李芳菲^1,,
王虹艳²,
牛楠²,
曲鹏²,
刘珍竹^2,,
1. 大连医科大学附属第二医院 消化内科, 辽宁 大连 116027
2. 大连医科大学附属第二医院 心内科, 辽宁 大连 116027

基金项目: 国家自然科学基金项目（82000415）


详细信息 作者简介: 李芳菲(1991-), 女, 住院医师。E-mail: 912517666@qq.com





通讯作者: 刘珍竹, 副主任医师。E-mail: liuzhenzhu@yeah.net 中图分类号: R541


摘要:目的分析伊伐布雷定在急性ST段抬高型心肌梗死（STEMI）伴Killip Ⅱ级患者治疗中的疗效。方法选取83例STEMI伴Killip Ⅱ级患者，其中32例患者应用伊伐布雷定，为观察组。其余51例患者应用常规治疗，为对照组。分析两组患者治疗前、出院前BNP水平变化；治疗前、出院前以及出院1个月后心率变化，出院前及出院1个月后左心室射血分数（LVEF）、左心室舒张末内径（LVEDD）变化；出院前ACEI/ARB及β受体阻滞剂的启动时间。结果经过治疗，出院前观察组患者BNP水平下降更为明显（P < 0.05）；观察组患者出院1个月后心率较对照组显著下降（P < 0.05）；LVEF较对照组显著升高（P < 0.05）；观察组患者ACEI/ARB、β受体阻滞剂的启动时间早于对照组（P < 0.05）。结论伊伐布雷定有效降低STEMI伴Killip Ⅱ级患者心率，改善心功能，增加心输出量，并帮助ACEI/ARB、β受体阻滞剂的启动。
关键词: 伊伐布雷定/
STEMI/
心力衰竭


Abstract:ObjectiveTo analyze the efficacy of ivabradine in the treatment of acute ST segment elevation myocardial infarction (STEMI) complicated with Killip Ⅱ.MethodsThe clinical data of 83 STEMI patients complicated with Killip Ⅱ were retrospectively analyzed. The control group (n=51) received conventional therapy, and ivabradine was added in the observation group (n=32) with conventional therapy. Before and after treatment, BNP levels, heart rate, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), and the start-up time of ACEI/ARB and β-blockers were analyzed in the two groups.ResultsAfter treatment, the BNP level of observation group decreased more significantly (P < 0.05) before discharge; the heart rate of observation group was significantly lower than that of control group one month after discharge (P < 0.05); the LVEF of observation group was higher than that in control group one month after discharge (P < 0.05); and the start time of ACEI/ARB and beta blocker of observation group was earlier than that in control group (P < 0.05).Conclusionivabradine can effectively reduce heart rate, improve cardiac function, increase cardiac output, and help start ACEI/ARB and beta blocker in STEMI patients complicated with Killip Ⅱ.
Keywords:ivabradine/
ST segment elevation myocardial infarction/
heart failure

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https://journal.dmu.edu.cn/data/article/export-pdf?id=dlykdxxb_20210603