伊伐布雷定联合美托洛尔治疗慢性心力衰竭的疗效观察

Observation of the Efficacy of Ivabradine Combined with Metolol in the Treatment of Chronic Heart Failure

目的探讨伊伐布雷定配合美托洛尔对于慢性心力衰竭(CHF)的效果。方法选取2019年1月至2022年1月我院CHF患者124例,按照随机数字表法分为单一组(n=62)和联合组(n=62),单一组使用美托洛尔,联合组在单一组的基础上使用伊伐布雷定。对比2组疗效、心功能[左室射血分数(LVEF)、N末端B型利钠肽前体(NT-proBNP)、心室收缩内径(LVESD)、心室舒张内径(LVEDD)]、心率变异性指标[所有正常R-R期间标准差(SDNN)、邻近正常R-R期间差值均方根(RMSSD)、R-R间期总数中相邻R-R间期占比(PNN50)]、血氧指标[氧饱和(SaO_(2))、氧分压(PaO_(2))]、运动耐力、心率、不良反应变化。结果联合组总有效率95.16%(59/62)比单一组77.42%(48/62)高(P<0.05);与单一组比较,联合组NT-proBNP、LVESD、LVEDD指数低,且LVEF含量高(P<0.05);与单一组比较,联合组PNN50、SDNN、RMSSD含量高(P<0.05);与单一组比较,联合组SaO_(2)、PaO_(2)含量高(P<0.05);与单一组比较,联合组运动耐力强,且心率指数低(P<0.05);联合组不良反应1.61%(1/62)与单一组8.06%(5/62)比较无明显变化(P>0.05)。结论伊伐布雷配合美托洛尔对于CHF患者疗效显著,可以改善心功能和心率变异性,改善血气水平,加强运动耐力,并具有安全性。

Objective To investigate the effect of ivavabradine with metolol on chronic heart failure(CHF).Methods 124 CHF patients from January 2019 to January 2022 were divided into a single group(n=62)and combined group(n=62)according to the random number table.The single group used metoprolol,and the combined group used ivavbradine based on a single group.Compare group 2 efficacy,cardiac function[left ventricular ejection fraction(LVEF),N terminal B natriuretic peptide precursor(NT-proBNP),ventricular systolic internal diameter(LVESD),ventricular diastolic diameter(LVEDD)],heart rate variability indicators[standard deviation(SDNN)during all normal R-R,root mean square difference during adjacent normal R-R(RMSSD),adjacent R-R interval proportion(PNN50)in total R-R interval],blood oxygen index[oxygen saturation(SaO_(2)),oxygen partial pressure(PaO_(2))],exercise endurance,heart rate,and adverse reactions.Results The total efficiency of 95.16%(59/62)was higher than 77.42%(48/62)(P<0.05);Comparison with a single group,Low proBNP,NT-group,LVESD,LVEDD,And it has a high LVEF content(P<0.05);Comparison with a single group,High in the combined group with PNN50,SDNN,and RMSSD content(P<0.05);Comparison with a single group,High content of SaO_(2) and PaO_(2)(P<0.05);Comparison with a single group,The Combined group has strong athletic endurance,And the heart rate index is low(P<0.05);No adverse effects changed between 1.61%(1/62)in the combined group and 8.06%(5/62)(P>0.05).Conclusion Combined with metool in CHF patients can improve heart function and heart rate variability,improve blood gas level,strengthen exercise endurance and have safety.