比索洛尔联合福辛普利治疗慢性阻塞性肺疾病并慢性心力衰竭临床观察

Clinical Observation on Bisoprolol Combined with Fosinopril in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Chronic Heart Failure

目的探讨比索洛尔联合福辛普利治疗慢性阻塞性肺疾病(COPD)并慢性心力衰竭(CHF)的临床疗效及对患者心肺功能和血清炎性因子的影响。方法选取三六三医院和成都市第三人民医院2016年1月至2018年1月收治的COPD并CHF患者72例,按信封法随机分为观察组和对照组,各36例。两组患者均口服富马酸比索洛尔片,观察组患者加服福辛普利钠片,两组均治疗12周。结果观察组总有效率为94.44%,显著高于对照组的75.00%(P<0.05);与治疗前比较,两组患者治疗后的左心室射血分数(LVEF)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、肺活量(VC)均显著升高,左心室舒张末期内径(LVEDd)、血清白细胞介素17(IL-17)、C反应蛋白(CRP)水平均显著降低,且观察组上述指标改善程度均显著优于对照组(P<0.05);观察组与对照组不良反应发生率相当(5.56%比16.67%,χ2=2.250,P> 0.05)。结论比索洛尔联合福辛普利治疗COPD并CHF,可改善心肺功能,降低炎性反应水平。

Objective To investigate the clinical efficacy of bisoprolol combined with fosinopril in the treatment of chronic obstructive pulmonary disease(COPD) complicated with congestive heart failure(CHF) and its effect on cardiopulmonary function and serum inflammatory factors.Methods Totally 72 patients with COPD complicated with CHF admitted to AVIC 363 Hospital and Chengdu Third People's Hospital from January 2016 to January 2018 were selected and randomly divided into the observation group and the control group by the envelope method,36 cases in each group.The patients in the two groups took Bisoprolol Fumarate Tablets orally,on this basis,the patients in the observation group took Fosinopril Sodium Tablets.Both groups were treated for 12 weeks.Results The total effective rate of the observation group was 94.44%,which was significantly higher than 75.00% of the control group(P<0.05).Compared with those before treatment,the left ventricular ejection fraction(LVEF) and forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC) were significantly increased,while the left ventricular end-diastolic diameter(LVEDd),the levels of serum interleukin17(IL-17) and C-reactive protein(CRP) were significantly decreased in the two groups after treatment,and the improvement of the above indexes in the observation group was significantly better than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(5.56% vs.16.67%,χ^2=2.250,P>0.05).Conclusion Bisoprolol combined with fosinopril in the treatment of COPD complicated with CHF can improve cardiopulmonary function and reduce the incidence of inflammatory reaction.