伊伐布雷定在稳定型心绞痛合并慢性阻塞性肺疾病患者中应用.docVIP

伊伐布雷定在稳定型心绞痛合并慢性阻塞性肺疾病患者中的应用 　　[摘要]目的 观察伊伐布雷定在稳定型心绞痛合并慢性阻塞性肺疾病（COPD）中的应用效果。方法 选取2014年1月1日～2016年12月30日本院接收的42例稳定型心绞痛合并COPD患者，将其随机分为常规治疗组、伊伐布雷定组，各21例。常规治疗组给予冠心病常规治疗，伊伐布雷定组在对照组基础上联合伊伐布雷定。比较两组的应用效果。结果 治疗后，两组的肺功能指标差异无统计学意义（P0.05）；与常规治疗组比较，伊伐布雷定组的6 min步行实验距离、CAT评分均改善，24 h平均心率明显下降，心绞痛发作次数及硝酸甘油使用量均较常规治疗组明显减少（P0.05）。结论 稳定型心绞痛合并COPD患者应用伊伐布雷定，可提高患者运动耐量和生活质量，减少心绞痛发作次数，效果确切，可推荐。 　　[关键词]伊伐布雷定；慢性阻塞性肺疾病；稳定型心绞痛 　　[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721（2017）10（a）-0039-03 　　[Abstract]Objective To observe the application effect of Ivabradine in patients with stable angina pectoris complicated with chronic obstructive pulmonary disease （COPD）.Methods From January 1，2014 to December 30，2016，42 patients with stable angina pectoris complicated with COPD were selected in our hospital.They were randomly divided into the routine treatment group and ivabradine group，with 21 cases in each group.Routine treatment was used in the former group and ivabradinewas added besides treatment in routine group.The application effect was compared between the two groups.Results After therapy，there was no statistical difference of pulmonary function indexes between the two groups （P0.05）.In the ivabradine group，6-min walking distance and CAT score were both improved.The 24-hour average heart rate was significantly decreased as well as frequency of angina pectoris and doses of Nitroglycerin compared with those in the routine group with statistical differences （P0.05）.Conclusion For patients with stable angina pectoris and COPD，Ivabradinecan applied can improve the patients′ exercise tolerance and quality of life，and reduce the attack times of angina pectoris in a definite effect，which can be recommended. 　　[Key words]Ivabradine；Chronic obstructive pulmonary disease；Stable angina pectoris 　　慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者由于缺氧而多存在心动过速，使患者心肌需氧量增加，加重心肌缺血，心绞痛发作率增高。临床治疗用选择性β受体阻滞剂，尽管有一定的效果，但仍有部分患者对β受体阻滞剂无法耐受，治疗剂量中即可出?F明显气管痉挛，限制了其使用[1]。为此，本文选取42例稳定型心绞痛合并慢性阻塞性肺疾病患者作研究对象进行研究，现报道如下。 　　1