比索洛尔不同用药剂量对老年慢性心力衰竭患者心肌重构和血管内皮功能及T淋巴细胞亚群的影响

Effects of different dosages of bisoprolol on myocardial remodeling,vascular endothelial function and T lymphocyte subsets in elderly patients with chronic heart failure

目的:探讨比索洛尔不同剂量口服对老年慢性心力衰竭(CHD)患者心肌重构、血管内皮功能及T淋巴细胞亚群的影响。方法:将南阳市中心医院2020年10月—2022年4月收治的118例老年CHD患者随机分为两组。在常规心力衰竭治疗基础上,A组59例给予比索洛尔,剂量从1.25 mg/d逐渐增加至5.00 mg/d;B组59例比索洛尔用药剂量从1.25 mg/d逐渐增加至10.00 mg/d。治疗10周后比较两组患者心肌重构、血管内皮功能、T淋巴细胞亚群比例和不良反应。结果:两组治疗前各观察指标差异无统计学意义(P> 0.05)。治疗10周后,B组的左心室舒张末期内径、左心室收缩末期内径、左心室后壁厚度、左心室质量指数均小于A组(P <0.05),内皮素水平低于A组,一氧化氮水平高于A组(P <0.05),CD4^(+)、CD4^(+)/CD8^(+)高于A组(P <0.05)。治疗期间两组不良反应发生率分别为13.6%和8.5%(P> 0.05)。结论:增加比索洛尔的给药剂量能在不增加不良反应的前提下提高延缓老年CHF患者心肌重构和改善血管内皮功能的效果,并有助于调节细胞免疫功能。

Objective:To investigate the effects of differentoral doses of bisoprolol on myocardial remodeling,vascular endothelial function and T lymphocyte subsets in elderly patients with chronic heart failure(CHD).Methods:From Oct.2020 to Apr.2022,a totalof 118 elderly patients with CHD were admitted to Nanyang Central Hospital,and they were randomly divided into two groups.All patients received conventional treatment for heart failure.Fifty-nine cases in group A were given bisoprolol at a dose gradually increased from 1.25 mg/d to 5.00 mg/d.Fifty-nine cases in group B,the dosage of bisoprolol was gradually increased from 1.25 mg/d to 10.00 mg/d.After 10 weeks of treatment,myocardial remodeling,vascular endothelial function,T lymphocyte subsets and adverse reactions were compared between the two groups.Results:There was no significant difference between the two groups before treatment(P>0.05).After 10 weeks of treatment,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular posterior wall thickness(LVPWT)and left ventricular mass index(LVMI)of group B were lower than those in group A(P<0.05),and endothelin level was lower than that in group A.The level of nitric oxide was higher than that in group A(P<0.05).CD4^(+),CD4^(+)/CD8^(+)were higher than those in group A(P<0.05).During the treatment,the incidence of adverse reactions in the two groups was 13.6%and 8.5%,respectively.(P>0.05).Conclusions:Increasing the dose of bisoprolol can improve the effect of delaying myocardial remodeling and vascular endothelial function in elderly patients with CHF without increasing adverse reactions,and help to regulate celluar immune function.