伊伐布雷定辅助常规治疗对重症心力衰竭患者心率变异性、血浆BNP及血清miR-27b、miR-208的影响  

Effects of ivabradine adjuvant conventional therapy on heart rate variability,plasma BNP and serum miR-27b and miR-208 in patients with severe heart failure

作　　者：王丹 李伟程 WANG Dan;LI Weicheng(Cardiology Department,the First People's Hospital of Xianyang,Xianyang 712000,China)

机构地区：[1]咸阳市第一人民医院心内科,陕西咸阳712000

出　　处：《临床医学研究与实践》2025年第7期70-73,共4页Clinical Research and Practice

摘　　要：目的探究伊伐布雷定辅助常规治疗对重症心力衰竭患者心率变异性、血浆脑钠肽(BNP)及血清miR-27b、miR-208的影响。方法选取2019年12月至2022年12月我院收治的94例重症心力衰竭患者为研究对象,按入院时间将其分为常规组和联合组,每组47例。常规组采取常规治疗,联合组采取伊伐布雷定辅助常规治疗。比较两组的心率变异性指标、血浆BNP水平、心功能参数、血清miR-27b、miR-208及治疗效果。结果治疗后,两组的相邻正常R-R间期差值的均方根(RMSSD)、24 h内每5 min节段R-R间期平均标准差(SDANN)、24 h内R-R间期标准差(SDNN)均升高,血浆BNP水平均降低,且联合组优于常规组,差异具有统计学意义(P<0.05)。治疗后,两组的左心室射血分数(LVEF)均升高,左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)均降低,且联合组优于常规组,差异具有统计学意义(P<0.05)。治疗后,两组的血清miR-27b、miR-208均降低,且联合组低于常规组,差异具有统计学意义(P<0.05)。联合组的治疗总有效率高于常规组,差异具有统计学意义(P<0.05)。结论伊伐布雷定辅助常规治疗可提高重症心力衰竭的治疗效果,值得推广。Objective To explore the effects of ivabradine adjuvant conventional therapy on heart rate variability,plasma brain natriuretic peptide(BNP)and serum miR-27b and miR-208 in patients with severe heart failure.Methods A total of 94 patients with severe heart failure admitted in our hospital from December 2019 to December 2022 were selected as the research objects.According to the time of admission,the patients were divided into conventional group and combined group,with 47 cases in each group.The conventional group received conventional treatment,and the combined group received ivabradine adjuvant conventional therapy.The heart rate variability indexes,plasma BNP level,cardiac function parameters,serum miR-27b,miR-208 and therapeutic effect were compared between the two groups.Results After treatment,the root mean square of the successive normal sinus R-R interval difference(RMSSD),mean standard deviation of R-R interval per 5 min segment within 24 h(SDANN)and standard deviation of R-R interval within 24 h(SDNN)in the two groups increased,the plasma BNP level decreased,and those in the combined group were better than the conventional group,the differences were statistically significant(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)in the two groups increased,the left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)decreased,and those in the combined group were better than the conventional group,the differences were statistically significant(P<0.05).After treatment,the serum miR-27b and miR-208 in the two groups decreased,and those in the combined group were lower than the conventional group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the combined group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Ivabradine adjuvant conventional therapy can improve the therapeutic effect of severe heart failure,which is worthy of promotion.

关 键 词：伊伐布雷定 重症心力衰竭 心率变异性 脑钠肽 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]