盐酸伊伐布雷定片联合酒石酸美托洛尔缓释片对左室射血分数<45%的缺血性心肌病患者的疗效  

Efficacy of Ivabradine Hydrochloride Tablets Combined with Metoprolol Tartrate Sustained-Release Tablets in Patients with Ischemic Cardiomyopathy with Left Ventricular Ejection Fraction Less Than 45%

作　　者：肖近杰 王瑞霞 陈辉玲 XIAO Jinjie;WANG Ruixia;CHEN Huiling(Department of Cardiology,Huaxian Hospital of the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 456400,China)

机构地区：[1]新乡医学院第一附属医院滑县医院心内科,河南新乡456400

出　　处：《河南医学研究》2022年第14期2597-2600,共4页Henan Medical Research

摘　　要：目的分析盐酸伊伐布雷定片联合酒石酸美托洛尔缓释片治疗左室射血分数(LVEF)<45%的缺血性心肌病(ICM)患者的临床效果。方法选取2019年2月至2020年11月新乡医学院第一附属医院滑县医院收治的148例LVEF<45%的ICM患者,按照治疗药物分为观察组(74例)和对照组(74例)。对照组患者接受酒石酸美托洛尔缓释片治疗,观察组患者接受盐酸伊伐布雷定片联合酒石酸美托洛尔缓释片治疗。对比两组患者的临床疗效、心功能[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、LVEF]、心率变异性[均值标准差(SDANN)、标准差(SDNN)]及血清相关指标[心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)、N-末端脑钠肽前体(NT-proBNP)、肌酸激酶(CK)]水平。结果观察组患者总有效率[97.30%(72/74)]高于对照组[86.49%(64/74)](P<0.05);治疗3个月后,观察组患者的LVESD、LVEDD低于对照组,LVEF高于对照组(P<0.05);治疗3个月后,观察组患者的SDANN、SDNN高于对照组(P<0.05);治疗3个月后,观察组患者的cTnⅠ、CK-MB、NT-proBNP、CK水平低于对照组(P<0.05)。结论盐酸伊伐布雷定片联合酒石酸美托洛尔缓释片治疗LVEF<45%的ICM患者效果较好,可减轻患者心肌受损,有效改善患者的心率变异性,提高患者的心功能。Objective To analyze the efficacy of ivabradine hydrochloride tablets and metoprolol tartrate sustained-release tablets in the treatment of patients with ischemic cardiomyopathy(ICM)with left ventricular ejection fraction(LVEF)<45%.Methods A total of 148 patients with ICM with LVEF<45%who were admitted to Huaxian Hospital of the First Affiliated Hospital of Xinxiang Medical College From February 2019 to November 2020 were selected and divided into observation group(74 cases)and control group(74 cases)according to treatment plans.Patients in the control group were given metoprolol tartrate sustained-release tablets,and patients in the observation group were given ivabradine hydrochloride tablets and metoprolol tartrated-release tablets.Clinical efficacy,cardiac function[left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),LVEF],heart rate variability[standard deviation of the mean(SDANN),standard deviation(SDNN)]and serum-related indicators[cardiac troponinⅠ(cTnⅠ),creatine kinase isoenzyme(CK-MB),N-terminal precursor brain natriuretic peptide(NT-proBNP),creatine kinase(CK)]were compared between the two groups.Results The clinical effective rate in the observation group[97.30%(72/74)]was higher than that in the control group[86.49%(64/74)](P<0.05).After 3 months of treatment,the LVESD and LVEDD in the observation group were lower than those in the control group,and the LVEF was higher than that in the control group(P<0.05).After 3 months of treatment,SDANN and SDNN in the observation group were higher than those in the control group(P<0.05).After 3 months of treatment,the levels of cTnⅠ,CK-MB,NT-proBNP and CK in the observation group were lower than those in the control group(P<0.05).Conclusion Ivabradine hydrochloride tablets and metoprolol tartrated-release tablets in the treatment of ICM patients with LVEF<45%has a positive effect,can reduce myocardial damage,improve the heart rate variability and improve patients’cardiac function.

关 键 词：缺血性心肌病 盐酸伊伐布雷定片 酒石酸美托洛尔缓释片 左室射血分数 心功能 心率变异性 

分 类 号：R542.2[医药卫生—心血管疾病]