摘要
目的观察伊伐布雷定对慢性肺源性心脏病合并心力衰竭患者心肌微循环状态及血小板参数水平的影响。方法前瞻性选取亳州市人民医院收治的86例慢性肺源性心脏病合并心力衰竭患者,以随机数字表法分为2组,每组各43例。对照组接受常规治疗,实验组在对照组基础上予以伊伐布雷定治疗。比较2组治疗前、治疗8周后肺功能[1 s用力呼气容积(FEV1)/用力肺活量(FVC)、FEV1占预计值百分比(FEV1%)]、心功能[左室后壁厚度(LVPWT)、左室射血分数(LVEF)、心率(HR)]、血清肌酸激酶同工酶-MB(CK-MB)、肌钙蛋白Ⅰ(TnⅠ)、血浆B型脑钠肽(BNP)、硫化氢、血小板参数[血小板计数(PLT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)]及不良反应情况。结果治疗前,两组患者各指标比较,差异无统计学意义(P>0.05)。治疗8周后,实验组FEV1%(68.25±8.24)%、FEV1/FVC(72.85±9.51)%显著高于对照组[(60.07±8.05)%、(63.72±9.16)%],差异有统计学意义(P<0.05);实验组治疗后LVPWT(9.25±1.60)mm、HR(64.73±1.12)次/min明显小于对照组[(10.48±1.74)mm、(87.52±1.49)次/min],LVEF(58.01±8.39)%明显高于对照组(46.32±7.15)%,差异有统计学意义(P<0.05);实验组治疗后CK-MB(7.04±1.23)IU/L、TnⅠ(0.58±0.09)μg/L、BNP(186.34±25.63)μmol/L水平明显低于对照组[(20.15±3.48)IU/L、(1.07±0.15)μg/L、(519.47±88.62)μmol/L],硫化氢(53.94±8.65)μmol/L水平明显高于对照组(41.86±7.02)μmol/L,差异有统计学意义(P<0.05);实验组治疗8周后MPV(9.24±1.60)fL、PDW(11.75±1.94)%明显小于对照组[(11.98±1.74)fL、(13.82±1.96)%],差异有统计学意义(P<0.05);两组不良反应比较(9.30%vs.4.65%),差异无统计学意义(P>0.05)。结论伊伐布雷定治疗慢性肺源性心脏病合并心力衰竭患者,可起到减轻心肌损伤、改善心肌微循环状态与血小板参数水平的作用,能够有效促进慢性肺源性心脏病合并心力衰竭患者肺功能与心功能恢复。
Objective To observe the effects of ivabradine on myocardial micro-circulation and levels of platelet parameters in patients with pulmonary heart failure(PHF).Methods A total of 86 patients with chronic pulmonary heart disease complicated with heart failure in the Bozhou People's Hospital were divided into two groups by random number table method,43 cases in each group.The control group was given routine treatment,while experimental group was additionally given ivabradine.The pulmonary function[forced expiratory volume in 1 second(FEV1)/forced vital capacity(FVC),FEV1 as a percentage of predictive value(FEV1%)],cardiac function[left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF),heart rate(HR)],serum creatine kinase isoenzyme-MB(CK-MB),troponinⅠ(TnⅠ),plasma B-type natriuretic peptide(BNP),hydrogen sulfide,platelet parameters[platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW)]and adverse reactions before and after 8 weeks of treatment were compared between the two groups.Results After treatment,FEV1%(68.25±8.24)%and FEV1/FVC(72.85±9.51)%in experimental group were significantly higher than those in control group[(60.07±8.05)%,(63.72±9.16)%],the differences were statistically significant(P<0.05).After treatment,LVPWT(9.25±1.60)mm and HR(64.73±1.12)times/min in experimental group were significantly fewer than those in control group[(10.48±1.74)mm,(87.52±1.49)times/min],while LVEF(58.01±8.39)%was significantly higher than that in control group(46.32±7.15)%,the differences were statistically significant(P<0.05).After treatment,the levels of CK-MB(7.04±1.23)IU/L,TnⅠ(0.58±0.09)μg/L and BNP(186.34±25.63)μmol/L in experimental group were significantly lower than those in control group[(20.15±3.48)IU/L,(1.07±0.15)μg/L,(519.47±88.62)μmol/L],while level of hydrogen sulfide(53.94±8.65)μmol/L was significantly higher than that in control group(41.86±7.02)μmol/L,the differences were statistically significant(P<0.05).After 8 weeks of t
作者
马同亮
韩若东
曹富流
MA Tong-liang;HAN Ruo-dong;CAO Fu-liu(Emergency Medicine,Bozhou People's Hospital,Bozhou Anhui 236800,China;Critical Care Medicine,Bozhou People's Hospital,Bozhou Anhui 236800,China;Department of Gastroenterology,First People's Hospital of Anqing City,Anqing Anhui 246000,China)
出处
《临床和实验医学杂志》
2020年第20期2156-2160,共5页
Journal of Clinical and Experimental Medicine
基金
安徽省卫生和计划生育委员会科研计划项目(编号:2016QK061)。
关键词
慢性肺源性心脏病合并心力衰竭
伊伐布雷定
心肌微循环
血小板参数
Chronic pulmonary heart disease with heart failure
Ivabradine
Pulmonary heart failure
Myocardial micro-circulation
Platelet parameter
