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目的 探讨伊伐布雷定治疗慢性收缩性心力衰竭的临床疗效。方法 入选左室收缩功能不全并发慢性心力衰竭且为窦性心率≥70次/min患者76例，随机分为伊伐布雷定组（试药组，39例）和常规治疗组（对照组，37例），在2周、4周、6周及3个月时随访，记录其心率、血压、心血管不良事件、药物剂量。入院后及3个月行6分钟步行试验及心脏彩超。结果 3个月时，与对照组相比，试药组心率显著降低［(72±5)次/min vs.(62±4)次/min，P<0.05］，血压显著升高［(116±8) mmHg vs.(123±7) mmHg，P<0.05］,左室射血分数显著提高（P<0.05），左室收缩末内径及左房直径较对照组显著减小［分别(4.6±0.3) cm vs.(4.1±0.2) cm；(4.0±0.4) cm vs.(3.7±0.2) cm，均P<0.05］。6分钟步行距离显著增加［(522±81) m vs.(578±91) m，P<0.05］；两组心功能分级至少增加1级，试药组左室射血分数改善更显著（62% vs. 35%，P<0.05）。结论 伊伐布雷定治疗慢性收缩性心力衰竭的疗效优于常规治疗。
Objective To investigate the clinical efficacy of ivabradine in the treatment of chronic systolic heart failure. Methods 76 patients with left ventricular systolic dysfunction complicated by chronic heart failure and with sinus heart rate≥70 beats / min were randomly divided into two groups: control group (37 cases) and control group (37 cases) Cases) were followed up at 2 weeks, 4 weeks, 6 weeks and 3 months, and their heart rate, blood pressure, cardiovascular adverse events and drug doses were recorded. After admission and 3 months 6-minute walk test and cardiac ultrasound. Results At 3 months, the heart rate was significantly lower in the test group compared with the control group [(72 ± 5) times / min vs. (62 ± 4) times / min, P <0.05) (P <0.05). The mean diameter of left ventricular end-systole and the diameter of left atrium were significantly decreased compared with the control group [(4.6 ± 4.6, P <0.05, respectively] ± 0.3) cm vs. (4.1 ± 0.2) cm; (4.0 ± 0.4) cm vs. (3.7 ± 0.2) cm, all P & lt; 0.05]. (522 ± 81) m vs. (578 ± 91) m, P & lt; 0.05]. The heart function scores increased by at least 1 grade in both groups, and the left ventricular ejection fraction improved more significantly % vs. 35%, P & lt; 0.05). Conclusions The efficacy of Ivabradine in the treatment of chronic systolic heart failure is better than that of conventional treatment.