计学意义(P>0.05)。治疗6个月后,采用阿森斯失眠量表对两组患者的临床睡眠质量进行比较,采用副反应量表(TESS)对两组患者的临床药物不良反应进行评价。比较两组患者心率变异性、血浆钠尿肽(BNP)水平及临床恶性心血管事件发生率。结果:治疗后,治疗组患者的阿森斯失眠量表评分较对照组[(11.42±3.91)比(16.87±4.05);t=2.905]明显减少,差异有统计学意义(P<0.05);临床药物不良反应率[(12/60,18.67%)比(19/60,31.67%);x^2=2.947]减少,差异有统计学意义(P<0.05);临床总有效率比较[(57/60,95.00%)比(23/60,38.33%);x^2=3.957]明显升高,差异有统计学意义(P<0.05)。治疗组患者的心率变异性(SDNN)[(123.85±24.79)比(102.93±25.86);t=2.984]较对照组增加,血浆BNP水平较对照组[(216.38±35.27)比(431.05±46.28)ng/L;t=3.026]明显降低,差异有统计学意义(P<0.05)。治疗后,治疗组患者出现心衰加重、频发室早、阵发性室上性心动过速几率减少,差异有统计学意义(P<0.05)。结论:右佐匹克隆具有显著改善失眠伴慢性心衰患者睡眠质量,保护心脏功能,减少恶性临床心血管事件发生几率作用,临床疗效肯定,不良反应少。

Objective： To observe and analyze clinical effects of Eszopiclone in treatment of insomnia combined with chronicheart failure. Methods： 120 patients with insomnia combined with chronic heart failure （NYHAⅠ-Ⅱ） were selected and randomly divided into treatment group （ n= 60） and control group （ n = 60） . The patients in the control group were given Alprazolam, while those in the treatment group received Eszopiclone. There were no statistical differences in the clinical data and the insomnia severity between the two groups. Six months after the treatment, the clinical sleep quality was assessed by the Athens insomnia scale, and the adverse drug reactions were evaluated by the treatment emergent symptom scale （TESS）. The heart rate variability, plasma natriuretic peptide （BNP） level and incidence of clinical malignant cardiovascular events were compared between the two groups. Results ： After the treat-ment ,the Athens insomnia scale score of the treatment group was significantly lower than that of the control group were [（11. 42 ± 3.91）vs （16. 87±4.05）, t = 2. 905] （ P 〈0. 05） , the clinical adverse drug reaction rate was lower than that of the control group [（12/60, 18.67%） vs （19/60, 31.67%）, x^2 =2. 947] （ P 〈 0 .0 5 ） , and the clinical efficacy was higher than that of the control group [ （57/60, 95. 00% ） vs （23/60, 38.33%）, x^2 = 3. 957] （P〈0. 05）. The level of heart rate variability of the treatment group was greater than that of the control group [（123.85±24.79） vs （102.93±25. 86）, t = 2.984], and the BNP level was obviously lower than that of the control group[（216.38±35.57） vs （41.05±46.28）ng/L, t = 3.026]（P〈0.05）. The probabilities of occurrence of heart failure exacerbation, frequent ventricular premature, paroxysmal supraventricular tachycardia rate in the treatment group were lower than those of the control group, the differences were statistically significant （P〈0. 05 ）. Conclusions ： Eszopiclone can effectively improve sleep quality, protect heart function and reduce the malignant clinical cardiovascular event incidence in the patients with insomnia combined with chronic heart failure with less adverse reactions.