伊伐布雷定联合托拉塞米治疗老年慢性心力衰竭的疗效及对相关指标的影响^*

Efficacy of ivabradine combined with torasemide in elderly patients with chronic heart failure and its effect on heart failure-related indices

摘要

目的 分析老年慢性心力衰竭 (CHF) 患者应用伊伐布雷定联合托拉塞米的疗效及对 CHF 相关指标的影响。方法 选取 2021 年 2 月—2023 年 9 月中国人民解放军联勤保障部队第九六○医院收治的 105 例老年 CHF 患者的临床资料进行回顾性分析, 按照不同治疗方法将其分为对照组和观察组, 对照组 52 例接受托拉塞米治疗, 观察组 53 例在对照组基础上加用伊伐布雷定治疗, 比较两组疗效、心力衰竭指标、生活质量及安全性。结果 观察组治疗有效率高于对照组 (P<0.05)。 治疗 3 个月, 两组左室射血分数、血管内皮生长因子、6 ^{min 内步行距离均高于治疗前, 且观察组高于对照组 (P<0.05); 左室收缩末期内径、N 末端脑钠肽前体、心肌钙蛋白Ⅰ、血清一氧化氮、脑钠肽、C 反应蛋白水平和明尼苏达心衰生活质量量表评分均低于治疗前, 且观察组低于对照组 (P<0.05)。 两组不良反应总发生比较, 差异无统计学意义 (P>0.05)。结论 老年 CHF 患者采取伊伐布雷定联合托拉塞米治疗可显著改善血管内皮功能、心功能和心肌指标, 减轻心力衰竭程度, 提升患者生活质量。}

Abstract

Objective To analyse the efficacy of ivbabradine in combination with torasemide in elderly patients with chronic heart failure (CHF) and its effect on heart failure-related indices. Methods The clinical data of 105 elderly patients with CHF admitted to the 960th Hospital of the PLA Joint Logistics Support Force from February 2021 to September 2023 were retrospectively analyzed and divided into the control group and the observation group according to different treatment methods. 52 patients in the control group received torasemide treatment, and 53 patients in the observation group were treated with ivabradine on the basis of the control group. The efficacy, heart failure indicators, quality of life and safety were compared between the two groups. Results The effective rate in the observation group was higher than that in the control group (P<0.05). At 3 months of treatment, the levels of left ventricular ejection fraction, vascular endothelial growth factor, and walking distance in 6 min in the two groups were higher than those before treatment, and in the observation group were higher than those in the control group (P<0.05), and the levels of left ventricular end-systolic diameter, N-terminal pro-brain natriuretic peptide precursor, cardiac troponin Ⅰ, serum nitric oxide, brain natriuretic peptide, and C-reactive protein levels and Minnesota living with heart failure questionnaire score in the two groups were higher than those before treatment, and in the observation group were lower than those in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion In elderly patients with CHF, Ivabradine combined with torasemide can significantly improve vascular endothelial function, cardiac function and myocardial indexes, reduce the degree of heart failure, and improve the quality of life of patients.

关键词

慢性心力衰竭 / 伊伐布雷定 / 托拉塞米

Key words

Chronic heart failure / Ivabradine / Torasemide

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基金资助

^*军队后勤科研项目保健专项课题(23BJZ45)