伊伐布雷定联合米力农治疗老年心力衰竭患者的临床疗效  

Clinical efficacy of ivabradine combined with milrinone in the treatment of elderly patients with heart failure

作　　者：夏林虎[1] 江荣炎[1] 卜令同[1] 涂胜 XIA Lin-hu;JIANG Rong-yan;BU Ling-tong(Department of Cardiology,Bozhou People's Hospital,Bozhou Anhui 236800,China)

机构地区：[1]亳州市人民医院心内科,安徽亳州236800

出　　处：《临床和实验医学杂志》2024年第14期1486-1489,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽高校自然科学研究重点项目(编号:KJ2020A0336)。

摘　　要：目的分析伊伐布雷定联合米力农治疗老年心力衰竭患者的临床疗效。方法前瞻性选取2022年1月至2023年1月亳州市人民医院收治的老年心力衰竭患者100例作为研究对象,按照随机数字表法分为观察组与对照组,各50例。两组患者均给予吸氧、利尿剂、β受体阻滞剂等常规抗心力衰竭治疗,对照组给予米力农治疗,观察组给予米力农联合伊伐布雷定治疗。随访3个月后,比较两组临床治疗效果、心衰标志物[氨基末端B型钠尿肽(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)、半胱氨酸蛋白酶抑制剂C(CysC)]、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、单核细胞趋化蛋白-1(MCP-1)]及心功能指标[左心射血分数(LVEF)、每搏输出量(SV)、左室舒张末内径(LVEDD)、心排血量(CO)]。结果随访3个月后,观察组总有效率为94.00%,高于对照组(76.00%),差异有统计学意义(P<0.05)。随访3个月后,观察组NT-proBNP、sST2、CysC分别为(754.45±211.31)pg/mL、(51.79±13.57)ng/mL、(1.31±0.31)mg/L,均低于对照组[(979.53±273.46)pg/mL、(80.46±15.63)ng/mL、(1.94±0.49)mg/L],差异均有统计学意义(P<0.05)。随访3个月后,观察组IL-6、TNF-α、MCP-1水平分别为(15.63±2.10)ng/L、(24.53±3.14)ng/L、(416.28±34.35)pg/mL,均低于对照组[(18.82±2.45)ng/L、(30.74±4.28)ng/L、(454.52±40.42)pg/mL],差异均有统计学意义(P<0.05)。随访3个月后,观察组LVEF、SV、CO分别为(50.23±10.17)%、(60.42±7.53)mL、(5.86±0.41)L/min,均高于对照组[(43.23±8.65)%、(50.34±6.75)mL、(4.92±0.31)L/min],观察组LVEDD为(34.64±4.78)mm,低于对照组[(46.33±5.13)mm],差异均有统计学意义(P<0.05)。结论伊伐布雷定联合米力农治疗老年心力衰竭患者的不仅能够提高临床疗效,调节心衰标志物指标水平,还能降低炎症因子水平,改善心功能,值得推广。Objective To analyze the clinical efficacy of ivabradine combined with milrinone in the treatment of elderly patients with heart failure.Methods One hundred elderly patients with heart failure admitted to Bozhou People's Hospital from January 2022 to January 2023 were prospectively selected as the study subjects,divided into an observation group and a control group according to the random number table method,with 50 cases in each group.Both groups of patients were given routine anti heart failure treatments such as oxygen therapy,diuretics,and beta blockers.The control group was treated with milrinone,while the observation group was treated with milrinone combined with ivabradine.After 3 months of follow-up,the clinical efficacy,heart failure biomarkers[N-terminal pro brain natriuretic peptide(NT-proBNP),soluble growth stimulating gene 2 protein(sST2),Cystatin C(CysC)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),monocyte chemotactic protein-1(MCP-1)],as well as cardiac function indicators[left ventricular ejection fraction(LVEF),stroke volume(SV),left ventricular end diastolic diameter(LVEDD),cardiac output(CO)]between two groups were compared.Results After 3 months of follow-up,the total effective rate of the observation group was 94.00%,which was higher than that of the control group(76.00%),the difference was statistically significant(P<0.05).After 3 months of follow-up,the levels of NT-proBNP,sST2,and CysC in the observation group were(754.45±211.31)pg/mL,(51.79±13.57)ng/mL,and(1.31±0.31)mg/L,respectively,which were lower than those in the control group[(979.53±273.46)pg/mL,(80.46±15.63)ng/mL,and(1.94±0.49)mg/L],the differences were statistically significant(P<0.05).After 3 months of follow-up,the levels of IL-6,TNF-α,and MCP-1 in the observation group were(15.63±2.10)ng/L,(24.53±3.14)ng/L,and(416.28±34.35)pg/mL,respectively,which were lower than those in the control group[(18.82±2.45)ng/L,(30.74±4.28)ng/L,and(454.52±40.42)pg/mL],and the differences were statistic

关 键 词：老年人 心力衰竭 伊伐布雷定 米力农 炎症因子 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]