目的：观察比索洛尔对高龄慢性阻塞性肺疾病（COPD）合并慢性心力衰竭（CHF）患者疗效及安全性。方法选择该院61例高龄COPD合并CHF患者，在常规治疗的基础上服用比索洛尔2．5 mg ，每天1次，检测治疗前、治疗4周后、治疗8周后、治疗6个月后心功能相关指标及第1秒用力呼气量占预计值百分比（FEV1％）变化。结果与治疗前比较，治疗4周后B型利钠肽前体（NT-proBNP）、左心室射血分数（LVEF％）、左心室舒张末期内径（LEVDD）无明显变化；治疗8周后，NT-proBNP、LEVDD降低（P＜0．05），但LVEF％无明显变化；治疗6个月后NT-proBNP、LEVDD明显降低，LVEF％升高，差异有统计学意义（P＜0．05）。治疗前、治疗4周后、治疗8周后、治疗6个月后 FEV1％分别为47．33±5．57、47．08±5．50、48．30±6．31、49．64±6．24，比较无明显变化（P＞0．05），患者治疗前、治疗4周后、治疗8周后、治疗6个月后，NT-proBNP与FEV1％均呈显著负相关（r＝-0．708、-0．702、-0．833、-0．778）。结论小剂量比索洛尔治疗高龄COPD合并CHF患者安全有效。%Objective To assess the curative effect and security of bisoprolol in the elderly chronic obstructive pulmonary disease (COPD) patients combined with chronic heart failure (CHF) .Methods 61 cases of elderly COPD patients combined with CHF in our hospital were selected .on the basis of conventional treatment ,the patients were applicated bisoprolol 2 .5 mg ,1 time each day , the NT-proBNP ,LVEF% ,LEVDD and FEV1% were respectively observed before treatment ,4 weeks after treatment ,8 weeks af-ter treatment ,6 months after treatment .Results 4 weeks after treatment ,NT-proBNP ,LVEF% ,LEVDD showed no significant changes .8 weeks after treatment ,NT-proBNP and LEVDD decreased(P<0 .05) ,LVEF% showed no significant changes .6 months after treatment ,NT-proBNP and LEVDD decreased significantly ,meanwhile LVEF% increased (P< 0 .05) .before treatment ,4 weeks after treatment ,8 weeks after treatment ,6 months after treatment ,FEV1% were 47 .33 ± 5 .57 ,47 .08 ± 5 .50 ,48 .30 ± 6 .31 , 49 .64 ± 6 .24 ,All groups showed no changes in the pulmonary function(P>0 .05) .NT-proBNP of all groups were negatively corre-lation with the FEV1% (r= -0 .708 ,-0 .702 ,-0 .833 ,-0 .778) .Conclusion Small doses of bisoprolol is safe and effective in the treament of the elderly COPD patients with chronic heart failure .
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