采用伊伐布雷定对慢性心力衰竭患者实行严格心率管理的临床效果研究

Study on the clinical effect of ivabradine on strict heart rate management in patients with chronic heart failure

目的采用伊伐布雷定对慢性心力衰竭患者进行严格心率管理,观察临床疗效。方法选取2019年1月至2020年8月在如皋市人民医院就诊的慢性心力衰竭患者102例,随机分为观察组(51例)和对照组(51例)。对照组服用美托洛尔采用宽松的心率管理方法,观察组在对照组基础上联合伊伐布雷定采用严格的心率管理方法。治疗12周后测定所有患者左室射血分数(LVEF)、氨基末端脑钠肽前体(NT-proBNP)、总体标准差(SDNN)、均值标准差(SDANN)、均方根(RMSSD)。结果治疗12周后观察组与对照组比较LVEF明显改善,NT-proBNP水平进一步降低,差异有统计学意义(P<0.05)。治疗12周后观察组与对照组比较发现SDNN、SDANN和RMSSD水平进一步升高,差异有统计学意义(P<0.05)。结论对于慢性心力衰竭患者联合使用伊伐布雷定和美托洛尔施行严格心率管理能够进一步改善心功能和心率变异性,值得临床推广。

Objective To adopt ivabradine to strictly manage the heart rate of patients with chronic heart failure(CHF),and to observe the clinical efficacy.Methods A total of 102 CHF patients who were treated in the People's Hospital of Rugao from January 2019 to August 2020 were selected and randomly divided into the observation group(51 cases)and the control group(51 cases).The control group took metoprolol with a loose heart rate management method,and the observation group received ivabradine on the basis of the same treatment in the control group with a strict heart rate management method.After 12 weeks of treatment,left ventricular ejection fraction(LVEF),N-terminal probrain natriuretic peptide(NT-proBNP),standard deviation of all normal-to-normal R-R intervals(SDNN),standard deviation of 5-minute segments of normalized RR intervals(SDANN)and Root Mean Square of Successive Differences(RMSSD)were measured for all patients.Results After 12 weeks of treatment,the LVEF in the observation group significantly increased compared to that in the control group and the level of NT-proBNP further decreased,with statistically significant differences(P<0.05).After 12 weeks of treatment,the levels of SDNN,SDANN and RMSSD in the observation group further increased compared to those in the control group,with statistically significant differences(P<0.05).Conclusion For CHF patients the combined medication of ivabradine and metoprolol for strict heart rate management can further improve heart function and heart rate variability,and is worthy of clinical promotion.