摘要
目的观察伊伐布雷定联合沙库巴曲缬沙坦治疗心力衰竭的效果及对心功能的影响。方法选取2019年3月—2022年3月湖南省职业病防治院收治的心力衰竭患者80例,根据随机分配法分为单一组40例和联合组40例。患者入院后均予以基础治疗,在此基础上单一组采用沙库巴曲缬沙坦钠片,联合组在单一组基础上采用盐酸伊伐布雷定片,2组患者均持续治疗2个月。比较2组临床疗效,治疗前及治疗2个月后心功能指标、心率(HR)、醛固酮(ALD)、细胞间黏附分子-1(ICAM-1)、心肌损伤标志物,治疗2个月后血管内皮功能指标,及药物不良反应。结果联合组治疗总有效率高于单一组(97.50%vs.80.00%,χ^(2)=4.507,P=0.034)。与治疗前相比,2组治疗2个月后每搏输出量、左心室射血分数升高,左心室收缩末期内径、左心室舒张末期内径缩小,HR降低,且联合组各指标变化幅度大于单一组(P<0.01);2组血浆ALD、N末端脑钠肽前体及血清ICAM-1、心肌肌钙蛋白T、心肌肌钙蛋白I、肌酸激酶同工酶水平降低,且联合组低于单一组(P<0.01)。联合组治疗2个月后血浆内皮素-1水平低于单一组,血浆一氧化氮水平高于单一组(P<0.01)。联合组与单一组用药不良反应总发生率比较,差异无统计学意义(2.50%vs.10.00%,χ^(2)=0.853,P=0.356)。结论伊伐布雷定联合沙库巴曲缬沙坦治疗心力衰竭的效果显著,能够有效改善患者的心功能及血管内皮功能,降低HR,减轻心肌损伤,并具有较高的安全性。
Objective To observe the effect of ivabradine combined with sacubitril valsartan in the treatment of heart failure and the impact on cardiac function.Methods A total of 80 patients with heart failure admitted to Hunan Prevention and Treatment Institute for Occupational Diseases from March 2019 to March 2022 were selected,and they were divided into the single group and the combination group according to the random allocation method,with 40 cases in each group.All patients were given basic treatment after admission,on the basis of this,the single group was treated with sacubitril valsartan sodium tablets,and the combination group was given ivabradine hydrochloride tablets on the basis of the single group,and the patients of the two groups were treated continuously for 2 months.Clinical efficacy,cardiac function indexes,HR,ALD,ICAM-1,myocardial injury markers before and after 2 months of treatment,vascular endothelial function indexes after 2 months of treatment,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the combination group was higher than that in the single group(97.50%vs.80.00%,χ^(2)=4.507,P=0.034).Compared with pre-treatment,SV,LVEF after 2 months of treatment in the two groups were higher,and LVESD,LVEDD were reduced,HR was lower,and the magnitude of increase/reduction of indexes in the combination group were greater than those in the single group(P<0.01);Plasma ALD,NT-proBNP and serum ICAM-1,cTnT,cTnI,CK-MB levels after 2 months of treatment in the two groups were lower,and the combination group were lower than those in the single group(P<0.01).Plasma ET-1 level after 2 months of treatment in the combination group was lower than that of the single group,and plasma NO level was higher than that of the single group(P<0.01).There was no significant difference of the total incidence of adverse reactions between the combination group and the single group(2.50%vs.10.00%,χ^(2)=0.853,P=0.356).Conclusion Ivabradine combined with sacubitril
作者
曾艳
李倩
ZENG Yan;LI Qian(Hunan Prevention and Treatment Institute for Occupational Diseases,Changsha 410007,China)
出处
《临床合理用药杂志》
2023年第30期5-8,共4页
Chinese Journal of Clinical Rational Drug Use
