伊伐布雷定治疗慢性阻塞性肺疾病合并心力衰竭的临床效果及安全性

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Abstract Objective To investigate the clinical effect and safety of Ivabradine in the treatment of chronic obstructive pulmonary disease (COPD) complicated with heart failure.Methods A total of 80 patients with COPD and heart failure who were admitted to Maoming People's Hospital from January 2018 to January 2021 were selected as research objects,and they were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was given conventional anti-heart failure treatment,and the observation group was additionally given Ivabradine on the basis of the control group.The two groups were treated for 3 months.The cardiac function (left ventricular ejection fraction [LVEF],cardiac output [CO] and stroke volume [SV]),resting heart rate changes,and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels,6 min walking distance and pulmonary function (peak expiratory flow rate [PEF],forced vital capacity [FVC] and forced expiratory volume in 1 second[FEV1]) were compared between the two groups,and the occurrence of adverse reactions were record between the two groups.Results There were no significant differences in the levels of LVEF,CO and SV between the two groups before treatment (P＞0.05).The levels of LVEF,CO and SV in the two groups after treatment were higher than those before treatment,and the differences were statistically significant (P＜0.05).The levels of LVEF,CO and SV in the observation group after treatment were higher than those in the control group,and the differences were statistically significant (P＜0.05).There were no significant differences in the resting heart rate,the level of NT-proBNP and 6-min walking distance between the two groups before treatment (P＞0.05).The resting heart rate and the level of NT-proBNP in the two groups after treatment were lower than those before treatment,and the 6-min walking distance in the two groups after treatment was longer than that before treatment,the differences were statistically significant (P＜0.05).The resting heart rate and the level of NT-proBNP in the observation group after treatment were lower than those in the control group,the 6-min walking distance in the observation group after treatment was longer than that in the control group,and the differences were statistically significant (P＜0.05).There were no significant difference in the levels of PEF,FVC,FEV1 between the two groups before treatment (P＞0.05).The levels of PEF,FVC in the two groups after treatment were higher than those before treatment,the differences were statistically significant (P＜0.05).The levels of PEF,FVC,FEV1 in the observation group after treatment were higher than those in the control group after treatment,the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions in the two groups (P＞0.05).Conclusion Ivabradine can enhance the therapeutic effect of COPD complicated with heart failure,correct the abnormal cardiopulmonary function,reduce the level of NT-proBNP,and stabilize the resting heart rate,which is safe and reliable.

Key words： Chronic obstructive pulmonary disease Heart failure Ivabradine Cardiac function Pulmonary function Adverse reactions

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