临床荟萃

• 论著 • 上一篇    下一篇

伊伐布雷定对急性失代偿性左心室射血分数降低型心力衰竭患者的近期疗效

  

  1. 南通大学附属医院 心内科, 江苏 南通  226001
  • 出版日期:2020-04-20 发布日期:2020-04-16
  • 通讯作者: 于小红,Email: Yuxiaohong669@aliyun.com
  • 基金资助:
    南通市市级科技计划项目----扩张型心肌病的规范化诊疗(MS22019004)

Shortterm efficacy  of ivabradine in patients with acute decompensated heart failure with reduced ejection fraction

  1. Department of Cardiology, Affiliated Hospital of Nantong University,  Nantong  226001,  China
  • Online:2020-04-20 Published:2020-04-16
  • Contact: Corresponding author: Yu Xiaohong, Email:Yuxiaohong669@aliyun.com

摘要: 目的  对急性失代偿性射血分数降低型心力衰竭(ADHFrEF)患者在常规药物治疗基础上加用伊伐布雷定,观察伊伐布雷定的临床疗效及安全性。方法  50例ADHFrEF患者随机分入对照组和观察组。对照组给予基础抗心衰治疗,观察组在对照组治疗基础上,加用伊伐布雷定5 mg,每日两次,口服,根据心率反应调整剂量。比较两组治疗前后患者心率、血压、心功能指标、血浆生化指标、平均住院时间以及主要不良心血管事件和不良反应。结果  两组患者治疗后,平均心率(HR)、BNP水平均较治疗前显著下降,6分钟步行距离(6MD)和左心室射血分数(LVEF)较治疗前显著提高(均P<0.05),左心室舒张末内径(LVEDD)和心室收缩末内径(LVESD)较治疗前缩小(均P<0.05)。与对照组比较,伊伐布雷定可进一步减慢心率,提高6MD和LVEF(均P<0.05)。结论  在基础抗心衰治疗基础上加用伊伐布雷定能进一步改善ADHFrEF患者心脏功能、提高患者运动耐量。

关键词: 伊伐布雷定, 心力衰竭,  , 充血性, 每搏输出量, 治疗结果

Abstract: Objective  To observe the clinical efficacy and safety of ivabradine in patients with acute decompensated heart failure with reduced ejection fraction(ADHFrEF) on the basis of conventional drug therapy. Methods  Fifty patients with ADHFrEF were randomly devided in to control  group (group C) and observation group (group O). Group C was given routine antiheart failure treatment. Group O was treated with ivabradine 5 mg orally in addition to the routine anti  heart failure treatment. Ivabradine dose was adjusted according to the heart rate response. The heart rate(HR),  blood pressure,  cardiac function indexes,  plasma biochemical parameters,  average hospital stay,  major adverse cardiovascular events and side effects of these two groups were compared before and after treatment.Results  After treatment,  the average HR  and brain natriuretic peptide(BNP)  lvevel in two groups were significantly lower than those before treatment. The 6minute walking distance (6MD) and left ventricular ejection fraction (LVEF) were significantly higher than those before treatment (both P<0.05). The left ventricular end diastolic diameter (LVEDD) and left  ventricular end systolic  diameter(LVESD) were smaller than those before treatment (both P<0.05). Compared to group C,  ivabradine could further slow HR,  and increase 6MD and LVEF (all P<0.05). Conclusion  On the basic of routine antiheart failure treatment ivabradine can further improve the cardiac function and improve the exercise tolerance of patients with ADHFrEF.

Key words: ivabradine;heart failure, , congestive, stroke volume, treatment outcome