[关键词]
[摘要]
目的 探讨伊伐布雷定对老年心力衰竭患者心功能、心率变异性及NT-proBNP水平的影响。方法 选择2016年4月—2019年4月延安大学附属医院治疗的老年心力衰竭患者92例作为研究对象,根据入院单双号分为对照组(n=46)和观察组(n=46)。对照组接受常规的标准化抗心衰治疗,观察组在对照组的基础上口服盐酸伊伐布雷定片,初始剂量2.5 mg/次,2次/d,之后根据患者心率调整给药剂量,最大剂量不超过7.5 mg/次,2次/d,控制患者静息心率在55~65次/min,两组均连续治疗2个月。观察两组患者的临床疗效,同时比较两组治疗前后的心功能、心率变异性和N末端B型钠尿肽原(NTproBNP)水平。结果 治疗后,观察组总有效率为93.48%,显著高于对照组的78.26%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组左心室射血分数(LVEF)、6 min步行距离(6 MWT)均明显升高,左室收缩末期内径(LVESD)和左室舒张末期内径(LVEDD)均显著降低(P<0.05);且观察组心功能指标显著优于对照组(P<0.05)。治疗后两组各心率变异性指标及NT-proBNP水平均明显改善(P<0.05),且观察组各指标显著优于对照组(P<0.05)。结论 伊伐布雷定可有效改善患者的心功能及心率变异性,降低NT-proBNP水平,疗效确切,安全性高,对控制老年心力衰竭患者病情进展有积极意义。
[Key word]
[Abstract]
Objective To investigate the effects of iavbredine on cardiac function, heart rate variability and NT-proBNP levels in elderly patients with heart failure. Methods A total of 92 elderly patients with heart failure treated in Yan'an University Affiliated Hospital from April 2016 to April 2019 were selected as the study subjects, and were divided into the control group (n=46) and the observation group (n=46) according to the odd-even number of admission. Patients in the control group were received routine standardized anti-heart failure therapy, patients in the observation group were po administered with Ivabradine Hydrochloride Tablets on the basis of control group, the initial dose was 2.5 mg/time, twice daliy, and then the dose was adjusted according to the patient's heart rate. The maximum dose was not more than 7.5 mg/time, twice daily. The resting heart rate of the patient was controlled at 55-65 times/min. Both groups were treated continuously for two months. The clinical efficacy in two groups was observed, and the cardiac function, heart rate variability, and NT-proBNP levels before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 93.48%, which was significantly higher than 78.26% in the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, LVEF and 6 MWT were significantly increased in two groups, while LVESD and LVEDD were significantly decreased (P<0.05). Moreover, the cardiac function index of the observation group was significantly better than that of the control group (P<0.05). After treatment, the indicators of heart rate variability and NT-proBNP levels in two groups were significantly improved (P<0.05), and the indicators in the observation group were significantly better than those in the control group (P<0.05). Conclusion Ivabradine can effectively improve the cardiac function and heart rate variability in patients, reduce the level of NT-proBNP, the efficacy is accurate, high safety, to control the disease progression of elderly heart failure patients has a positive significance.
[中图分类号]
R972
[基金项目]
延安市科学技术项目(7902015Y0011)