伊伐布雷定联合小剂量β-受体阻滞剂治疗慢性心力衰竭的临床疗效  

Clinical effect of ivabradine combined with small dose β-blocker in the treatment of chronic heart failure

作　　者：张文颖 郑燕琳 周金敬 ZHANG Wen—ying;ZHENG Yan-lin;ZHOU Jin-jing(Department of Pharmacy,Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen,Shenzhen 518000,China)

机构地区：[1]中国医学科学院阜外医院深圳医院药剂科,广东省深圳市518000 [2]中国医学科学院阜外医院深圳医院检验科,广东省深圳市518000

出　　处：《临床合理用药杂志》2020年第15期1-3,共3页Chinese Journal of Clinical Rational Drug Use

基　　金：2017年深圳市卫生计生系统科研项目(SZFZ2017045)。

摘　　要：目的探讨伊伐布雷定联合小剂量β-受体阻滞剂治疗慢性心力衰竭的临床疗效。方法选取中国医学科学院阜外医院深圳医院2016年5月—2019年5月收治的慢性心力衰竭患者410例,按照随机数字表法分为对照组201例与观察组209例。对照组予以伊伐布雷定联合靶剂量或最大耐受剂量β-受体阻滞剂治疗,观察组予以伊伐布雷定联合小剂量β-受体阻滞剂治疗。比较两组治疗前后收缩压、舒张压、心率、N末端B型脑钠肽原(NT-proBNP)、左心室射血分数(LVEF),并观察两组不良心血管事件及不良反应发生情况。结果治疗前及治疗1个月、1年后两组收缩压、舒张压、心率、NT-proBNP、LVEF比较,差异无统计学意义(P>0.05)。治疗1个月、1年后两组心力衰竭恶化住院率、非致命心肌梗死率、任何心血管事件住院发生率比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论伊伐布雷定联合小剂量β-受体阻断剂的疗效不劣于联合靶剂量β-受体阻断剂。慢性心力衰竭患者的治疗目标更应致力于早期控制心率而非必须将β-受体阻断剂滴定到靶剂量或者最大耐受剂量,应建立降低心率药物早期联合治疗。Objective To discuss the clinical effect of ivabradine combined with small doseβ-blocker in treating chronic heart failure.Methods A total of 410 cases of patients with chronic heart failure were selected from May 2016 to May 2019 in Fuwai Hospital Chinese Academy of Medical Sciences,which were divided into control group 201 cases and observation group 209 cases according to the random number table method.The control group was treated with ivabradine combined with target dose or maximum tolerated doseβ-receptor blocker,the observation group was treated with ivabradine combined with small doseβ-receptor blocker.Systolic blood pressure,diastolic blood pressure,heart rate,NT-proBNP and LVEF before and after treatment were compared between the two groups,the unconscious vascular events and incidence of adverse reactions were observed.Results Before treatment,1 month and 1 year after treatment,there was no significant difference in systolic blood pressure,diastolic blood pressure,heart rate,NT-proBNP and LVEF between the two groups(P>0.05).After 1 month and 1 year of treatment,there was no significant difference in hospitalization rate of heart failure deterioration,non-fatal myocardial infarction rate,hospitalization rate of any cardiovascular event between the two groups(P>0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion The efficacy of ivabradine combined with small dose ofβ-receptor blocker is not inferior to that of combined target dose ofβ-receptor blocker.The therapeutic goal of patients with chronic heart failure should be to control heart rate at an early stage instead of titratingβ-receptor blockers to the target dose or the maximum tolerated dose,early combined treatment with drugs for lowering heart rate should be established.

关 键 词：心力衰竭 伊伐布雷定 Β-受体阻断剂 治疗结果 

分 类 号：R541.6[医药卫生—心血管疾病]