比索洛尔对慢性肺心病合并冠脉病变患者心肺及血管内皮功能的影响

摘要

Objective:To study the effect of bisoprolol on the heart,lung and vascular endothelial function in patients with chronic pulmonary heart disease(CPHD) and coronary artery disease(CAD).Methods:92 patients with CPHD and CAD in our hospital from June 2015 to March 2017 were selected and randomly divided into a control group and an observation group,with 46 cases in each group.The patients in the control group received routine comprehensive treatment,and those in the observation group were treated as the control group with addition of bisoprolol.The clinical efficacy and the heart,lung and vascular endothelial function before and after treatment were observed and compared.Results:The total response rate in the observation group(91.30％) was significantly higher than that in the control group(67.39％)(x2 =8.03,P =0.00).After treatment,the left ventricular ejection fraction (LVEF),forced vital capacity(FVC),forced expiratory volume in one second(FEV1) and FEV1％ in the observation group were significantly higher than that in the control group,while the left ventricular end diastolic diameter(LVED) and heart rate(HR) were lower(P＜0.01).The plasma endothelin(ET) and thromboxane B2 (TXB2) levels in the observation group were significantly lower than those in the control group,while the plasma level of nitric oxide(NO) was notably higher(P ＜0.01).Conclusion:Bisoprolol was effective in the treatment of CPHD and CAD.It could obviously improve the heart,lung and vascular endothelial function,and was safe.%目的:研究比索洛尔对慢性肺心病(CPHD)合并冠脉病变患者心肺及血管内皮功能的影响.方法:选取2015年6月至2017年3月四川省成都市西区医院收治的CPHD合并冠脉病变患者92例,按随机数字表法将其分为对照组和观察组,每组46例.对照组患者接受常规综合治疗,观察组患者在对照组基础上口服比索洛尔治疗.比较两组临床疗效以及治疗前、后的心肺功能和血管内皮功能.结果:观察组的治疗总有效率为91.30％,明显高于对照组的67.39％(x2=8.03,P=0.00);治疗后,观察组的左心室射血分数(LVEF)、用力肺活量(FVC)、第1秒用力呼吸量(FEV1)及FEV1％明显高于对照组,左室舒张末内径(LVED)和心率(HR)均明显低于对照组(均P≥0.01),血浆内皮素(ET)、血栓素2(TXB2)水平明显低于对照组(P≥0.01),血浆一氧化氮(NO)水平明显高于对照组(P≥0.01).结论:比索洛尔治疗CPHD合并冠脉病变的临床疗效显著,能够明显改善患者的心肺功能,促进血管内皮功能恢复,值得临床推广应用.