伊伐布雷定对慢性阻塞性肺疾病所致慢性肺源性心脏病失代偿期患者心肺功能的影响

目的:观察伊伐布雷定对COPD所致慢性肺源性心脏病失代偿期患者心肺功能的影响。方法：62例COPD所致慢性肺源性心脏病患者随机分为常规治疗组及伊伐布雷定组,进行常规抗心衰治疗或联合伊伐布雷定治疗3个月,记录治疗前后NT-proBNP、hs-CRP、PCT、肺功能、COPD评估测试(CAT)、6分钟步行实验距离、心脏彩超(LVEF、SV、RVD)、24小时平均心率等治疗。结果：两组患者治疗前一般情况一致,无统计学差异。治疗后,伊伐布雷定组患者6分钟步行实验距离、CAT评分均改善,NT-proBNP较常规治疗组明显降低,24小时平均心率明显下降,两组差异具有统计学意义。hs-CRP、PCT、肺功能指标(PEF、FEV1%pred、FEV1/FVC％)、LVEF、SV、RVD改变无统计学差异。结论:在COPD所致肺心病患者中应用伊伐布雷定3个月,可改善患者心功能,提高运动耐量及生活质量,但对患者肺功能及心脏改变无影响。

Effects of Ivabradine on Cardiopulmonary Function in Patients with Cor Pulmonale Caused by Chronic Obstructive Pulmonary Disease

Objective: To observe the effect of ivabradine on cardiopulmonary function in patients with cor pulmonale caused by COPD. Methods: Sixty-two patients with chronic pulmonary heart disease were randomly divided into the routine-treatment group and ivabradine group. The patients were treated with conventional Anti-heart failure treatment or combined with ivabradine for 3 months. NT-proBNP, Hs-CRP, PCT, lung function, COPD assessment test (CAT), 6-minute walking distance (6MWD), cardiac ultrasound (LVEF, SV, RVD), average heart rate. Results: There was no significant difference between the two groups before treatment. After treatment, the 6MWD and CAT score were improved and the NT-proBNP in the ivabradine group was significantly lower than that in the conventional treatment group, and the average heart rate was significantly decreased. However, there were no significant differences in the changes of hs-CRP, PCT and pulmonary function (PEF, FEV1% pred, FEV1/ FVC), LVEF, SV and RVD. Conclusion: After treatment of ivabradine for 3 months, it is possible to improve cardiac function, exercise tolerance and quality of life in patients with pulmonary heart disease caused by COPD. It has no effect on lung function and cardiac structural change.