摘要
目的研究探讨伊伐布雷定治疗慢性心力衰竭伴窦性心动过速的疗效。方法选择我院收治的2017年1月至2018年6月65例慢性心力衰竭伴窦性心动过速患者,随机分为对照组32例、观察组33例,对照组实施常规抗心力衰竭治疗,观察组在其基础上加用伊伐布雷定,比较临床疗效、症状及体征改善情况、心率、心功能指标、心功能不全生命质量评分、不良反应。结果观察组显效率(51.52%比25.00%)、总有效率(96.97%比81.25%)均较对照组更高(P<0.05),而两组有效率(45.45%比56.25%)、无效率(3.03%比18.75%)比较均无统计学差异(P>0.05)。观察组的全身水肿[(2.09±0.64)d比(2.98±0.81)d]、呼吸困难[(1.75±0.51)d比(2.36±0.62)d]、肺啰音[(2.06±0.54)d比(2.73±0.69)d]等缓解时间均较对照组缩短,差异均有统计学意义(均P<0.05)。两组患者治疗后的心率、左心室射血分数、每搏输出量、脑钠肽水平均较治疗前改善,而在治疗后,观察组的左心室射血分数[(59.36±6.25)%比(53.17±5.52)%]、每搏输出量[(76.29±5.31)ml比(70.85±4.98)ml]均高于对照组,其心率[(87.28±5.69)次/分比(93.51±6.25)次/分]、NT-proBNP水平[(378.32±27.82)ng/ml比(410.26±31.65)ng/ml]低于对照组,且观察组治疗前后的差值均较对照组更大,差异均有统计学意义(均P<0.05)。两组治疗后的心功能不全生命质量评分均较治疗前降低,而治疗后观察组较对照组更低,且观察组治疗前后的差值均较对照组更大,差异均有统计学意义(均P<0.05)。对照组用药后发生恶心1例,观察组用药后发生光幻视2例,其不良反应总发生率分别为3.13%、6.06%。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论伊伐布雷定用于慢性心力衰竭伴窦性心动过速治疗中,可提高患者的临床疗效,更好地缓解症状、改善心功能,且不良反应少,安全性良好。
Objective To study the effect of ivabradine on chronic heart failure with sinus tachycardia.Methods65 patients with chronic heart failure and sinus tachycardia(January 2017-June 2018)were randomly divided into control group(32 cases)and observation group(33 cases).The control group was treated with routine anti-heart failure therapy.The observation group was treated with ivabradine on the basis of the treatment.The clinical efficacy,improvement of symptoms and signs,heart rate,cardiac function index and life quality of cardiac insufficiency were compared.Quantity score,adverse reactions.Results(1)The total clinical effective rates were 96.97%(observation group)and 81.25%(control group),respectively.The observation group was higher than the control group,P<0.05.(2)The remission time of systemic edema,dyspnea and rale in the observation group was shorter than that in the control group,P<0.05.(3)After treatment,the heart rate,brain natriuretic peptide level and quality of life score of the observation group were lower than those of the control group,and the left ventricular ejection fraction and stroke output of the observation group were higher than those of the control group,all P<0.05.(4)There was no significant difference in the total incidence of adverse reactions between groups(P>0.05).Conclusion Ivabradine in the treatment of chronic heart failure with sinus tachycardia can improve the clinical efficacy,alleviate symptoms and improve cardiac function,with fewer adverse reactions and good safety.
作者
曾凡超
ZENG Fan-chao(Department of Cardiology,Shaoguan First People's Hospital,Shaoguan 512000,China)
出处
《中国误诊学杂志》
CAS
2019年第4期168-171,共4页
Chinese Journal of Misdiagnostics
