伊伐布雷定联合美托洛尔对缺血性心肌病PCI术患者心功能、预后及血清炎性因子的影响

目的:探讨伊伐布雷定联合美托洛尔对缺血性心肌病(ICM)行经皮冠状动脉介入术(PCI)术后患者心功能、预后及血清炎性因子的影响。方法:选取2018年7月-2019年4月我院收治的行PCI术的ICM患者98例,将随机数字表法分为实验组与对照组,各49例,对照组给予美托洛尔治疗,实验组给予伊伐布雷定联合美托洛尔治疗,对比两组优良率、心功能、预后、不良反应及血清炎性因子。结果:实验组治疗8周后的优良率为93.75%(45/48),高于对照组的70.83%(34/48)(P<0.05)。实验组治疗8周后左心室射血分数(LVEF)、6 min步行试验(6MWT)距离高于对照组,N末端B型钠尿肽原(NT-proBNP)、24 h心率(24hHR)低于对照组(P<0.05)。实验组治疗8周后肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)低于对照组(P<0.05)。实验组3个月内再住院率、3个月内病死率低于对照组(P<0.05)。两组不良反应发生率比较无差异(P>0.05)。结论:相较于单用美托洛尔,联合伊伐布雷定治疗PCI术后的ICM患者,可更好地改善患者心功能,降低炎性因子水平,且安全性较好,改善患者预后的效果更佳。

Effects of Ivabradine Combined with Metoprolol on Cardiac Function, Prognosis and Serum Inflammatory Factors in Patients with Ischemic Cardiomyopathy Undergoing PCI

Objective:To investigate the effect of ivabradine combined with metoprolol on cardiac function,prognosis and serum inflammatory factors in patients with ischemic cardiomyopathy(ICM)undergoing percutaneous coronary intervention(PCI).Methods:98 patients with ICM undergoing PCI in our hospital from July 2018 to April 2019 were selected,and randomly divided into experimental group and control group by random number table method,49 cases in each group.The control group was treated with metoprolol,and the experimental group was treated with ivabradine combined with metoprolol.The excellent and good rate,cardiac function,prognosis,adverse reactions and serum inflammatory factors were compared between two groups.Results:8 weeks after treatment,the excellent and good rate of the experimental group was 93.75%(45/48),which was higher than 70.83%(34/48)of the control group(P<0.05).8 weeks after treatment,left ventricular ejection fraction(LVEF)and 6-minute walk test(6MWT)distance of experimental group were higher than control group,and N-terminal pro-B-type natriuretic peptide(NT proBNP),24h heart rate(24hHR)of experimental group were lower than those of control group(P<0.05).8 weeks after treatment,the levels of tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)of experimental group were lower than control group(P<0.05).The rehospitalization rate and mortality within 3 months of the experimental group were lower than control group(P<0.05).There was no significant difference in incidence of adverse reactions between two groups(P>0.05).Conclusion:Compared with metoprolol alone,combined with ivabradine in the treatment of patients with ICM after PCI,can effectively improve the cardiac function,reduce the level of inflammatory factors,and has better safety,and the effect of improving the prognosis of patients is better.