比索洛尔对左心室射血分数保留的心力衰竭患者神经内分泌因子的影响  

Effects of bisoprolol on neuroendocrine hormones in patients with heart failure with preserved left ventricular ejection fraction

作　　者：甄宇治[1] 邓彦东[2] 李立卓[1] 战吟戈 刘超[1] 刘刚[1] 刘坤申[1] 

机构地区：[1]河北医科大学第一医院心血管内科,石家庄050031 [2]河北医科大学第一医院超声科,石家庄050031

出　　处：《中国临床药理学杂志》2015年第15期1471-1474,共4页The Chinese Journal of Clinical Pharmacology

基　　金：河北省卫生厅指令性课题基金资助项目(20130278)

摘　　要：目的探讨左心室射血分数保留的心力衰竭（HFPEF）患者在接受常规治疗的基础上加用比索洛尔治疗对神经内分泌因子的影响。方法将51例左心室射血分数保留的心力衰竭患者随机分为对照组25例和试验组26例。对照组予以血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体拮抗剂、醛固酮受体拮抗剂、利尿剂等药物联合治疗;试验组在对照组的基础上,加用比索洛尔5~10mg·d^-1,2组疗程均为2周。比较2组治疗前、治疗后第14天的B型尿钠肽、心房钠尿肽、瘦素、嗜铬粒蛋白A、白细胞介素-6、血栓素B2、肿瘤坏死因子α、内皮素、高敏C反应蛋白等神经内分泌因子水平的变化,以及不良反应发生率。结果试验组总有效率88.46%显著高于对照组60.00%（P〈0.05）。与治疗前比较,治疗后2组的B型尿钠肽、心房钠尿肽、瘦素、嗜铬粒蛋白A、内皮素、高敏C反应蛋白水平明显下降（P〈0.05）。治疗后,试验组血浆B型尿钠肽、瘦素、嗜铬粒蛋白A、内皮素、高敏C反应蛋白水平与对照组比较差异有统计学意义（P〈0.05）。2组不良反应发生率比较差异无统计学意义（P〉0.05）。结论左心室射血分数保留的心力衰竭患者在常规治疗基础上加用比索洛尔辅助治疗,可明显改善心功能和神经内分泌因子水平。Objective To explore the effects of bisoprolol adding to the conventional therapy on neuroendocrine hormones in patients with heart failure with preserved left ventricular ejection fraction （HFPEF）. Methods Fifty - one patients with HFPEF were randomly assigned into two groups： control group （n =25） and trial group （n =26）. The control group was treated with angiotensin -converting enzyme inhibitors or angiotensin II receptor antagonist and aldosterone receptor antagonists, diuretics and other drugs combination therapy. The trial group was the control group plus bisoprolol 5 - 10 mg · d^-1. Each group was two weeks. The levels of brain natriuretic peptide （BNP） , atrial natriuretic peptide （ANP）, leptin, ehromogranin A （CGA）, intedeukin- 6 （IL-6）, thromhoxane B2 （ TXB2 ）, tumor necrosis factor - α（TNF-α）, endothelin （ET）, hypersensitive C-reactive protein （hs- CRP） were observed fourteen days before and after the treatments, and the incidence rate of adverse drug reactions. Results The total efficiency of the trial group was 88.46% significantly higher than 60. 00% in the control group （ P 〈 0. 05）. The levels of plasma BNP, ANP, leptin, CGA, ET, hs - CRP were significantly decreased in the trial group （ P 〈 0. 05 ） after treatment. The levels of plasma BNP, ANP, Leptin, CGA, hs - CRP were significantly decreased in the control group （P 〈 0.05） after treatment. The levels of BNP, leptin, CGA, ET, hs - CRP lower in trial group than in the control group （P 〈 O. 05 ）. The incidence rate of adverse drug reactions were not statistical difference between the two groups （ P 〉 0. 05）. Conclusion Bisoprolol adding to the convertional therapy can significantly improve the heart function of patients with HFPEF and can lead to more decrease of BNP, leptin, CGA, ET, hs - CRP than the conventional therapy.

关 键 词：比索洛尔 左心室射血分数保留的心力衰竭 神经内分泌因子 瘦素 嗜铬粒蛋白A 

分 类 号：R541.61[医药卫生—心血管疾病] R972[医药卫生—内科学]