比索洛尔对高血压伴心功能不全患者血管内皮系统功能的影响

Evaluation of endothelial function of bisoprolol on hypertension patients with heart failure

目的探讨比索洛尔对高血压伴心功能不全患者血管内皮系统功能的影响。方法将80例高血压伴心功能不全患者完全随机分为常规治疗组和比索洛尔治疗组，各40例。常规治疗组给予常规治疗，比索洛尔治疗组在常规治疗的基础上加用比索洛尔5mg，1次／d，疗程12周。观察2组患者治疗前后血压、HR，评价治疗后心功能改善情况，检测患者血管内皮生长因子（VEGF）、内皮素1、NO和肿瘤坏死因子α（TNF-α）等血管内皮功能指标。结果2组患者治疗后SBP、DBP及HR均明显低于治疗前[常规治疗组：（135±13）mmHg（1mmHg=0．133kPa）比（156±12）mmHg，（86±4）mmHg比（96±8）mmHg，（64±7）次／min比（74±7）次／min；比索洛尔治疗组：（133±11）mmHg比（155±14）mmHg，（85±4）mmHg比（97±7）mmHg，（64±7）次／min比（74±7）次／min]，差异均有统计学意义（P〈0．05或P〈0．01）。治疗前后常规治疗组与比索洛尔治疗组SBP、DBP及HR差异均无统计学意义（均P〉0．05）。2组患者治疗后内皮素1、VEGF及TNF-α均明显低于治疗前[常规治疗组：（76±14）ng／L比（87±20）ng／L，（121±20）ng／L比（150±26）ng／L，（36±8）μg/L比（41±7）μg／L；比索洛尔治疗组：（69±18）ng／L比（88±18）ng／L，（120±20）ng／L比（148±27）ng／L，（25±7）μg／L比（41±8）μg／L]，NO明显高于治疗前[常规治疗组：（74±21）μmol／L比（65±19）μmol／L；比索洛尔治疗组：（86±23）μmol／L比（65±21）μmol／L]，差异均有统计学意义（P〈0．05或P〈0．01）。比索洛尔治疗组患者治疗后内皮素1和TNF-α明显低于常规治疗组治疗后，而NO的含量则明显高于常规治疗组，差异均有统计学意义（P〈0．05或P〈0．01）；但2组患者治疗后的VEGF差异无统计学意义（P〉0．05）。结论比索洛尔治疗高血压伴心功能不全疗效确切，并可改善内皮功能障碍。

Objective To investigate the endothelial function of bisoprolol on hypertension patients with heart failure. Methods A total of 80 patients with hypertension and heart failure were divided into two groups ： 40 cases with regular treatment as a control group and 40 cases with regular treament and bisoprolol as a treatment group. The blood pressure and heart rate were observed and the heart function was evaluated before and after treatment. Vascular endothelial function indicators such as vascular endothelial growth factor （VEGF）, endothelin-1 （ET-1）, nitric oxide （NO） and tumor necrosis factor-α （TNF-α） of two groups were compared. Results Both groups had a lower systolic blood pressure, diastolic blood pressure and heart rate after treatment [ control group： （135 ± 13）mm Hg （1 mm Hg =0. 133 kPa） vs （156 ± 12）mm Hg,（86 ±4）mm Hg vs （96 ±8）mm Hg,（64 ±7） times/min vs （74 ± 7 ） times/min ; treatment group ： （ 133 ± 11 ） mm Hg vs （ 155 ± 14 ） mm Hg, （ 85 ± 4 ） mm Hg vs （97 ± 7 ）mm Hg, （64 ± 7 ） times/min vs （74 ± 7 ） times/min, P 〈 0.05 or P 〈 0.01 ]. The levels of ET-1, VEGF and TNF-α in control group and treatment group after treatment were lower than those before treatment [ control group： （76 ±14） ng/L vs （87 ±20） ng/L, （ 121±20）vs （ 150 ± 26）, （36 ± 8） μg/L vs （41±7） μg/L; treatment group： （69 ± 18）ng/L vs （88 ± 18） ng/L, （ 120±20） ng/L vs （ 148 ±27） ng/L, （25 ±7） μg/L vs （41 ± 8） μg/L], and the level of NO was higher than that before treatment[ control group：（74± 21 ）μmol/L vs （65± 19 ）μmo]/L; treatment group ： （ 86 ± 23 ） μmol/L vs （ 65± 21 ） μmol/L ] ; there were significant differences （ P 〈 0.05 or P 〈 0.01 ）. After treatment, the levels of ET-1, TNF-α in treatment group were lower than those in control group, and the level of NO in treatment group was higher than that in control group, there were significant differences（ P 〈 0.05 or P 〈 0.01 ）. Condusion Bisoprolol has good effect on hypertension patients with heart failure and it can improve endothelial dysfunction.