伊伐布雷定联合美托洛尔治疗CHF及对SCysC、Tei指数的影响

Effects of ivabradine in combination with metoprolol on CHF and SCysC and Tei index

目的探讨伊伐布雷定联合美托洛尔治疗慢性心力衰竭(CHF)的临床效果及对血清胱抑素C(CysC)、Tei指数的影响。方法选择2017年6月至2019年6月北京市大兴区中西医结合医院136例CHF患者,根据治疗方案分为行美托洛尔治疗的对照组和行伊伐布雷定联合美托洛尔治疗的观察组,治疗12周后,比较两组临床疗效、6 min步行距离试验(6MWT)、生活质量综合评定量表-74(GQOLI-74)量表评分、Tei指数、左室收缩末期内径(LVESD)、左心室舒张末内径(LVEDD)以及左室射血分数(LVEF)水平,比较治疗前后血清CysC、NT-proBNP水平。结果治疗后,观察组总有效率高于对照组,GQOLI-74评分、6MWT值、LVEF值均大于对照组,Tei指数、LVESD、LVEDD值及血清CysC、NT-proBNP均低于对照组,差异均有统计学意义(P<0.05)。Tei指数和血清CysC与LVESD、LVEDD及NT-proBNP呈正相关(P<0.05),与LVEF呈负相关(P<0.05)。结论伊伐布雷定联合美托洛尔治疗CHF能够降低患者血清CysC、NT-proBNP水平,改善心肌细胞功能,疗效明显。

Objective To investigate the effects of ivabradine combined with metoprolol on the clinical effect and serum CysC,Tei index in patients with chronic heart failure(CHF).Methods From June 2017 to June 2019,136 patients with CHF from the Daxing District Hospital of Integrated Traditional Chinese and Western Medicine in Beijing were selected.According to the treatment plan,they were divided into the control group treated with metoprolol and the observation group treated with ivabradine combined with metoprolol.After 12 weeks of treatment,the efficacy of the two groups of patients was compared.6 min minutewalk test(6 MWT),Generic Quality of Life Inventory-74(GQOLI-74),Tei index,LVESD,LVEDD and LVEF,serum CysC,NT-proBNP levels were monitored and compared before and after treatment.Results After treatment,the total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The GQOLI-74 score,6 MWT value,LVEF values in the observation group were higher than those in the control group,the Tei index,LVESD,LVEDD values,serum CysC and Nt-probNP in the observation group were lower than those in the control group,with statistical significance(P<0.05).Tei index and serum CysC were positively correlated with LVESD,LVEDD and NTprobNP(P<0.05),and negatively correlated with LVEF(P<0.05).Conclusion Ivabradine combined with metoprolol in the treatment of CHF patients can reduce the levels of serum CysC and NT-probNP,and improve the function of cardiomyocytes,and the efficacy is obvious.