伊伐布雷定联合沙库巴曲缬沙坦治疗低血压状态HFrEF疗效观察  

Effect of ivabradine combined with sacubatrovalsartan in the treatment of patients of heart failure with reduced ejection fraction(HFrEF)under hypotension

作　　者：张春莹 白志生[1] 吕永会 王露 ZHANG Chun-ying;BAI Zhi-sheng;LV Yong-hui;WANG Lu(Department of Cardiovascular Medicine,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]宝鸡市人民医院心血管内科,陕西宝鸡721000

出　　处：《海南医学》2022年第23期3013-3016,共4页Hainan Medical Journal

基　　金：陕西省宝鸡市卫生健康委员会科研计划立项课题(编号:2020-100)。

摘　　要：目的观察伊伐布雷定联合沙库巴曲缬沙坦治疗低血压状态射血分数降低心力衰竭(HFrEF)患者的临床效果。方法回顾性分析2020年3月至2021年3月期间宝鸡市人民医院收治的118例低血压状态HFrEF患者的临床诊治资料。根据不同治疗方法分组,其中58例给予沙库巴曲缬沙坦治疗者纳入对照组,60例给予伊伐布雷定联合沙库巴曲缬沙坦治疗者纳入研究组。两组患者均连续治疗5个月,比较两组患者治疗前后的心率、左心射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)、6 min步行距离(6MWT)、白细胞介素1(IL-1)、白细胞介素6(IL-6)水平,并采用生活质量综合评定问卷(GQOLI-74)评估患者的生活质量评分及治疗后不良反应发生情况。结果治疗后,两组患者的心率、NT-proBNP均明显降低,且研究组患者分别为(57.36±11.24)次/min、(1137.68±462.35)ng/L,明显低于对照组的(64.28±10.62)次/min、(1628.64±473.54)ng/L,LVEF、6MWT距离明显升高或增长,且研究组患者分别为(46.32±5.67)%、(586.32±48.76)m,明显高(长)于对照组的(42.62±5.18)%、(506.37±46.82)m,差异均具有统计学意义(P<0.05);治疗后,两组患者的IL-1、IL-6水平均明显降低,且研究组患者分别为(101.26±12.58)pg/mL、(89.26±7.32)pg/mL,明显低于对照组的(106.53±13.54)pg/mL、(101.65±8.05)pg/mL,差异均有统计学意义(P<0.05);治疗5个月后评价,研究组患者的情感功能、社会功能、身体功能、认知功能、角色功能评分分别为(62.56±6.23)分、(52.21±4.62)分、(52.16±7.26)分、(58.69±5.01)分、(50.28±8.06)分,明显高于对照组的(42.62±5.16)分、(43.52±5.06)分、(46.58±7.02)分、(46.32±4.98)分、(41.32±7.85)分,差异均具有统计学意义(P<0.05);研究组患者的不良反应发生率为8.33%,略低于对照组的17.24%,但差异无统计学意义(P>0.05)。结论伊伐布雷定联合沙库巴曲缬沙坦治疗低血压状态HFrEF能有效改善患者的心功能,降低炎症反应,�Objective To study the clinical effect of ivabradine combined with sacubatrovalsartan in the treatment of patients of heart failure with reduced ejection fraction(HFrEF)under hypotension.Methods The clinical diagnosis and treatment data of 118 HFrEF patients under hypotension admitted to Baoji People's Hospital from March 2020 to March 2021 were retrospectively analyzed.According to different treatment methods,the patients were divided into a study group(60 cases)and a control group(58 cases).The patients in the control group were treated with sacubatrovalsartan,and the patients in the study group were treated with ivabradine combined with sacubatrovalsartan,both for 5 months continuously.The heart rate,left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP),6-minute walking distance(6MWT),interleukin-1(IL-1),interleukin-6(IL-6)levels of the two groups were compared before and after treatment.The quality of life score and the incidence of adverse reactions after treatment were assessed with the comprehensive quality of life assessment questionnaire(GQOLI-74).Results After treatment,the heart rate and NT-proBNP of patients in the two groups decreased significantly,and the heart rate and NT-proBNP in the study group were(57.36±11.24)times/min and(1137.68±462.35)ng/L,which were significantly lower than(64.28±10.62)times/min and(1628.64±473.54)ng/L in the control group;LVEF and 6MWT increased significantly,and the LVEF and 6MWT in the study group were(46.32±5.67)%and(586.32±48.76)m,which were significantly higher/longer than(42.62±5.18)%,(506.37±46.82)m in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of IL-1 and IL-6 in the study group were(101.26±12.58)pg/mL and(89.26±7.32)pg/mL,which were significantly lower than(106.53±13.54)pg/mL and(101.65±8.05)pg/mL in the control group(P<0.05).The scores of emotional function,social function,physical function,cognitive function,and role function in the study group were(62.56

关 键 词：低血压 射血分数降低心力衰竭 伊伐布雷定 沙库巴曲缬沙坦 疗效 生活质量 

分 类 号：R544.2[医药卫生—心血管疾病]