伊伐布雷定对慢性心力衰竭患者的效果分析

Effect of Ivabradine on Patients with Chronic Heart Failure

目的探讨对于慢性心力衰竭(CHF)患者使用伊伐布雷定后的效果。方法选择2018年6月至2019年10月在泰安市第四人民医院心内科进行治疗的CHF患者128例作为研究对象,按照数字表法随机分为两组,观察组64例,对照组64例。两组患者均给予常规治疗,降脂、抗血小板聚集、血管紧张素转化酶抑制剂(ACEI)、β受体阻滞剂、醛固酮抑制剂等治疗;观察组在常规治疗的基础上加用伊伐布雷定,每次5 mg,每日2次,口服,根据心率增加剂量,最大剂量至每次7.5 mg,每日2次,口服,控制患者静息心率55~60次/分。两组均治疗3个月。治疗前后检测左心室射血分数(LVEF)、左心室收缩末期内径(LVESd)及左心室舒张末期内径(LVEDd)、静息状态下心率(HR)、平均动脉压和氨基末端脑利钠肽前体(NT-proBNP)。结果两组患者治疗后LVEF均有明显升高(P均<0.01),且观察组治疗后较对照组治疗后升高更明显(P<0.05)。两组患者治疗后LVESd均有明显降低(P均<0.05),且观察组治疗后较对照组治疗后降低更明显(P<0.05)。两组患者治疗后HR、平均动脉压、NT-proBNP均有明显降低(P均<0.01),且观察组治疗后较对照组治疗后降低更明显(P<0.05)。结论对CHF患者在常规降脂、抗血小板聚集、血管紧张素转化酶抑制剂(ACEI)、β受体阻滞剂、醛固酮抑制剂等治疗基础上加用伊伐布雷定治疗,可以减慢患者心率、降低平均动脉压、改善心功能。

Objective To explore the effect of ivabradine on patients with chronic heart failure.Methods A total of 128 patients with chronic heart failure who were treated in the Department of Cardiology,Fourth People's Hospital of Tai'an City from June 2018 to October 2019 were selected as the research objects.They were randomly divided into two groups according to the number table method,with 64 cases in the observation group and 64 cases in the control group.Both groups of patients were given conventional treatments such as lipid-lowering,anti-platelet aggregation,angiotensin-converting enzyme inhibitor(ACEI),β-receptor blockers,aldosterone inhibitors,etc;the observation group was treated with irabradine on the basis of conventional treatment,5 mg each time,2 times a day,orally,increase the dose according to the heart rate,the maximum dose is 7.5 mg each time,2 times a day,orally,to control the patient's resting heart rate 55-60 beats/min.Both groups were treated for 3 months.Detect left ventricular ejection fraction(LVEF),left ventricular endsystolic diameter(LVESd)and left ventricular end-diastolic diameter(LVEDd)before and after treatment,resting heart rate(HR),mean arterial pressure and N-terminal brain natriuretic peptide Body(NT-proBNP).Results LVEF increased significantly after treatment in the two groups(all P<0.01),and the increase in the observation group was more significant after treatment than in the control group(P<0.05).The LVESd of the two groups of patients was significantly reduced after treatment(all P<0.05),and the observation group was significantly lower than the control group after treatment(P<0.05).HR,mean arterial pressure,and NT-proBNP were significantly reduced after treatment in the two groups of patients(all P<0.01),and the reduction in the observation group was more significant after treatment than in the control group(P<0.05).Conclusion In patients with chronic heart failure,the addition of ivabradine therapy to conventional lipid-lowering,anti-platelet aggregation,angiotensin converting enzyme inhibitor(ACEI),β-receptor blockers,aldosterone inhibitors and other treatments can slow down Patient's heart rate,lower mean arterial pressure,and improve heart function.