目的 探讨维立西呱片联合盐酸伊伐布雷定片治疗慢性心力衰竭的临床疗效。方法 选取2023年6月—2025年5月在青岛市第八人民医院就诊的慢性心力衰竭患者共计95例，患者按随机数字表法分为对照组（47例）和治疗组（48例）。对照组口服盐酸伊伐布雷定片，2次/d，初始剂量5 mg/次，3～4周后调整为7.5 mg/次。治疗组在对照组基础上口服维立西呱片，1次/d，初始剂量2.5 mg/次，每2周增加1次剂量，维持剂量10 mg/次。两组患者连续治疗3个月。比较两组的治疗效果、心率（HR）、平均动脉压（MAP）、心功能指标、生活质量、血清纤维化指标。结果 治疗组的总有效率为91.67%，对照组的总有效率为76.60%，组间比较差异有统计学意义（P＜0.05）。治疗后，两组的HR、MAP均明显降低（P＜0.05），且治疗组的HR、MAP均明显低于对照组（P＜0.05）。两组治疗后的左房内径（LAD）明显降低，左心室射血分数（LVEF）、心排血量（CO）明显升高（P＜0.05）；治疗组治疗后的LAD明显低于对照组，LVEF、CO明显高于对照组（P＜0.05）。治疗后，两组的明尼苏达生活质量量表（MLHFQ）评分均降低（P＜0.05），治疗组的MLHFQ评分明显低于对照组（P＜0.05）。两组患者治疗后的血清生长分化因子-15（GDF-15）、基质金属蛋白酶-9（MMP-9）、结缔组织生长因子（CTGF）水平明显降低（P＜0.05）；治疗组治疗后的血清GDF-15、MMP-9、CTGF水平明显低于对照组（P＜0.05）。结论 维立西呱片联合盐酸伊伐布雷定片可提高慢性心力衰竭的临床疗效，改善心率、血压、心功能和生活质量，延缓心肌重塑进程。

Objective To investigate the clinical efficacy of Vericiguat Tablets combined with Ivabradine Hydrochloride Tablets in treatment of chronic heart failure. Methods A total of 95 patients with chronic heart failure who were admitted to Qingdao Eighth People’s Hospital from June 2023 to May 2025 were selected. The patients were divided into control group (47 cases) and treatment group (48 cases) using a random number table. The control group was po administered with Ivabradine Hydrochloride Tablets, twice daily, starting with 5 mg per dose and adjusted to 7.5 mg per dose after 3 – 4 weeks. The treatment group was po administered with Vericiguat Tablets on the basis of the control group, once daily, starting with 2.5 mg per dose, with the dose increased every 2 weeks, and maintained at 10 mg per dose. Two groups received continuous treatment for 3 months. The therapeutic effects, heart rate (HR), mean arterial pressure (MAP), cardiac function indicators, quality of life, and serum fibrosis markers were compared between two groups. Results The total effective rate of the treatment group was 91.67%, while the total effective rate of the control group was 76.60%, and the difference between two groups was statistically significant (P < 0.05). After treatment, the HR and MAP of two groups were significantly reduced (P < 0.05), and the HR and MAP of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the left atrial diameter (LAD) significantly decreased in two groups, while the left ventricular ejection fraction (LVEF) and cardiac output (CO) significantly increased (P < 0.05). The LAD of the treatment group was significantly lower than that of the control group after treatment, while LVEF and CO were significantly higher than those of the control group (P < 0.05). After treatment, the Minnesota Quality of Life Questionnaire (MLHFQ) scores of two groups decreased (P < 0.05), and the MLHFQ score of the treatment group was significantly lower than that of the control group (P < 0.05). The serum levels of growth differentiation factor-15 (GDF-15), matrix metalloproteinase-9 (MMP-9), and connective tissue growth factor (CTGF) were significantly reduced in two groups after treatment (P < 0.05). The serum levels of GDF-15, MMP-9, and CTGF in the treatment group were significantly lower than those in the control group after treatment (P < 0.05). Conclusion The combination of Vericiguat Tablets and Ivabradine Hydrochloride Tablets can improve the clinical efficacy of chronic heart failure, improve heart rate, blood pressure, heart function, and quality of life, and delay the process of myocardial remodeling.

R972

山东省自然科学基金项目（ZR2023MH268）