伊伐布雷定治疗冠心病合并慢性阻塞性肺病心力衰竭临床疗效研究

摘要

Objective:To explore the clinical efficacy and safety of Ivabradine on the coronary heart disease (CHD) patients combined Chronic obstructive pulmonary disease (COPD) and heart failure.Methods:The patients (n=60) who diagnosed coronary heart disease (CHD) with COPD by physician internist were randomly divided into control group (30) and treatment group (30), both groups' patients were accepted the standardized treatment of anti heart failure and the treatment of anti-infection, and relieving asthma, eliminating phlegm when necessary, in the meantime, patients in treatment group were treated with Ivabradine.The PaO2, PaCO2, SaO2, heart rate, left ventricular ejection fraction (LVEF), Nterminal brain natriuretic peptide (NT-proBNP) with 6 min walking distance (6 MWDS) were compared in both groups before and after medication.And record adverse reactions during the treatment.Results:Compared with control group, the PaO2, SaO2, LVEF increased significantly and the PaCO2, heart rate, blood plasma NT-proBNP significantly decreased in the patients of treatment group.The 6 MWDS compared with before treatment differences were statistically significant.Conclusion:The Ivabradine is safe and effective to the the coronary heart disease (CHD) patients combined chronic obstructive pulmonary disease (COPD) and heart failure, Ivabradine can reduce the level of serum biomarkers obviously.%目的:探讨伊伐布雷定片对冠心病合并慢性阻塞性肺病 (COPD) 心力衰竭患者的临床疗效及安全性.方法:收集冠心病合并COPD患者60例, 随机分入对照组和治疗组各30例.两组均予标准化抗心力衰竭及必要时抗感染、平喘、祛痰等治疗, 同时治疗组联合应用伊伐布雷定治疗.比较分析对照组与治疗组用药前后的PaO2、PaCO2、SaO2、心率、左心室射血分数 (LVEF) 、N末端脑钠肽原 (NT-proBNP) 与6min步行距离 (6MWD) ;记录治疗期间的不良反应.结果:与对照组相比, 治疗组患者的PaO2、SaO2、LVEF明显升高, PaCO2、心率、血浆NT-proBNP明显降低, 6MWD与治疗前比较差异均有统计学意义.结论:伊伐布雷定治疗冠心病合并COPD心力衰竭患者安全有效, 可明显降低血浆生物标志物水平.