伊伐布雷定联合常规抗心力衰竭治疗老年心力衰竭的疗效及对心率变异性的影响

Efficacy of ivabradine combined with conventional anti-heart failure on elderly patients with heart failure and its effect on heart rate variability

目的探讨伊伐布雷定联合常规抗心力衰竭治疗老年心力衰竭的效果及对心率变异性的影响。方法抽取2018年1月至2020年11月濮阳市人民医院收治的老年心力衰竭患者108例, 按随机数字表法分为观察组(54例)与对照组(54例), 对照组采用常规抗心力衰竭治疗, 观察组在对照组基础上采用伊伐布雷定, 对比两组疗效、不良反应发生率和治疗前后心功能、心率变异性、血管内皮功能变化。结果观察组总有效率(94.44%)较对照组(79.63%)高, P<0.05;治疗后, 观察组左室射血分数(LVEF)较对照组高, 左室收缩末期容积(LVESV)较对照组低(P<0.05);治疗后, 观察组R-R间期、全窦性心搏间期总体标准差(SDNN)较对照组高(P<0.05);治疗后, 观察组一氧化氮(NO)较对照组高, 内皮素-1(ET-1)较对照组低(P<0.05);观察组不良反应发生率(3.70%)与对照组(7.41%)比较, P>0.05。结论伊伐布雷定联合常规抗心力衰竭治疗老年心力衰竭可提高疗效, 调节心率变异性, 改善血管内皮功能, 提高心功能, 且未增加不良反应发生风险, 具有安全性。

Objective To analyze the effect of ivabradine combined with conventional anti-heart failure in the treatment of elderly patients with heart failure and its effect on heart rate variability.Methods A total of 108 elderly patients with heart failure in Puyang People’s Hospital from January 2018 to November 2020 were selected,and divided into observation group(54 cases)and control group(54 cases)according to the random number table method.The control group was treated with conventional anti-heart failure treatment,and the observation group was treated with ivabradine on the basis of the control group.The curative effect,incidence of adverse reactions,changes of cardiac function,heart rate variability,vascular endothelial function before and after treatment were compared between the two groups.Results The total effective rate of the observation group(94.44%)was higher than that of the control group(79.63%),P<0.05.After treatment,the left ventricular ejection fraction(LVEF)in the observation group was higher than that in the control group,left ventricular end systolic volume(LVESV)was lower than that in the control group(P<0.05).After treatment,the R-R interval and total standard deviation of total sinus beat interval(SDNN)of the observation group were higher than those of the control group(P<0.05).After treatment,nitric oxide(NO)in the experimental group was higher than that in the control group,and endothelin-1(ET-1)was lower than that in the control group(P<0.05).The incidence of adverse reactions in the observation group(3.70%)was compared with that in the control group(7.41%),P>0.05.Conclusions Ivabradine combined with conventional anti-heart failure in the treatment of elderly heart failure can improve the curative effect,regulate heart rate variability,improve vascular endothelial function,improve cardiac function,and does not increase the risk of adverse reactions,and it is safe.