盐酸伊伐布雷定联合比索洛尔治疗充血性心力衰竭患者的效果  

Effect of Ivabradine Hydrochloride Tablets Combined with Bisoprolol in the Treatment of Patients with Congestive Heart Failure

作　　者：李国栋[1] 杨国杰[1] 赵士超 LI Guodong;YANG Guojie;ZHAO Shichao(Department of Geriatric Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院老年心血管科,河南郑州450000 [2]郑州大学第一附属医院心血管内科,河南郑州450000

出　　处：《河南医学研究》2025年第4期710-713,共4页Henan Medical Research

摘　　要：目的探讨充血性心力衰竭(CHF)患者接受盐酸伊伐布雷定片与比索洛尔联合治疗的效果,观察其对患者心功能指标、血清基质金属蛋白酶及神经内分泌激素表达的影响。方法采用前瞻性研究,纳入2021年6月至2023年1月郑州大学第一附属医院收治的109例CHF患者,以随机数字表法分为对照组(55例)与观察组(54例),两组均接受标准化抗心力衰竭治疗,对照组接受盐酸伊伐布雷定片治疗,观察组接受盐酸伊伐布雷定片联合比索洛尔治疗,两组均连续治疗2周,对比两组临床疗效、心功能指标[左心室射血分数(LVEF)、每搏量(SV)、心输出量(CO)、脑钠肽(BNP)]、血清基质金属蛋白酶指标[金属蛋白酶组织抑制因子1(TIMP-1)、基质金属蛋白酶9(MMP-9)、MMP-2]、神经内分泌激素[醛固酮、血管紧张素Ⅱ(ATⅡ)、去甲肾上腺素(NE)、一氧化氮(NO)、内皮素(ET)],并统计两组不良反应。结果观察组临床疗效高于对照组(P<0.05);观察组LVEF、CO、SV、血清TIMP-1高于对照组,血清BNP、MMP-2、MMP-9、醛固酮、ATⅡ、NE、ET、NO低于对照组(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论盐酸伊伐布雷定片联合比索洛尔治疗效果显著,能有效改善CHF患者心功能指标,能调节基质金属蛋白酶、神经内分泌激素表达。Objective To explore clinical efficacy of ivabradine hydrochloride tablets combined with bisoprolol in the treatment of patients with congestive heart failure(CHF).Methods A prospective cohort study was conducted to include 109 CHF patients admitted to the First Affiliated Hospital of Zhengzhou University from June 2021 to January 2023.They were randomly divided into the control group(55 cases)and the observation group(54 cases),both groups received standardized anti-heart failure treatment,the control group was treated with ivabradine hydrochloride tablets,and observation group was treated with ivabradine hydrochloride tablets combined with bisoprolol,both groups were treated continuously for 2 weeks,the clinical efficacy of the two groups was compared.The clinical efficacy,cardiac function indexes[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),brain natriuretic peptide(BNP)],serum matrix metalloproteinase indexes[tissue inhibitor of metalloproteinase-1(TIMP-1),matrix metalloproteinase-9(MMP-9),MMP-2]and neuroendocrine hormones[aldosterone,angiotensinⅡ(ATⅡ),norepinephrine(NE),nitric oxide(NO),endothelin(ET)]were compared in both groups,and adverse reactions of both groups were counted.Results The clinical efficacy of the observation group was higher than that of the control group(P<0.05).Compared with control group,LVEF,CO,SV and serum TIMP-1 in observation group were higher,and serum BNP,MMP-2,MMP-9,aldosterone,ATⅡ,NE,ET and NO were lower(P<0.05).The difference was not statistically significant in adverse reactions between the two groups(P>0.05).Conclusion Ivabradine hydrochloride tablets combined with bisoprolol can improve cardiac function indexes,matrix metalloproteinase indexes and neuroendocrine hormone levels in patients with CHF,improve clinical efficacy,and will not increase adverse reactions.

关 键 词：充血性心力衰竭 盐酸伊伐布雷定片 比索洛尔 基质金属蛋白酶 神经内分泌激素 

分 类 号：R541.6[医药卫生—心血管疾病]