比索洛尔治疗慢性阻塞性肺疾病合并肺部感染的疗效和安全性及其作用机制

Clinical effect,safety and mechanism of bisoprolol on chronic obstructive pulmonary disease combined with lung infection

目的研究比索洛尔治疗慢性阻塞性肺疾病(COPD)合并肺部感染的疗效和安全性及其作用机制。方法将2013年6月—2015年6月就诊于南通市第二人民医院呼吸内科的84例COPD合并肺部感染的患者随机均分成对照组和观察组,对照组接受常规治疗,观察组加用比索洛尔治疗,治疗30 d后比较两组患者的肺功能指标(FVC,FEV1,FEV1/FVC)和静息心率;比较两组患者的治疗总有效率和不良反应发生率;并比较两组患者血清中炎症因子:C反应蛋白(CRP),转化生长因子-β(TGF-β),肿瘤坏死因子-α(TNF-α)和白细胞介素(IL)(IL-1β,IL-6,IL-8)的含量。结果治疗后两组患者的FVC、FEV1和FEV1/FVC数值均明显升高,静息心率明显降低(P<0.05),而且观察组较对照组变化的效果更为显著(P<0.05)。观察组治疗的总有效率为90.48%,显著高于对照组的71.43%(P<0.05),两组的不良反应发生率无统计学差异(P>0.05)。治疗后两组患者血清中的CRP,TGF-β,TNF-α,IL-1β,IL-6,IL-8的含量均明显降低,且观察组较对照组降低更为显著(P<0.05)。结论在治疗COPD合并肺部感染的过程中,加用比索洛尔能够显著改善患者的心肺功能,提高治疗的临床效果,这与其能够显著降低各种炎性因子,减轻炎症反应有着密切的关系。

[ Objective ] To study the clinical effect and safety of bisoprolol on chronic obstructive pulmonary disease （COPD） combined with lung infection, analyze its mechanism. [Methods]84 patients with COPD combined with lung infection, who were treated in the Respiratory Medicine Department of Nantong Second People＇s Hospital from June 2013 to June 2015, were randomly divided into control group and observation group. The control group received conventional treatment,and the observation group was given bisoprolol on the basis of conventional treatment. After 30 days of treatment, the pulmonary function indexes （FVC,FEV1,FEV1/FVC） and resting heart rate （RHR）,as well as total effective rate and the incidence of adverse reactions of two groups were compared. Meanwhile, the levels of inflammatory factors （CRP, TGF-β,TNF-α, IL-1β, IL-6 and IL-8）in serum of two groups were analyzed. [Results]After treatment, the values of FVC, FEV1 and FEV1/FVC in two groups increased significantly, while the RHR reduced significantly （P〈0.05）, and the effects in the observation group were more significant than those in the control group （P〈0.05）. The total effective rate of the observation group （90.48%） was higher than that of the control group （71.43%） significantly （P〈0.05）, and there was no significant difference in the incidence of adverse reactions between the two groups （P〉0.05）. The levels of CRP, TGF-β, TNF-α, IL-1β, IL-6 and IL-8 in serum significantly decreased in the two groups after treatment, and the effects in the observation group were more significant than those in the control group （P〈0.05）. [ Conclusion ]In the treatment of COPD combined with pulmonary infection, the addition of bisoprolol can significantly improve the patienVs heart and pulmonary function and improve the clinical effect which is closely related to its effect on significantly reducing inflammatory factors and decreasing the inflammation reaction.