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|本期目录/Table of Contents|

伊伐布雷定治疗慢性收缩性心力衰竭的效果

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2018年第2期
页码:
192-195
栏目:
临床研究
出版日期:
2018-02-15

文章信息/Info

Title:
The effectof ivabradine in patients with chronic systolic heart failure
作者:
王 群; 林文华
(天津医科大学心血管病临床学院泰达国际心血管病医院心内一科,天津 300457)
Author(s):
WANG Qun;  LIN Wen-hua
(First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin 300457, China)
关键词:
伊伐布雷定; 心力衰竭; 心率
Keywords:
ivabradine;  heart failure;  heart rate
分类号:
R541.61
DOI:
-
文献标识码:
A
摘要:
目的 探讨伊伐布雷定治疗慢性收缩性心力衰竭的临床疗效。方法 入选左室收缩功能不全并发慢性心力衰竭且为窦性心率≥70次/min患者76例，随机分为伊伐布雷定组（试药组，39例）和常规治疗组（对照组，37例），在2周、4周、6周及3个月时随访，记录其心率、血压、心血管不良事件、药物剂量。入院后及3个月行6分钟步行试验及心脏彩超。结果 3个月时，与对照组相比，试药组心率显著降低［(72±5)次/min vs.(62±4)次/min，P<0.05］，血压显著升高［(116±8) mmHg vs.(123±7) mmHg，P<0.05］,左室射血分数显著提高（P<0.05），左室收缩末内径及左房直径较对照组显著减小［分别(4.6±0.3) cm vs.(4.1±0.2) cm；(4.0±0.4) cm vs.(3.7±0.2) cm，均P<0.05］。6分钟步行距离显著增加［(522±81) m vs.(578±91) m，P<0.05］；两组心功能分级至少增加1级，试药组左室射血分数改善更显著（62% vs. 35%，P<0.05）。结论 伊伐布雷定治疗慢性收缩性心力衰竭的疗效优于常规治疗。
Abstract:
AIM To assess the clinical effects of ivabradine in patients with chronic heart failure. METHODS 76 patients (baseline HR ≥70 bpm) with chronic heart failure were randomly divided into an Ivabradine group (treatment group 39 cases) and a conventional therapy group (control group 37 cases). Dosages of ivabradine were recorded at every routine patient visit (at 2, 4, and 6 weeks, and then 3 months), along with resting heart rate (by electrocardiogram), blood pressure, and major adverse cardiovascular events. A 6-min walking test and echocardiography were performed at baseline and at 3 months. Patients with and without ivabradine were compared for performance on the 6-min walking test at 3months (primary endpoint) and echocardiographic parameters at 3 months (LV ejection fraction, LV end-diastolic diameter, LV end-systolic diameter, and left atrial dimension). RESULTS Patients receiving ivabradine had lower resting heart rate at 3 months ［(62±4) bpmversus (72±5) bpm, P<0.05］. In addition, the patients in the treatment group had higher systolic blood pressure ［(123±7) mmHg versus (116±8) mmHg, P<0.05］, a significant rise in left ventricular ejection fraction (P<0.05), and significantly reduced LV end-systolic diameter and left atrial dimension ［(4.6±0.3) cm vs.(4.1±0.2) cm, (4.0±0.4) cm vs.(3.7±0.2) cm, P<0.05］. The distance reached in 6-min walking test was significantly longer in the ivabradine group than in the control group (P<0.05). Significantly, more patients in the ivabradine group (62%) had an improvement of at least one NYHA class than in the control group (35%) (P<0.05). CONCLUSION Clinical effects of ivabradine administration in patients with chronic heart failure are superior to conventional treatment.

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备注/Memo

备注/Memo:
收稿日期：2017-03-01.作者简介：王群，主治医师，硕士 Email：tianyiwangqun@126.com
更新日期/Last Update: 1900-01-01