伊伐布雷定治疗高龄老年射血分数中间值心衰患者的疗效观察

目的评价伊伐布雷定治疗高龄老年射血分数中间值心衰(HFmrEF)患者的临床疗效。方法选择我院治疗的120例高龄老年HFmrEF患者,按随机数字表法分为观察组和对照组各60例,对照组给予规范化抗心衰治疗,观察组在此基础上加用伊伐布雷定治疗。随访6个月后,比较两组治疗前后静息心率(RHR)、氨基末端脑钠肽前体(NT-proBNP)、6 min步行距离(6MWD)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、左室射血分数(LVEF)水平的差异,并比较两组治疗后的心衰再住院率及药物不良反应(ADR)情况。结果治疗前,两组患者的RHR、NT-proBNP、6MWD、LVDd、LVDs、LVEF指标比较,差异无统计学意义(均P>0.05);治疗后,两组的RHR、NT-proBNP、6MWD、LVDd、LVDs、LVEF指标均较治疗前明显改善(均P<0.05),且观察组各指标改善优于对照组(均P<0.05)。两组患者的心衰再住院率、不良反应发生率比较,差异有统计学意义(均P<0.05)。结论伊伐布雷定能有效改善高龄HFmrEF患者心功能及左室重构,降低心衰再住院率,值得临床推广。

Efficacy of Iavbredeen in treatment of very elderly patients with heart failure with mid-range ejection fraction

Objective The purpose of this study was to evaluate the clinical efficacy of Iavbredine in the treatment of very elderly patients with heart failure with mid-range ejection fraction(HFmrEF).Methods A total of 120 very elderly patients with HFmrEF were included in this study,and were randomly divided into observation group(n=60)and control group(n=60).Control group was treated by standardized anti-heart failure treatment,while observation group was treated by ivarbrectin on this basis.The comparisons in rest heart rate(RHR),N-terminal pro brain natriuretic peptide(NT-proBNP),6-minute walking distance(6 MWD),left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVDs),left ventricular ejection fraction(LVEF)levels were made between two groups before and after treatment after a 6-month follow-up period.The incidence of rehospitalization for heart failure and adverse drug reactions(ADR)were compared between two groups after treatment.Results Before treatment,there were no significant changes in the level of RHR,NT-proBNP,6 MWD,LVDd,LVDs,LVEF between two groups(all P>0.05).After treatment,the level of RHR,NT-proBNP,6 MWD,LVDd,LVDs,LVEF in the both groups were significantly improved compared with the those of baseline(all P<0.05).After treatment,compared with control group,the level of RHR,NT-proBNP,6 MWD,LVDd,LVDs and LVEF in observation group were significantly improved,and the incidence rehospitalization for heart failure was significantly reduced(all P<0.05).No change in the incidence of ADR between two groups was found(P<0.05).Conclusion Iavbreidine can improved cardiac function,left ventricular remodeling,and reduced the incidence of rehospitalization for heart failure.It is worthy of further clinical promotion in the treatment for very elderly patients with HFmrEF.