伊伐布雷定在心衰易损期控制心室率的作用分析

王瑞梅

（中铁一局集团西安中心医院，陕西 西安，710054）

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摘要：

目的 探讨伊伐布雷定在心衰易损期控制心室率的作用。方法 选择2014年1月至2016年6月在本院治疗后离院的心衰易损期患者78例作为研究对象，随机分为对照组和观察组，每组39例。对照组行常规心衰易损期治疗，观察组在对照组基础上增加伊伐布雷定治疗。观察治疗前、后两组患者心室率变化情况，两组患者的每搏出量搏出量（SV）、心输出量（CO）、射血分数（EF）、舒张早期心室充盈速度最大值（E）、心脏指数（CI）等心功能指标和治疗期间不良反应发生情况，并随访统计两组患者出院后的心衰恶化再住院和心血管事件死亡发生率。结果 治疗后，两组患者的心室率均较治疗前显著降低，且观察组患者的心室率显著低于对照组（P<0.05）；治疗后，两组患者的SV、CO、CI、E、EF 等指标均较治疗前显著升高，且观察组患者的上述指标显著高于对照组（P<0.05）。观察组患者的不良反应发生率与对照组比较，差异无统计学意义（P>0.05）。随访结果显示，观察组患者的心衰恶化再住院率显著低于对照组（P<0.05），两组的心血管事件死亡率比较，差异不具有统计学意义（P>0.05）。结论 伊伐布雷用于控制心衰易损期心室率效果良好，有助于改善患者心功能，并降低再住院率，临床应用安全有效。

关键词：伊伐布雷定；心衰；易损期；心室率

中图分类号：R541.6文献标志码：A文章编号：2096-1413(2017)26-0005-03

Effect of ivabradine on ventricular rate control in heart failure vulnerable period
WANG Rui-mei
(Xi``an Central Hospital of China Railway First Group, Xi``an 710054, China)

ABSTRACT: Objective To study the ventricular rate control effect of ivabradine in heart failure vulnerable period. Methods Seventy-eight cases of patients with heart failure in vulnerable stage in our hospital from January 2014 to June 2016 were randomly divided into control group and observation group, with 39 cases in each group. The control group received routine treatment, the observation group was treated with ivabradine based on the control group. The stroke volume (SV), cardiac output (CO), ejection fraction (EF), early diastolic ventricular filling maximum velocity (E), cardiac index (CI) before and after treatment and adverse reactions during treatment of the two groups were observed. The mortality of heart failure, heart failure deterioration rehospitalization were compared between the two groups. Results After treatment, the ventricular rates of the two groups were significantly lower than those before treatment, and the ventricular r ate in the observation group was significantly lower than the control group, the SV, CO, CI, E and EF of the two groups were significantly higher than those before treatment (P<0.05), and these indexes above of the observation group were significantly higher than the control group(P<0.05). There was no significantly difference in the incidence of adverse reactions between the two groups (P>0.05). The follow-up results showed that the heart failure deterioration rehospitalization rate of the observation group were significantly lower than those of the control group (P<0.05), and there was no significantly differences in the mortality rate of cardiovascular events between the two groups (P>0.05). Conclusion Ivabradine has good ventricular rate control function in heart failure vulnerable period, which can help to improve the heart function of patients, and reduce the rate of hospitalization. The clinical application of ivabradine is safe and effective.
KEYWORDS: ivabradine; heart failure; vulnerable period; ventricular rate

参考文献:
[1] 张梦雅,蔡鑫.伊伐布雷定临床应用进展[J].国际心血管病杂志,2014,41(6):388-390.
[2] 侯鹏高.伊伐布雷定在心血管疾病中的临床应用进展[J].齐齐哈尔医学院学报,2015,36(21):3237-3238.
[3] 钟丽球,黎艺毅.伊伐布雷定在慢性心力衰竭治疗中的应用[J].河北医药,2016,38(5):756-758.
[4] 谢立,张文颖.茁-受体阻断剂剂量对伊伐布雷定在心衰患者治疗中疗效的影响[J].成都医学院学报,2016,11(4):515-518.
[5] 黄龙祥,罗素新.伊伐布雷定在心血管疾病应用中的研究进展[J].心血管病学进展,2014,35(3):375-379.
[6] 于怡卉,李明慧,许周涛,等.伊伐布雷定在心血管疾病中的研究新进展[J].中华临床医师杂志:电子版,2014,8(14):2721-2724.
[7] 左军,彭杏容.两种抗心衰药物对心衰患者心脏指标及血浆N末端 BNP水平影响的比较分析[J].世界最新医学信息文摘,2016,16(39):96-98.
[8] 张文颖.心力衰竭患者中伊伐布雷定临床疗效的影响因素[J].中国药业,2016,25(15):4-9.
[9] 马振.硫酸氢伊伐布雷定对中-重度慢性心衰并左心室收缩功能不全患者疗效研究[D].济南:济南大学,2016:28-29.
[10] 李春雷,李竹琴,王岚峰.伊伐布雷定在心血管疾病中的研究进展 [J].心血管病学进展,2012,33(3):327-330.
[11] 何海潇,郭晓曦,张慧敏.伊伐布雷定与心血管系统疾病[J].心血管病学进展,2012,33(6):792-796.