盐酸伊伐布雷定联合卡维地洛治疗心绞痛的疗效及心功能的影响  

Effect of ivabradine hydrochloride combined with carvedilol on angina pectoris and cardiac function

作　　者：孙瑜 李慧 赵智儒 Sun Yu;Li Hui;Zhao Zhiru(Emergency Department,Beijing Dongcheng District First People's Hospital,Beijing 100075,China)

机构地区：[1]北京市东城区第一人民医院急诊科,100075

出　　处：《中华保健医学杂志》2022年第1期11-14,共4页Chinese Journal of Health Care and Medicine

基　　金：北京市科技计划项目(7202132)。

摘　　要：目的研究探讨盐酸伊伐布雷定联合卡维地洛治疗心绞痛的疗效及对心功能的影响。方法选取2019年8月~2021年8月北京市东城区第一人民医院收治的244例老年心绞痛患者,随机数表法分为观察组、对照组,各122例。对照组以卡维地洛治疗,观察组以盐酸伊伐布雷定联合卡维地洛治疗。对两组患者的临床疗效、心功能指标、冠状动脉血流储备、血管内皮功能、治疗安全性进行评估比较。结果观察组总有效率为94.26%(115/122),高于对照组患者为80.33%(98/122),差异有统计学意义(P<0.05)。治疗后观察组左室射血分数(LVEF)、每搏输出量(SV)均高于对照组,左室舒张末径(LVEDD)、QT间期离散度(QTd)均低于对照组,差异有统计学意义(P<0.05)。治疗后观察组冠脉血流储备(CFR)、血流储备分数(FFR)、峰值血流速度(CFV)水平均高于对照组,差异有统计学意义(P<0.05)。治疗后观察组一氧化氮(NO)高于对照组,血管内皮素-1(ET-1)、ET-1/NO均低于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者不良反应发生率为11.48%(14/122)、8.20%(10/122)(P>0.05)。结论盐酸伊伐布雷定联合卡维地洛治疗心绞痛的疗效显著,能够改善患者的心功能,提升患者的冠状动脉血流储备,改善患者的血管内皮功能,治疗安全性良好。Objective To study the efficacy of ivabradine hydrochloride combined with carvedilol in the treatment of angina pectoris and its effect on cardiac function.Methods 244 Elderly Patients with angina pectoris treated in our hospital from August 2019 to August 2021 were randomly divided into observation group and control group,with 122 cases in each group.The control group was treated with carvedilol,and the observation group was treated with ivabradine hydrochloride combined with carvedilol.The clinical efficacy,cardiac function indexes,coronary flow reserve,vascular endothelial function and treatment safety of the two groups were evaluated and compared.Results the total effective rate in the observation group was 94.26%(115/122),which was higher than 80.33%(98/122)in the control group(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)and stroke output(SV)in the observation group were higher than those in the control group,and the left ventricular end diastolic diameter(LVEDD)and QT interval dispersion(QTd)were lower than those in the control group(P<0.05).After treatment,the levels of coronary flow reserve(CFR),flow reserve fraction(FFR)and peak flow velocity(CFV)in the observation group were higher than those in the control group(P<0.05).After treatment,nitric oxide(no)in the observation group was higher than that in the control group,and vascular endothelin-1(ET-1)and ET-1/NO in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the two groups was 11.48%(14/122),8.20%(10/122)(P>0.05).Conclusion Ivabradine hydrochloride combined with carvedilol is effective in the treatment of angina pectoris.It can improve patients'cardiac function,enhance patients'coronary blood flow reserve and improve patients'vascular endothelial function.The treatment is safe and can be recommended clinically.

关 键 词：心绞痛 卡维地洛 盐酸伊伐布雷定 心功能 血管内皮功能 

分 类 号：R541[医药卫生—心血管疾病]