目的 探讨盐酸伊伐布雷定片联合酒石酸美托洛尔片治疗稳定型心绞痛的临床疗效。方法 选取2019年9月—2020年4月天津市第二医院收治的84例稳定型心绞痛患者为研究对象。所有患者均口服酒石酸美托洛尔片，25 mg/次，2次/d。治疗4周后静息心率<70次/min的患者为对照组（34例），对照组继续口服酒石酸美托洛尔片，25 mg/次，2次/d。静息心率≥70次/min的患者继续口服上述剂量酒石酸美托洛尔片的基础上口服盐酸伊伐布雷定片，5 mg/次，2次/d，根据患者心率变化调整用药量，最大耐受度7.5 mg/次，2次/d。治疗12周后心率<70次/min的患者为治疗组（38例）。两组患者均连续治疗12周。观察两组的临床疗效，比较两组静息和最大运动量时心率、心绞痛发作情况和生活质量评分。结果 治疗后，治疗组总有效率为92.11%，高于对照组的79.41%，两组总有效率比较差异有统计学意义（P<0.05）。治疗后，两组静息心率、最大运动量时心率均较治疗前明显降低，差异有统计学意义（P<0.05）；治疗后，治疗组最大运动量时心率较对照组降低更显著，差异有统计学意义（P<0.05）。治疗后，两组患者发作频率、持续时间、硝酸甘油消耗量均较治疗前显著下降，差异有统计学意义（P<0.05），且治疗组发作频率、持续时间、硝酸甘油消耗量较对照组下降更显著，差异具有统计学意义（P<0.05）。治疗后，两组西雅图心绞痛量表（SAQ）中各维度评分较治疗前均显著升高，差异有统计学意义（P<0.05），且治疗组SAQ中除对疾病的认识外，其他各维度评分均显著高于对照组，差异有统计学意义（P<0.05）。结论 盐酸伊伐布雷定片联合酒石酸美托洛尔片治疗稳定型心绞痛疗效良好，可能明显降低患者的心率，改善患者的心绞痛发作情况，保护心脏功能，提高患者的生活质量。

Objective To explore the clinical effect of Ivabradine Hydrochloride Tablets combined with Metoprolol Tartrate Tablets in treatment of stable angina pectoris. Methods Patients (84 cases) with stable angina pectoris in Tianjin Second Hospital from September 2019 to April 2020 were selected as research subjects. All patients were treated with Metoprolol Tartrate Tablets, 25 mg/time, twice daily. After 4 weeks of treatment, patients with resting heart rate less than 70 times/min were selected as the control group (34 cases). Patients with resting heart rate ≥ 70 times/min were po administered with Ivabradine Hydrochloride Tablets on the basis of the control group, 5 mg/time, twice daily, adjusted the dosage according to the change of heart rate, and the maximum tolerance could be given 7.5 mg/time, twice a day. Patients whose heart rates were less than 70 times/min after 12 weeks of treatment were selected as treatment group (38 cases). Patients in the control group were po administered with Metoprolol Tartrate Tablets, 25 mg/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and resting heart rate and maximal exercise rate, the attack of angina pectoris, and quality of life score in two groups were compared. Results After treatment, the total effective rate of the treatment group was 92.11%, which was higher than 79.41% of the control group, and the difference was statistically significant (P<0.05). After treatment, the resting heart rate and maximum exercise heart rate of two groups were significantly lower than before treatment, and the difference was statistically significant (P<0.05). After treatment, the maximum exercise heart rate of the treatment group was significantly lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the frequency, duration and nitroglycerin consumption of angina pectoris in two groups were significantly lower than those before treatment (P<0.05), and the frequency, duration and nitroglycerin consumption of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, the scores of each dimension in SAQ of two groups were significantly higher than those before treatment (P<0.05), and the scores of other dimensions in SAQ of the treatment group were significantly higher than those of the control group (P<0.05). Conclusion Ivabradine Hydrochloride Tablets combined with Metoprolol Tartrate Tablets has good effect in the treatment of stable angina pectoris, can significantly reduce the heart rate of patients, improve the attack of angina pectoris, protect the heart function and improve the quality of life of patients.

R972