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目的观察伊伐布雷定对老年慢性心力衰竭患者生物标记物的影响。方法连续入选北京市两所治疗心血管疾病为特长的医院2015年8月-2016年2月就诊的病情稳定的老年慢性心力衰竭患者52例,接受心力衰竭标准治疗心率仍不能低于70次/分,予以伊伐布雷定治疗。初始剂量每次2.5mg,每日两次,根据心率调整用量,最大剂量至每次7.5mg,每天两次。控制患者静息心率在60次/分左右,不低于55次/分。连续用药3个月,记录用药前后心率,N末端B型利钠肽原(NT-pro BNP)和半乳糖凝集素-3(Galectin-3)水平。并记录药物的不良反应。结果治疗3个月后心率、血浆NT-pro BNP水平和Galectin-3显著降低(P均<0.05),基线时HR与NT-pro BNP及Galectin-3相关。心率下降绝对值(10.2±8.9次/分)与NT-pro BNP下降值中位数756ng/l显著相关(r=0.682,P=0.006)。且心率下降绝对值与galectin-3下降值中位数4.1ng/l亦显著相关(r=0.592,P=0.015)。药物不良反应发生少。结论伊伐布雷定可显著降低老年慢性心衰患者血浆生物标记物水平。
Objective To observe the effect of ivabradine on biomarkers in elderly patients with chronic heart failure. Methods A total of 52 elderly patients with chronic heart failure who were admitted to the hospital from August 2015 to February 2016 in our hospital were enrolled in this study. The heart rate of patients receiving heart failure was no lower than 70 times / Points to be treated with ivabradine. The initial dose of 2.5mg each time, twice daily, according to adjust the amount of heart rate, the maximum dose to 7.5mg twice daily. Control the patient resting heart rate at 60 beats / min or so, not less than 55 beats / min. After 3 months of continuous administration, the heart rate, N-terminal proBNP and Galectin-3 levels were recorded before and after treatment. And record the adverse drug reactions. Results After 3 months of treatment, heart rate, plasma NT-pro BNP level and Galectin-3 significantly decreased (all P <0.05). Baseline HR correlated with NT-pro BNP and Galectin-3. The absolute value of heart rate decline (10.2 ± 8.9 beats / min) was significantly associated with a median decrease of NT-pro BNP of 756 ng / l (r = 0.682, P = 0.006). The absolute value of heart rate decline was also significantly associated with the median galectin-3 decline of 4.1 ng / l (r = 0.592, P = 0.015). Adverse drug reactions occur less. Conclusion Ivabradine can significantly reduce the level of plasma biomarkers in elderly patients with chronic heart failure.