比索洛尔对慢性阻塞性肺疾病急性加重期并发肺心病患者心肺功能和运动耐量的影响

Effects of bisoprolol on cardiopulmonary function and exercise tolerance in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary heart disease

目的分析比索洛尔对慢性阻塞性肺疾病急性加重期(AECOPD)并发肺心病患者心肺功能和运动耐量的影响。方法选取2015年1月至2018年3月焦作煤业(集团)有限责任公司中央医院收治的70例AECOPD并发肺心病患者,采用随机数表法分为观察组和对照组,每组35例。对照组患者接受常规综合治疗,观察组在对照组基础上增加比索洛尔治疗,两组均连续治疗3个月。比较两组治疗前后左室射血分数(LVEF)、血浆脑钠肽(BNP)水平、静息心率(HR)、第1秒用力呼气容积(FEV1)、6 min步行距离。结果治疗后,两组LVEF均较治疗前提高,HR及血浆BNP水平均较治疗前降低,观察组LVEF高于对照组,HR及血浆BNP水平低于对照组(均P<0.05)。治疗后,两组FEV1、6 min步行距离均高于治疗前,差异有统计学意义(均P<0.05)。治疗后,两组FEV1相比,差异无统计学意义(P>0.05),观察组6 min步行距离大于对照组,差异有统计学意义(P<0.05)。结论采用比索洛尔治疗AECOPD并发肺心病,可有效改善患者心功能,提高患者运动耐量,且对肺功能无明显抑制作用。

Objective To analyze the effects of bisoprolol on cardiopulmonary function and exercise tolerance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary heart disease.Methods Seventy patients with AECOPD complicated pulmonary heart disease admitted to Jiaozuo Coal Industry(Group)Co.,Ltd.Central Hospital from January 2015 to March 2018 were enrolled.The patients were divided into observation group and control group by random number table,with 35 cases in each group.Patients in control group received routine comprehensive treatment.Observation group was treated with bisoprolol on the basis of control group.The two groups were treated continuously for 3 months.Left ventricular ejection fraction(LVEF),plasma brain natriuretic peptide(BNP)level,resting heart rate(HR),forced expiratory volume in one second(FEV1),and 6 min walking distance before and after treatment in the two groups were compared.Results After treatment,LVEF of both groups was higher than that before treatment(P<0.05),and HR and plasma BNP levels were lower than those before treatment(all P<0.05).LVEF of observation group after treatment was higher than that of control group,and HR and plasma BNP levels were lower than control group(all P<0.05).After treatment,FEV1 and 6 min walking distance in the two groups were higher than those before treatment,and the differences were statistically significant(both P<0.05).After treatment,there was no significant difference in FEV1 between the two groups(P>0.05).The walking distance in 6 min of observation group was greater than that of control group(P<0.05).Conclusion The use of bisoprolol in the treatment of AECOPD complicated with pulmonary heart disease could effectively improve the heart function of patients and improve their exercise tolerance,and has no significant inhibitory effect on lung function.