CAJ | 학술논문

目的：观察富马酸比索洛尔治疗老年血压伴心功能不全患者的临床疗效。方法：将100例患者随机分为治疗组和对照组，各50例，对照组给予常规治疗，治疗组在常规治疗的基础上加用比索洛尔，疗程8周。观察其治疗前后血压、心率、左室质量指数（ LVMI ）、室间隔厚度（ IVS ）、左室后壁厚度（LVWP）、左室舒张末期容量（LVEDV）、左室收缩末期容量（LVESV）、射血分数（EF）和舒张功能指标（ E／A），以及血浆脑钠素（ BNP ）、血管内皮生长因子（ VEGF）和高敏C－反应蛋白（ hs－CRP ）、肝肾功能等血液生化指标。结果：治疗组患者治疗后收缩压、舒张压及心率均较治疗前明显降低（ P＜0．01），且治疗后的心功能各指标（除NYHA分级IV）均优于治疗前（P＜0．05），其中LVEDV、LVESV、LV-MI 、EF和E／A优于对照组（ P＜0．05）。治疗组治疗后BNP、VEGF及hs－CRP较治疗前显著降低（ P＜0．01），且治疗组BNP水平显著优于对照组（ P＜00．1）。两组患者血常规及肝肾功能检查治疗前后均在正常范围，差异无统计学意义（ P＞0．05）。结论：比索洛尔治疗高血压伴心功能不全疗效确切且安全可靠。
목적：관찰부마산비색락이치료노년혈압반심공능불전환자적림상료효。방법：장100례환자수궤분위치료조화대조조，각50례，대조조급여상규치료，치료조재상규치료적기출상가용비색락이，료정8주。관찰기치료전후혈압、심솔、좌실질량지수（ LVMI ）、실간격후도（ IVS ）、좌실후벽후도（LVWP）、좌실서장말기용량（LVEDV）、좌실수축말기용량（LVESV）、사혈분수（EF）화서장공능지표（ E／A），이급혈장뇌납소（ BNP ）、혈관내피생장인자（ VEGF）화고민C－반응단백（ hs－CRP ）、간신공능등혈액생화지표。결과：치료조환자치료후수축압、서장압급심솔균교치료전명현강저（ P＜0．01），차치료후적심공능각지표（제NYHA분급IV）균우우치료전（P＜0．05），기중LVEDV、LVESV、LV-MI 、EF화E／A우우대조조（ P＜0．05）。치료조치료후BNP、VEGF급hs－CRP교치료전현저강저（ P＜0．01），차치료조BNP수평현저우우대조조（ P＜00．1）。량조환자혈상규급간신공능검사치료전후균재정상범위，차이무통계학의의（ P＞0．05）。결론：비색락이치료고혈압반심공능불전료효학절차안전가고。
Objective:To observe the clinical effect of bisoprolol in treating elderly patients with hyper-tension and cardiac insufficiency .Method:100 patients were enrolled and randomly divided into treatment group (n=50) and control group (n=50).The control group received routine treatment , while bisoprolol was added to treatment group for a course of 8 weeks.The blood pressure, heart rate, left ventricular mass index (LVMI), interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVWP),left ventricular end-diastolic volume ( LVEDV ) , left ventricular end systolic volume ( LVESV ) , ejection fraction ( EF) and diastolic function index ( E/A) before and after the treatment were observed .Blood bio-chemical indicators including brain natriuretic peptide ( BNP ) , vascular endothelial growth factor ( VEGF) , high-sensitivity C-reactive protein ( hc-CRP ) and hepatorenal functions were also recorded .Result: The systolic pressure , diastolic pressure and heart rate of the treatment group were obviously lower than those be-fore the treatment ( P<0.01) , and cardiac function indicators ( except for NYHA grading IV ) were all better than those before the treatment (P<00.5 ), among which LVEDV, LVESV, LVMI, EF and E/A were supe-rior to those of control group (P<0.05).BNP, VEGF and hs-CRP of the treatment group decreased remark-ably after the treatment ( P<00.1 ) , and BNP level of the treatment was superior to that of control group ( P<0.01) .The blood routine and hepatorenal function examination of the two groups before and after the treat-ment all showed normal results, and the difference was no statistical significance (P>0.05).Conclusion:Bisoprolol is effective and safe in treating patients with hypertension and cardiac insufficiency .