比索洛尔对高血压伴心绞痛患者心肌功能及血管内皮功能的影响

Effect of bisoprolol on myocardial function and vascular endothelial function in hypertensive patients with angina pectoris

目的探讨比索洛尔对高血压伴心绞痛患者心肌功能及血管内皮功能的影响。方法选取2017年3月至2018年3月安徽省六安市中医院收治的高血压伴心绞痛患者108例,均给予比索洛尔连续治疗4周。观察临床疗效并比较患者治疗前后心率、血压、左心室射血分数、心输出量、心脏指数、左心室收缩末期内径、左心室舒张末期内径水平和血浆内皮素1、一氧化氮和血管紧张素Ⅱ含量。结果108例患者治疗后显效65例、有效30例、无效13例,总有效率为88.0%(95/108)。所有患者治疗前后心率、左心室射血分数和心脏指数比较差异均无统计学意义(均P>0.05)。治疗后,患者收缩压和舒张压均明显低于治疗前[(119±18)mmHg(1mmHg=0.133kPa)比(156±20)mmHg,(74±10)mmHg比(96±16)mmHg],心输出量明显高于治疗前,左心室收缩末期内径和左心室舒张末期内径明显低于治疗前[(5.0±0.6)L/min比(4.7±0.8)L/min,(47±5)mm比(53±5)mm,(50±5)mm比(57±4)mm],血浆内皮素1和血管紧张素Ⅱ含量明显低于治疗前,一氧化氮含量明显高于治疗前[(58±6)ng/L比(66±10)ng/L,(49±16)ng/L比(65±18)ng/L,(47±7)μmol/L比(42±7)μmol/L],差异均有统计学意义(均P<0.01)。结论比索洛尔用于治疗高血压伴心绞痛患者,可有效降低血压并改善心绞痛症状、心肌功能和血管内皮功能。

Objective To investigate the effect of bisoprolol on myocardial function and vascular endothelial function in hypertensive patients with angina pectoris.Methods A total of 108 hypertensive patients with angina pectoris admitted to Traditional Chinese Hospital of LuAn,Anhui Province from March 2017 to March 2018 were treated with bisoprolol for 4 weeks.Clinical efficacy was observed.Heart rate,blood pressure,left ventricular ejection fraction,cardiac output,cardiac index,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,endothelin-1,nitric oxide and angiotensinⅡlevels were measured before and after treatment.Results After treatment,65 cases were markedly effective,30 cases were effective and 13 cases were ineffective;the total effective rate was 88.0%(95/108).There were no significant changes of heart rate,left ventricular ejection fraction and cardiac index(all P>0.05).Systolic and diastolic blood pressures after treatment were significantly lower than those before treatment[(119±18)mmHg vs(156±20)mmHg,(74±10)mmHg vs(96±16)mmHg](both P<0.01).Cardiac output after treatment was significantly higher while left ventricular end-systolic and end-diastolic diameters were significantly lower than those before treatment[(5.0±0.6)L/min vs(4.7±0.8)L/min,(47±5)mm vs(53±5)mm,(50±5)mm vs(57±4)mm](all P<0.01).Plasma levels of endothelin-1 and angiotensinⅡafter treatment were significantly lower and nitric oxide level was significantly higher than those before treatment[(58±6)ng/L vs(66±10)ng/L,(49±16)ng/L vs(65±18)ng/L,(47±7)μmol/L vs(42±7)μmol/L](all P<0.01).Conclusion Bisoprolol treating hypertensive patients with angina pectoris can effectively suppress blood pressure,relieve angina symptoms,improve myocardial function and vascular endothelial function.