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美托洛尔联合伊伐布雷定对稳定型心绞痛患者的疗效分析

Effect of metoprolol combined with ivabradine on patients with stable angina pectoris

    摘要
  • 摘要:
    目的 探讨美托洛尔与伊伐布雷定联合使用对稳定型心绞痛的临床疗效影响。
    方法 选择2019年1月至2020年1月上海交通大学医学院附属新华医院收治的稳定型心绞痛患者126例，随机分为对照组（n=63）和试验组（n=63），进行前瞻性观察、单中心试验。对照组使用美托洛尔（每天1次，初始剂量23.75 mg，2周内加量至47.50 mg），试验组联合使用美托洛尔和伊伐布雷定（初始计量为5 mg，每天2次），治疗8周后，对比2组患者心率、心绞痛症状及预后。
    结果 治疗前2组患者性别、年龄、体质量指数、血压、心率、合并症等基线资料差异均无统计学意义。治疗后，试验组和对照组的心率分别为（59.13±9.26）次/min和（67.13±8.43）次/min，较治疗前均明显降低（P < 0.05），试验组效果更佳（P < 0.05）。同时，试验组的心绞痛疗效显著优于对照组，总有效率差异有统计学意义（87.3% vs 76.2%；χ2=4.79，P=0.039）。治疗8周后，讨验组恶性心律失常及再发心梗的发生率低于对照组（P < 0.05）。
    结论 美托洛尔和伊伐布雷定联合应用可显著改善稳定型心绞痛患者的心绞痛症状，有助于改善预后。

     

    Abstract:
    Objective To explore the effect of metoprolol combined with ivabradine on patients with stable angina pectoris.
    Methods From January 2019 to January 2020, 126 patients with stable angina pectoris were selected from Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, and were randomly divided into the control group (n=63) and experimental group (n=63). The prospective observation and single-center trial were conducted. The patients in the control group was treated with metoprolol(once a day, the initial dose was 23.75 mg, and the dosage was increased to 47.5 mg within 2 weeks), and patients in the experimental group was treated with ivabradine based on the treatment of the control group(the initial dose was 5 mg and twice daily). After 8 weeks of treatment, the heart rate, angina symptoms, and prognosis of patients between the two groups were compared.
    Results Before treatment, there was no statistically significant difference in the base data between the two groups. After treatment, the heart rates in the experimental group and the control group were (59.13±9.26) times/min and (67.13±8.43) times/min, respectively, which were significantly lower than before treatment (P < 0.05), and the effect in the experimental group was better (P < 0.05). At the same time, the curative effect on angina pectoris in the experimental group was significantly better than that in the control group, and the difference in the total effective rate was statistically significant (87.3% vs 76.2%; χ2=4.79, P=0.039). In short-term prognosis monitoring, the incidences of malignant arrhythmia and recurrent myocardial infarction decreased significantly in the experimental group than those in the control group (P < 0.05).
    Conclusions Metoprolol combined with ivabradine can significantly improve angina symptoms, and is helpful to further improve the prognosis.

     

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