替米沙坦比索洛尔联合曲美他嗪治疗对慢性阻塞性肺疾病合并冠心病患者血浆BNP Fg水平及心肺功能的影响

Effects of Telmisartan Bisoprolol Combined with Trimetazidine on Plasma BNP and Fg Levels and Cardiopulmonary Function in Patients with COPD Complicated with CHD

目的:探讨替米沙坦、比索洛尔联合曲美他嗪治疗对慢性阻塞性肺疾病(COPD)合并冠心病(CHD)患者血浆B型利钠肽(BNP)、纤维蛋白原(Fg)水平及心肺功能的影响。方法:选择2014年3月至2019年3月我院收治的164例COPD合并CHD患者,按入院顺序进行编号,以密封信封法随机分为研究组与对照组,研究组82例给予替米沙坦、比索洛尔治疗,对照组82例给予替米沙坦、比索洛尔+曲美他嗪治疗,比较两组患者肺功能指标、心功能指标、血浆BNP、Fg水平以及血清炎性相关指标的变化情况。结果:治疗后,两组PEF、FVC、FEV1/FVC明显升高(P<0.05),研究组上升幅度大于对照组(P<0.05);两组LVEF明显升高(P<0.05),LVEDD、LVESD明显降低(P<0.05),研究组变化幅度大于对照组(P<0.05);两组血浆BNP、Fg水平明显降低(P<0.05),与对照组比较,研究组下降幅度更大;两组血清NF-κB、Chemerin、TGF-β、MMP-9明显降低(P<0.05),研究组下降幅度大于对照组(P<0.05)。结论:替米沙坦、比索洛尔联合曲美他嗪治疗COPD合并CHD疗效明确,可显著改善患者心肺功能,降低血浆BNP、Fg水平,抑制血清NF-κB、Chemerin、TGF-β、MMP-9合成释放,减轻机体炎性损伤。

Objective:To explore the effects of telmisartan,bisoprolol combined with trimetazidine on plasma B-type natriuretic peptide(BNP)and fibrinogen(Fg)levels and cardiopulmonary function in patients with chronic obstructive pulmonary disease(COPD)complicated with coronary heart disease(CHD).Methods:164 patients with COPD and CHD admitted to our hospital from March 2014 to March 2019 were selected,numbered according to the order of admission and randomly divided into study group and control group by sealed envelope method.82 cases in study group were given telmisartan+bisoprolol,and 82 cases in control group were treated with telmisartan,bisoprolol+trimetazidine.The changes of lung function indexes,cardiac function indexes,plasma BNP and Fg levels and serum inflammatory related indexes were compared between the two groups.Results:After treatment,the PEF,FVC and FEV1/FVC were significantly increased in the two groups(P<0.05),and the increases in study group were higher than those in control group(P<0.05).The LVEF in the two groups was significantly increased(P<0.05)while the LVEDD and LVESD were significantly decreased(P<0.05),and the changes in study group were greater than those in control group(P<0.05).The plasma BNP and Fg levels were significantly decreased in the two groups(P<0.05),and the decreases in study group were greater compared with those in control group.The serum levels of NF-κB,Chemerin,TGF-βand MMP-9 were significantly decreased in the two groups(P<0.05),and the decreases in study group were greater than those in control group(P<0.05).Conclusion:Telmisartan,bisoprolol combined with trimetazidine has exact efficacy in the treatment of COPD with CHD,and can significantly improve cardiopulmonary function,reduce plasma BNP and Fg levels,and inhibit synthetic release of serum NF-κB,Chemerin,TGF-βand MMP-9,and reduce the body’s inflammatory damage.