伊伐布雷定联合呋塞米对老年高血压合并心力衰竭患者的临床疗效

doi:10.3760/cma.j.cn441417-20250331-19004

摘要/Abstract

摘要：

目的　探究伊伐布雷定联合呋塞米对老年高血压合并心力衰竭患者的临床疗效。方法　选择2024年1月至12月期间西安大兴医院心血管结合重症医学科收治的102例老年高血压合并心力衰竭患者，根据随机数字表法将其分为对照组和联合组各51例。对照组男32例，女19例，年龄（68.49±5.28）岁；联合组男29例，女22例，年龄（67.97±5.81）岁。对照组采用伊伐布雷定干预，前2周5.0 mg/次，2次/d，第3周开始7.5 mg/次，2次/d；联合组在对照组基础上联合呋塞米干预，60 mg/次，2次/d。两组均持续干预3个月。比较两组临床疗效，干预前后的血压水平（收缩压、舒张压）、心功能指标［左心室舒张末期内径（LVEDD）、左室射血分数（LVEF）］、肾功能指标［24 h尿蛋白定量（24 h UP）、尿微量白蛋白（mAlb）］以及安全性。采用t检验、χ²检验进行统计学分析。结果　联合组总有效率98.04%（50/51），高于对照组84.31%（43/51），差异有统计学意义（P<0.05）。干预后，联合组收缩压（122.07±8.05）mmHg（1 mmHg=0.133 kPa）、舒张压（77.94±7.31）mmHg、LVEDD（49.53±4.35）mm，均低于对照组［（132.69±8.20）mmHg、（84.54±7.62）mmHg、（53.64±4.26）mm］，LVEF［（52.65±4.36）%］高于对照组［（44.86±4.72）%］，差异均有统计学意义（均P<0.05）；联合组24 h UP（128.45±6.29）mg、mAlb（15.52±1.02）mg/L，均低于对照组［（142.62±6.51）mg、（18.63±1.06）mg/L］，差异均有统计学意义（均P<0.05）。联合组不良反应发生率13.73%（7/51），与对照组［7.84%（4/51）］相比，差异无统计学意义（P>0.05）。结论　伊伐布雷定联合呋塞米治疗老年高血压合并心力衰竭患者，能够有效降低血压，改善心功能，缓解肾功能损伤，且安全性较高。

关键词:

高血压, 心力衰竭, 伊伐布雷定, 呋塞米, 心功能, 肾功能

Abstract:

Objective　To explore the clinical efficacy of ivabradine combined with furosemide in elderly patients with hypertension and heart failure. Methods　A total of 102 elderly patients with hypertension and heart failure who were admitted to Department of Cardiovascular and Critical Care Medicine, Xi'an Daxing Hospital from January to December 2024 were selected. They were divided into a control group and a combined group according to the random number table method, with 51 cases in each group. In the control group, there were 32 males and 19 females, with an age of (68.49±5.28) years old; in the combined group, there were 29 males and 22 females, with an age of (67.97±5.81) years old. The control group was intervened with ivabradine: for the first two weeks, the dosage was 5.0 mg per time, twice a day; since the third week, the dosage was 7.5 mg per time, twice a day. The combined group was intervened with furosemide on the basis of the control group, 60 mg per time, twice a day. Both groups were continuously intervened for 3 months. The clinical efficacies of the two groups were compared, as well as the blood pressure levels (systolic and diastolic blood pressure), cardiac function indicators [left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)], and renal function indicators [24-hour urine protein quantification (24 h UP) and urine microalbumin (mAlb)] before and after intervention and safety. Statistical analysis was conducted using t-test and χ² test. Results　The total effective rate of the combined group was 98.04% (50/51), which was higher than that of the control group [84.31% (43/51)], with a statistically significant difference (P<0.05). After intervention, the systolic blood pressure [(122.07±8.05) mmHg (1 mmHg = 0.133 kPa)], diastolic blood pressure [(77.94±7.31) mmHg], and LVEDD [(49.53±4.35) mm] in the combined group were all lower than those in the control group [(132.69±8.20) mmHg, (84.54±7.62) mmHg, and (53.64±4.26) mm], and the LVEF was higher than that in the control group [(52.65±4.36)% vs. (44.86±4.72)%], with statistically significant differences (all P<0.05). After intervention, the 24 h UP [(128.45±6.29) mg] and mAlb [(15.52±1.02) mg/L] in the combined group were lower than those in the control group [(142.62±6.51) mg and (18.63±1.06) mg/L], with statistically significant differences (both P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the combined group and the control group [13.73% (7/51) vs. 7.84% (4/51)] (P>0.05). Conclusion　The combination of ivabradine and furosemide in the treatment of hypertensive patients with heart failure can effectively reduce the blood pressure, improve the heart function, and alleviate the renal function damage, with high safety.

Key words:

Hypertension, Heart failure, Ivabradine, Furosemide, Heart function, Renal function

李超寇银艳潘硕.

伊伐布雷定联合呋塞米对老年高血压合并心力衰竭患者的临床疗效 [J]. 国际医药卫生导报, 2025, 31(19): 3186-3190.

Li Chao, Kou Yinyan, Pan Shuo.

Clinical efficacy of ivabradine combined with furosemide in elderly patients with hypertension and heart failure [J]. International Medicine and Health Guidance News, 2025, 31(19): 3186-3190.

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