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目的观察比索洛尔对慢性阻塞性肺疾病(COPD)合并慢性心衰(CHF)高龄患者心肺功能影响及比索洛尔的安全剂量。方法选取我院COPD合并CHF患者160例,年龄均≥80岁,将其随机分为常规组和比索洛尔组,常规组给予吸氧、解痉平喘、抗炎、化痰、扩冠、利尿、强心等治疗;比索洛尔组在常规治疗基础上联用比索洛尔,由小剂量逐渐增加至最大剂量。分别于治疗前和治疗后3、6、10个月行心脏彩超[包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、心率(HR)]及肺功能(FEV1、FVC、FEV1/FVC、VC),6 min步行距离,脑钠肽(BNP)等检测,并统计研究过程中患者全因死亡率、心血管病死亡率、肺部原因死亡率。结果两组治疗前后心功能各项指标均明显改善。在3、6、10个月时,比索洛尔组心脏各指标改善情况明显优于同期常规组(P<0.05)。在治疗过程中,两组肺功能指标和死亡率比较无明显差异(均P>0.05)。结论比索洛尔对改善COPD合并CHF高龄患者心功能效果较显著,且安全性高。
Objective To observe the effect of bisoprolol on cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with chronic heart failure (CHF) and the safe dosage of bisoprolol. Methods A total of 160 COPD patients with CHF were enrolled in this study. All patients were ≥80 years old. They were randomly divided into routine group and bisoprolol group. Patients in routine group were given oxygen, antispasmodic and phlegm - The patients in the bisoprolol group were treated with bisoprolol on the basis of conventional treatment, and gradually increased from the small dose to the maximum dose. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic diameter (LVESD), heart rate (HR) and left ventricular ejection fraction were measured before treatment and at 3, ], Pulmonary function (FEV1, FVC, FEV1 / FVC, VC), walking distance 6 min, and brain natriuretic peptide (BNP) were measured. The incidence of all-cause, cardiovascular, mortality rate. Results Before and after treatment, the indexes of cardiac function in both groups were significantly improved. At 3, 6, and 10 months, the cardiac indexes in the bisoprolol group were significantly better than those in the conventional group (P <0.05). In the course of treatment, there was no significant difference in the indexes of lung function and mortality between the two groups (all P> 0.05). Conclusion Bisoprolol is effective in improving cardiac function in elderly patients with COPD complicated with CHF and is safe.