富马酸比索洛尔对老年患者慢性心功能不全的疗效及安全性研究

Efficacy and safety of bisoprolol fumarate in treatment of elderly patients with congestive heart failure

关键词:  富马酸比索洛尔  老年患者  慢性  心功能不全  脑钠素  脑钠素前体

Key words:  bisoprolol fumarate  chronic congestive heart failure  plasm brain natriuretic peptide and pro-brain natriuretic peptide  elderly patient

摘要:

目的 观察富马酸比索洛尔对老年患者慢性心功能不全（或是慢性心力衰竭）的临床疗效、安全性及其对血浆脑钠素（BNP）和脑钠素前体（pro—BNP）的影响。方法 46例年龄在79—96岁的慢性心功能不全患者，在基础用药的前提下给予富马酸比索洛尔1．25-5．0mg，每日一次，随访（14±5）个月。观察其治疗前后血浆BNP、pro-BNP、左心室射血分数（LVEF）、肝肾功能等血液生化指标。结果 富马酸比索洛尔治疗前平均LVEF、血浆BNP、pro-BNP分别为0．397±0．0758、179．36±45．88、1686．69±488．73；随访结束时（治疗没停止）上述指标分别为0．456±0．0611、86．25±19．89、832．47±262．48（P＜0．05）。富马酸比索洛尔治疗前、随访结束时及随访期间肝肾功能、血糖、血脂代谢水平等无明显变化。结论 在基础用药的前提下加用富马酸比索洛尔，能降低血浆BNP、pro-BNP水平，改善慢性心功能不全老年患者的心功能。药物对肝肾功能、血糖、血脂代谢等无明显不良影响，具有一定的安全性。

Abstract:

Objective To investigate the efficacy and safety of bisoprolol fumarate in treatment of elderly patients with chronic congestive heart failure(CHF) and to observe its effect on blood plasm brain natriuretic peptide(BNP) and pro-brain natriuretic peptide(pro-BNP) levels.Methods Forty six patients with chronic CHF aged of 79 - 96 years were enrolled in this study.On the basic medication for CHF,bisoprolol fumarate was administered to the patients with a dosage of 1.25 mg to 5.0 mg per day.The patients were followed up for(14±5) months.Left ventricular ejection fraction (LVEF),blood plasm BNP,pro-BNP level,and routine blood biochemical measurement items including renal and hepatic function biomarkers were determined before the administration of bisoprolol fumarate and at the end of follow-up.Results The average of LVEF,plasm BNP and pro-BNP level were 0.397±0.075 8,179.36±45.88 and 1 686.69±488.73,respectively before the administration of bisoprolol fumarate and 0.456±0.0611,86.25±19.89 and 832.47±262.48,respectively at the end of follow-up(P＜0.05).No significant changes were observed in the renal and hepatic function biomarkers,plasm glucose and lipid levels during and at the end of follow-up.Conclusion On the basic medication for CHF,bisoprolol fumarate can decrease plasm BNP and pro-BNP levels and improve cardiac function in elderly patients with CHF without affecting renal and hepatic function, blood glucose and lipid metabolism.