【摘要】 目的探讨伊伐布雷定在老年心力衰竭合并衰弱综合征患者中的应用及对心功能、血浆N-末端脑钠肽(NT-proBNP)的影响。方法选择2018年1月～2019年12月我院收治的老年心力衰竭合并衰弱综合征患者96例,随机数字表法分为对照组(n=48)和观察组(n=48)。对照组给予常规药物治疗,观察组在对照组基础上联合伊伐布雷定治疗,比较两组患者治疗前后心功能指标及hs-CRP、NT-proBNP水平、ADL评分、SAS评分、六分钟步行距离。结果两组患者治疗前心功能指标比较差异均无统计学意义(P>0.05),治疗后两组患者心功能指标均有所改善,观察组患者LVEDD、LVESD指标均低于对照组,LVEF、CO、CI指标高于对照组(均P<0.05);两组患者治疗前hs-CRP、NT-proBNP水平比较差异均无统计学意义(P>0.05),治疗后观察组hs-CRP、NT-proBNP水平均低于对照组(P<0.05);两组治疗后ADL评分、六分钟步行距离均高于治疗前(P<0.05),SAS评分低于治疗前(P<0.05),观察组治疗后ADL评分、六分钟步行距离均高于对照组(P<0.05),SAS评分低于对照组(P<0.05)。结论伊伐布雷定在老年心力衰竭合并衰弱综合征患者中的治疗效果显著,可有效改善患者的心功能,降低血浆中hs-CRP、NT-proBNP水平,提高患者的预后效果,值得临床借鉴。更多还原

【Abstract】 Objective To investigate the effect of ivabradine on cardiac function and plasma N-terminal brain natriuretic peptide in elderly patients with heart failure and asthenia syndrome. Methods Ninety-six elderly patients with heart failure and wasting syndrome treated from January 2018 to December 2019 were selected as the research subjects. The random number table was divided into the control group(n=48) and the observation group(n=48). The control group was given conventional drug treatment, and the observation group was combined with ivabradine treatment on the basis of the control group. The cardiac function indexes, hs-CRP, NT-proBNP levels, ADL score, SAS score, and six-minute walking distance were compared between the two groups of patients before and after treatment.Results There was no statistically significant difference in cardiac function indexes between the two groups of patients before treatment(P>0.05). The cardiac function indexes of the two groups were improved after treatment. The LVEDD and LVESD indexes of the observation group were lower than those of the control group. The CO and CI indicators were higher than those in the control group(P<0.05). hs-CRP and NT-proBNP levels were not statistically significant before treatment in the two groups(P>0.05). hs-CRP and NT-proBNP were observed in the observation group after treatment. Levels were lower than those in the control group(P<0.05). ADL scores and six-minute walking distances after treatment were higher in both groups than before treatment(P<0.05). SAS scores were lower than before treatment(P<0.05). After treatment in the observation group ADL score and six-minute walking distance were higher than the control group(P<0.05), and SAS score was lower than the control group(P<0.05).Conclusion Ivabradine is effective in treating elderly patients with heart failure and wasting syndrome. It can effectively improve the heart function of patients, reduce the levels of hs-CRP and NT-proBNP in plasma, and improve the prognosis of patients.更多还原