比索洛尔辅治老年心力衰竭的疗效及对血浆中NT－proBNP和hs－CRP水平的影响

摘要

目的：探讨比索洛尔治疗老年心力衰竭患者的临床疗效及对血浆中 N 端脑钠肽前体（ NT－proBNP）和高敏C反应蛋白（ hs－CRP）水平的影响。方法选取2013年6月至2014年6月在鞍山市灵山医院诊治的116例老年慢性心力衰竭患者为研究对象，根据随机抽签法分为观察组和对照组，各58例。两组均采取卧床休息、吸氧、醛固酮拮抗剂、血管紧张素转换酶抑制剂／血管紧张素受体阻断剂、利尿剂、强心剂等常规性治疗。观察组在常规治疗的基础上采用比索洛尔递增剂量治疗，达到维持剂量，共治疗3个月。比较治疗前、治疗3个月后两组患者血浆中 NT－proBNP和 hs－CRP的水平以及治疗后心脏功能的疗效。结果治疗3个月后，观察组心率、NT－proBNP和hs－CRP 低于对照组[（64±5）次／min比（74±5）次／min，（240±124） ng／L比（421±105） ng／L，（4.2±1.3） mg／L比（7.8±1.7） mg／L]，差异有统计学意义（P＜0.05）。观察组总有效率高于对照组[94.8％（55／58）比79.3％（46／58）]，差异有统计学意义（P＜0.05）。结论比索洛尔辅治老年心力衰竭的临床疗效有优势，而且能有效降低血浆中NT－proBNP和hs－CRP的水平，适合临床积极采用。%Objective To evaluate the clinical efficacy of bisoprolol in treatment of elderly patients with heart failure and the influence on the levels of N-terminal pro-brain natriuretic peptide ( NT-proBNP) and hypersensitive C-reactive protein(hs-CRP) in plasma.Methods Total of 116 elderly patients with chronic heart failure in Anshan City Lingshan Hospital from Jun.2013 to Jun.2014 were included in the study,and were randomly divided into two groups by lottery method:observation group and control group,58 cases in each group.Both groups adopted bed rest, oxygen uptake, aldosterone antagonists, angiotensin angiotensin converting enzyme inhibitors/angiotensin receptor blocking agents,diuretics,digitalis and other conventional selective treatment.On the basis of using the conventional treatment, the observation group adopted the increasing doses of bisoprolol treatment to maintenance dose for 3 months in total.The changes of hs-CRP and NT-proBNP in plasma of the two groups before and after 3 months of treatment were compared,and the effica-cy of cardiac function after treatment was compared too.Results After 3 months of treatment,HR,NT-proB-NP and hs-CRP of the observation group were lower than those of the control group [(64 ±5) times/min vs (74 ±5) times/min,(240 ±124) ng/L vs (421 ±105) ng/L,(4.2 ±1.3) mg/L vs (7.8 ±1.7) mg/L], the differences were statistically significant(P<0.05).Total effective rate of the observation group was high-er than the control group[94.8% (55/58) vs 79.3% (46/58)],the difference was statistically significant (P<0.05).Conclusion In the treatment of elderly patients with chronic heart failure,bisoprolol have an advantage in clinical effect,and can effectively reduce the levels of NT-proBNP and hs-CRP in plasma,thus is suitable for active clinical use.