伊伐布雷定结合参芎葡萄糖注射液在慢性阻塞性肺疾病伴肺心病发病人群中的临床疗效

目的：伊伐布雷定结合参芎葡萄糖注射液在慢性阻塞性肺疾病（chronic obstructive pulmonary，COPD）伴肺心病发病人群中的临床疗效以及对血浆血管性假性血友病因子（vWF）、血小板α颗粒膜蛋白-140（GMP-140）、心型脂肪酸结合蛋白（H-FABP）水平的影响。方法：选取衡水市人民医院2017年6月-2019年6月期间收治的126例COPD并肺心病患者，依据随机数字表法分为观察组和对照组，每组63例。对照组采用常规治疗，观察组在对照组的基础上应用伊伐布雷定结合参芎葡萄糖注射液，均治疗3个月。比较2组患者疗效、心肺功能指标、凝血功能指标以及血浆vWF、GMP-140水平变化，并统计不良反应发生情况。结果：治疗3个月后观察组总有效率（92.06%）显著高于对照组（79.37%），差异有统计学意义（P<0.05）。观察组患者住院时间、再住院、治疗费用以及急性加重次数明显低于对照组（P<0.05）。治疗3个月后2组患者心功能指标（LVEF、SV）、肺功能指标（FEV1/FVC、FEV1%、PEF）水平明显升高，且观察组各指标水平明显高于对照组（P<0.05）。2组患者经治疗2周后外周血H-FABP、vWF、GMP-140水平以及血浆黏度、全血黏度、纤维蛋白原水平均显著下降，且观察组外周血H-FABP、vWF、GMP-140水平以及凝血功能指标水平显著低于对照组（P<0.05）。结论：伊伐布雷定联合参芎葡萄糖注射液治疗COPD并肺心病患者疗效显著，可改善患者凝血功能、心肺功能，降低治疗费用和缩短住院时间，提高临床疗效。>

Clinical efficacy of ivabradineplus Shenxiong glucose injection in COPD patients with cor pulmonale

OBJECTIVE To explore the clinical effect of ivabradine plus Shenxiong glucose injection in COPD patients with cor pulmonale and examine its effect on the levels of vWF,GMP-140 and H-FABP.METHODS A total of 126 COPD patients with cor pulmonale hospitalized from June 2017 to June 2019 were recruited.According to the method of random number table,they were divided into observation and control groups(n=63 each).The control group received 3-month conventional treatment while observation group received 3-month ivabradine plus Shenxiong glucose injection on the basis of control group.Therapeutic efficacy,cardiopulmonary&coagulation function parameters,plasma vWF and GMP-140 level of two groups were compared and adverse reactions counted.RESULTS The total effective rate of observation group(92.06%)was significantly higher than that of control group(79.37%)and the difference was statistically significant(P<0.05).Hospitalization duration,rehospitalization,cost of treatment and frequency of acute aggravation in observation group were significantly lower than those in control group(P<0.05).After 3 months of treatment,the levels of heart function parameters(LVEF&SV)and lung function parameters(FEV1/FVC,FEV1%&PEF)increased significantly in two groups and the level of each parameter was significantly higher in observation group than that in control group(P<0.05).After 2-week treatment,H-FABP,VWF,GMP-140,plasma viscosity,whole blood viscosity and fibrin levels decreased markedly in two groups and H-FABP,VWF,GMP-140 and coagulation parameters were significantly lower in observation group than those in control group(P<0.05).CONCLUSION Ivabradine plus Shenxiong glucose injection is efficacious for COPD patients with cor pulmonale.It can improve coagulation and cardiopulmonary functions,reduce treatment costs,shorten hospitalization duration and improve clinical efficacy.