维拉帕米治疗射血分数正常心力衰竭患者的近期疗效及安全性研究

摘要

Objective To investigate the short - term curative effect and safety of verapamil on heart failure with normal ejection fraction. Methods From January 2013 to January 2015,a total of 96 heart failure patients with normal ejection fraction were selected in the Department of Cardiology,the First People′s Hospital of Zaoyang,and they were divided into control group and experiment group according to random number table,each of 48 cases. Patients of control group received ACEI combined with diuretic,while patients of experiment group received extra verapamil based on that of control group;both groups continuously treated for 30 days. Clinical effect,6 - minute walk - distance, plasma BNP level and cardiac ultrasound examination results before treatment,after 10 weeks and 30 weeks of treatment,incidence of adverse reactions were compared between the two groups. Results The clinical effect of experiment group was statistically significantly better than that of control group(P < 0. 05). No statistically significant differences of 6 - minute walk distance or plasma BNP level was found between the two groups before treatment(P > 0. 05);after 10 weeks and 30 weeks of treatment,6 - minute walk distance of experiment group was statistically significantly longer than that of control group,respectively,while plasma BNP of experiment group was statistically significantly lower than that of control group,respectively( P < 0. 05). No statistically significant differences of Emax,Amax,E/ A ratio or IVRT was found between the two groups before treatment or after 10 weeks of treatment(P > 0. 05);after 30 weeks of treatment,Emax and E/ A ratio of experiment group were statistically significantly higher than those of control group,Amax of experiment group was statistically significantly lower than that of control group,while IVRT of experiment group was statistically significantly shorter than that of control group( P < 0. 05). No one of the two groups occurred any serious adverse reactions during the treatment. Conclusion Verapamil has certain short - term curative effect in treating heart failure with normal ejection fraction,can effectively improve the cardiac function,and is relatively safe.%目的：探讨维拉帕米治疗射血分数正常心力衰竭（ HFNEF）患者的近期疗效及安全性。方法选取2013年1月—2015年1月枣阳市第一人民医院心内科收治的 HFNEF 患者96例，按照随机数字表法分为对照组和试验组，每组48例。对照组患者给予常规血管紧张素转换酶抑制剂（ACEI）联合利尿剂治疗，试验组患者在对照组基础上给予维拉帕米；两组患者均治疗30周。比较两组患者临床疗效，治疗前及治疗后10、30周 6 分钟步行距离、血浆脑钠肽（BNP）水平、心脏超声检查指标，不良反应发生情况。结果试验组患者临床疗效优于对照组（ P <0.05）。治疗前，两组患者6分钟步行距离、血浆 BNP 水平比较，差异无统计学意义（P >0.05）；治疗后10、30周，试验组患者6分钟步行距离均长于对照组，血浆 BNP 水平均低于对照组（P <0.05）。治疗前、治疗后10周，两组患者左心室舒张早期左房室瓣血流峰值（Emax）、左心室舒张晚期左房室瓣血流峰值（Amax）、E/ A 比值及左心室等容舒张时间（IVRT）比较，差异无统计学意义（P >0.05）；治疗后30周，试验组患者 Emax、E/ A 高于对照组，Amax 低于对照组，IVRT 短于对照组（P <0.05）。两组患者均未出现严重不良反应。结论维拉帕米治疗 HFNEF 的近期疗效确切，可有效改善患者心功能，且安全性较高。