广州医药2023，Vol.54Issue(12)：83-88,6.DOI:10.3969/j.issn.1000-8535.2023.12.014
伊伐布雷定对冠心病合并心律失常患者心率变异性的影响及对心房颤动的防治效果
Effect of ivabradine on heart rate variability and prevention and treatment of atrial fibrillation in patients with arrhythmia in coronary heart disease
摘要
Abstract
Objective To observe the effect of ivabradine on heart rate variability(HRV)in coronary heart disease(CHD)patients with arrhythmia and its preventive and therapeutic effects on atrial fibrillation(AF).Methods This is a prospective cohort study.The 125 CHD patients with arrhythmia were included from January 2021 to January 2023 and divided into the conventional group(62 cases)and the combined group(63 cases)by random number table.The conventional group was treated with conventional drugs,and the combined group was treated with ivabradine additionally.The HRV index,vascular endothelial function index,improvement of cardiac function indicators,incidence of AF and medication safety were compared.Results After treatment,the standard deviation of normal RR intervals in 24 h of the combination group was(88.25±10.36)ms,root mean square of successive RR interval differences in 24 h was(50.25±10.61)ms,and successive RR interval differences＞50 ms was(12.04±3.41)%.Compared with the conventional group[(81.44±10.77)ms,(43.28±10.71)ms and(10.77±3.08)%],the above indicators were all higher(P＜0.05).After treatment,the flow-mediated dilation and nitrite-mediated dilation of the combination group were(12.33±3.27)%and(9.83±2.21)%,respectively.Compared with the conventional group(10.25±3.23)%and(8.14±2.03)%),the above indicators were higher.The incidence of AF was 4.76%(3/63),which was lower(P＜0.05)than the conventional group of 16.13%(10/62).After treatment,the left ventricular ejection fraction of the combination group was(55.35±10.27)%,which was higher than that of the conventional group(48.45±10.61)%.The left ventricular diastolic diameter was(40.24±10.37)mm and the left ventricular posterior wall thickness was(9.22±2.06)mm.Compared with the conventional group[(46.33±10.28)mm,(10.88±2.46)mm],the above indicators were all lower(P＜0.05).After treatment,the incidence of drug-related side effects in the combination group was 7.94%(5/63),which was similar to 6.45%(4/62)in the conventional group(P＞0.05).Conclusions The combination of ivabradine and conventional drugs in the treatment of CHD complicated with arrhythmia can effectively improve HRV indicators in patients,promote the recovery of vascular endothelial cell function and cardiac function,reduce the incidence of AF,and do not significantly increase the risk of drug side effects.关键词
冠心病/心律失常/伊伐布雷定/心率变异性/心房颤动/用药安全性Key words
coronary heart disease/arrhythmia/Ivabradine/heart rate variability/atrial fibrillation/drug safety引用本文复制引用
侯宇鹏..伊伐布雷定对冠心病合并心律失常患者心率变异性的影响及对心房颤动的防治效果[J].广州医药,2023,54(12):83-88,6.基金项目
河南省医学科技攻关项目(LHGJ202100237) （LHGJ202100237）
