伊伐布雷定治疗窄QRS心动过速的临床疗效  

Clinical Effect of Ivabradine on Narrow QRS Tachycardia

作　　者：孙志明 SUN Zhi-ming(Department of Cardiovascular Medicine,the Fourth People's Hospital of Shaanxi Province,Xi'an 710043,China)

机构地区：[1]陕西省第四人民医院心血管内科,陕西省西安市710043

出　　处：《实用心脑肺血管病杂志》2018年第10期103-106,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察伊伐布雷定治疗窄QRS心动过速的临床疗效。方法选取2013年8月—2017年7月陕西省第四人民医院收治的窄QRS心动过速患者123例,采用随机数字表法分为对照组61例和观察组62例。在常规对症治疗基础上,对照组患者给予普罗帕酮治疗,观察组患者给予伊伐布雷定治疗;两组患者均连续治疗120 d。比较两组患者治疗有效率,治疗前后心率、收缩压(SBP)、舒张压(DBP)、QT间期(QTc)、QT离散度(QTcd)、心功能指标[包括6分钟步行距离、左心室射血分数(LVEF)、心脏指数(CI)]及健康状况调查简表(SF-36)评分,并观察两组患者治疗期间不良反应发生情况。结果 (1)观察组患者治疗有效率高于对照组(P<0.05)。(2)治疗前两组患者心率、SBP、DBP、QTc、QTcd比较,差异无统计学意义(P>0.05);治疗后观察组患者心率、SBP、DBP低于对照组,QTc、QTcd短于对照组(P<0.05)。(3)治疗前两组患者6分钟步行距离、LVEF、CI及SF-36评分比较,差异无统计学意义(P>0.05);治疗后观察组患者6分钟步行距离长于对照组,LVEF、CI及SF-36评分高于对照组(P<0.05)。(4)两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论伊伐布雷定治疗窄QRS心动过速的临床疗效确切,降低患者心率及血压,改善患者心功能及生活质量,且安全性较高。Objective To observe the clinical effect of ivabradine on narrow QRS tachycardia.Methods A total of123patients with narrow QRS tachycardia were selected in the Fourth People's Hospital of Shaanxi Province from August2013to July2017,and they were divided into control group(n=61)and observation group(n=62)according to random number table.Based on conventional symptomatic treatment,patients in control group received propafenone,while patients in observation group received ivabradine;both groups continuously treated for120days.Effective rate,heart rate,SBP,DBP,QTc,QTcd,index of cardiac function(including6-minute walking distance,LVEF and CI)and SF-36score before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment.Results(1)Effective rate in observation group was statistically significantly higher than that in control group(P<0.05).(2)No statistically significant differences of heart rate,SBP,DBP,QTc or QTcd was found between the two groups before treatment(P>0.05);after treatment,heart rate,SBP and DBP in observation group were statistically significantly lower than those in control group,meanwhile QTc and QTcd in observation group was statistically significantly shorter than that in control group(P<0.05).(3)No statistically significant differences of6-minute walking distance,LVEF,CI or SF-36score was found between the two groups before treatment(P>0.05);after treatment,6-minute walking distance in observation group was statistically significantly longer than that in control group,LVEF,CI and SF-36score in observation group were statistically significantly higher than those in control group(P<0.05).(4)No statistically significant differences of incidence of adverse reactions was observed during treatment(P>0.05).Conclusion Ivabradine has certain clinical effect in treating narrow QRS tachycardia,reduce the heart rate and blood pressure,improve the cardiac function and quality of life,with relativity high safety.

关 键 词：心动过速 窄QRS 伊伐布雷定 普罗帕酮 治疗结果 

分 类 号：R441.4[医药卫生—诊断学]