摘要
目的观察比索洛尔治疗肺源性心脏病(肺心病)并发心律失常的效果,并分析其对肺功能、血气指标及炎性因子、脑钠肽(BNP)等的影响。方法选择2015年3月—2016年3月云南省第三人民医院心内科收治的肺心病并发心律失常患者96例作为研究对象,随机数字表法分为观察组和对照组48例。对照组患者在常规治疗基础上应用盐酸地尔硫治疗,而观察组患者则在常规治疗基础上应用比索洛尔治疗。治疗12个月,比较2组患者的临床效果,治疗前后肺功能、血气指标、肺动脉收缩压、6 min步行距离、心率、炎性因子及BNP水平的变化情况,并进行安全性评价。结果观察组总有效率高于对照组(91.7%vs.75.0%,χ~2=4.800,P=0.028)。与治疗前比较,2组治疗后肺功能指标、血气指标均改善(P<0.05),且治疗后观察组FEV1、FEV1%、PaO_2、VC水平明显高于对照组,PaCO_2、pH水平明显低于对照组(t=2.503、12.617、4.823、1.739、2.655、1.781,P均<0.05);6 min步行距离观察组长于对照组,并且肺动脉SBP、HR显著低于对照组(t=14.312、7.419、16.917,P均=0.000);观察组CRP、IL-6、TNF-α、BNP水平显著低于对照组(t=16.379、1.921、4.625、57.221,P均=0.000)。观察组患者的再次住院及病死率低于对照组(χ~2=5.056,P=0.025)。结论比索洛尔应用于肺心病并发心律失常治疗中的效果良好,能够有效改善血气指标、肺功能,减轻炎性反应,并且有助于患者活动能力、生活质量的改善,值得临床推广。
Objective To observe the effects of bisoprolol in patients with pulmonary heart disease complicated with arrhythmia,and analyze its effects on lung function,blood gas index and CRP,BNP.Methods Ninety-six patients with pulmonary heart disease complicated with arrhythmia who were treated in hospital from March 2015 to March 2016 were selected.Patients were divided into the observation group(48 cases)and control group(48 cases).The patients of control group were treated with dilthiazole,while the patients of observation group were treated with bisoprolol.Compare the clinical effect,safety and changes of the lung function,blood gas index,pulmonary artery systolic pressure,6 min walking distance,heart rate,CRP and BNP levels of the two groups.Results After the appropriate treatment,the total effective rate of the observation group was significantly better than those of the control group(χ2=4.800;P=0.028);The FEV 1,FEV 1%,PaO 2,VC levels of the observation group were significantly higher than those of the control group,and the PaCO 2,PH levels of the observation group were significantly lower than those of the control group(t=2.503,t=12.617,t=4.823,t=1.739,t=2.655,t=1.781;P=0.007,P=0.000,P=0.000,P=0.043,P=0.005,P=0.039);The 6 min walking distance of the observation group were significantly longer than those of the control group,and the pulmonary artery SBP,HR,BNP levels of the observation group were significantly lower than those of the control group(t=14.312,t=7.419,t=16.917,t=57.221;P=0.000,P=0.000,P=0.000,P=0.000);The CRP,IL-6,TNF-αlevels of the observation group were significantly lower than those of the control group(t=16.379,t=1.921,t=4.625;P=0.000,P=0.000,P=0.000);The number of hospitalized again and the number of dead of the observation group were significantly lower than those of the control group(χ2=5.056;P=0.025).Conclusion The effect of bisoprolol in pulmonary heart disease complicated with arrhythmia is good.It can improve the blood gas and lung function,reduce inflammatory symptoms,and help to improve the patient's mobility and quality of life,which makes it worthy of clinical application.
作者
蔡叶锐
魏引
张鑫
王新楼
周季
CAI Yerui;WEI Yin;ZHANG Xin;WANG Xinlou;ZHOU Ji(Cardiology,The Third People's Hospital of Yunnan Province,Kunming 650000,China)
出处
《疑难病杂志》
CAS
2018年第4期347-351,共5页
Chinese Journal of Difficult and Complicated Cases
关键词
比索洛尔
肺源性心脏病
心律失常
C反应蛋白
脑钠肽
Bisoprolol
Pulmonary heart disease
Arrhythmia
C reactive protein
Brain natriuretic peptide
作者简介
通信作者:魏引,E-mail:weiyin@sina.com
