伊伐布雷定对肺动脉高压致右心功能不全伴窦性心动过速患者心功能及血流动力学的影响  

Effects of Lvabradine on Cardiac Function and Hemodynamics in Patients with Right Ventricular Insufficiency Caused by Pulmonary Hypertension and Sinus Tachycardia

作　　者：芮明艳 马磊 RUI Ming-yan;MA Lei(Department of Cardiology,Zhengzhou Seventh People's Hospital(Zhengzhou Cardiovascular Hospital,Henan Cardiovascular Hospital Affiliated to Southern Medical University,Henan Key Laboratory of Arrhythmia Medicine),Zhengzhou 450016,Henan Province,China)

机构地区：[1]郑州市第七人民医院心内科(郑州市心血管病医院,南方医科大学附属河南心血管病医院,河南省心律失常医学重点实验室),河南郑州450016

出　　处：《罕少疾病杂志》2024年第1期62-64,共3页Journal of Rare and Uncommon Diseases

基　　金：河南医学科技攻关计划联合共建项目(LHGJ20203074)。

摘　　要：目的探索伊伐布雷定对肺动脉高压致右心功能不全伴窦性心动过速患者心功能及血流动力学的影响。方法选取我院2021年8月至2023年3月期间93例肺动脉高压致右心功能不全伴窦性心动过速患者作为研究对象,依照治疗方式分为基础组和联用组。基础组46例给予规范治疗,联用组47例给予加用伊伐布雷定,对比两组患者心率,心功能,血流动力学,不良反应。结果两组治疗2个月后运动最大心率水平经比较无差异(P>0.05);基础组治疗前、治疗2个月后运动最大心率水平经比较无差异(P>0.05);两组治疗2个月后静息心率水平较治疗前降低,联用组低于基础组(P<0.05)。两组治疗2个月后LVEF水平较治疗前升高,联用组高于基础组;LVEDD、LVESD水平较治疗前降低,联用组低于基础组(P<0.05)。两组治疗2个月后MAP水平经比较无差异(P>0.05);两组治疗2个月后MAP、CO水平较治疗前升高,联用组CO水平高于基础组(P<0.05)。经Fisher确切概率法检验,联用组不良反应发生率6.38%(3/47)与基础组2.17%(1/46)经比较无差异(双侧P=0.6168,P>0.05)。结论伊伐布雷定可调节肺动脉高压致右心功能不全伴窦性心动过速患者血流动力学,稳定心率及改善心功能,有良好的安全性。Objective To explore the effects of ivabradine on cardiac function and hemodynamics in patients with right ventricular insufficiency caused by pulmonary hypertension and sinus tachycardia.Methods 93 patients with right ventricular insufficiency caused by pulmonary hypertension with sinus tachycardia in our hospital from August 2021 to March 2023 were selected as the study objects,and were divided into basic group and combined group according to treatment methods.Standard treatment was given to 46 patients in the basic group and ivabradine was given to 47 patients in the combined group.Heart rate,cardiac function,hemodynamics and adverse reactions were compared between the two groups.Results There was no difference in the maximum heart rate of exercise between the two groups after 2 months of treatment(P>0.05).There was no difference in the maximal heart rate before and after 2 months of treatment in the basic group(P>0.05).The resting heart rate of the two groups after 2 months of treatment was lower than that before treatment,and the combined group was lower than the basic group(P<0.05).After 2 months of treatment,LVEF level of the two groups was higher than before treatment,and the combined group was higher than the basic group.The levels of LVEDD and LVESD in combination group were lower than those in basic group(P<0.05).There was no difference in MAP level between the two groups after 2 months of treatment(P>0.05).After 2 months of treatment,the levels of MAP and CO in the two groups were higher than before treatment,and the level of CO in the combined group was higher than that in the basic group(P<0.05).By Fisher's exact probability test,there was no difference in the incidence of adverse reactions between the combined treatment group(6.38%(3/47)and the basic group(2.17%(1/46))(bilateral P=0.6168,P>0.05).Conclusion Ivabradine can regulate hemodynamics,stabilize heart rate and improve cardiac function in patients with right ventricular dysfunction caused by pulmonary hypertension and sinus tachycardia,and ha

关 键 词：伊伐布雷定 右心功能不全 窦性心动过速 血流动力学 

分 类 号：R54[医药卫生—心血管疾病]