CAJ | 학술논문

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5～10 mg· 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。
목적：탐토좌심실사혈분수보류적심력쇠갈（ HFPEF）환자재접수상규치료적기출상가용비색락이치료대신경내분비인자적영향。방법장51례좌심실사혈분수보류적심력쇠갈환자수궤분위대조조25례화시험조26례。대조조여이혈관긴장소전화매억제제혹혈관긴장소Ⅱ수체길항제、철고동수체길항제、이뇨제등약물연합치료；시험조재대조조적기출상，가용비색락이5～10 mg· d－1，2조료정균위2주。비교2조치료전、치료후제14천적B형뇨납태、심방납뇨태、수소、기락립단백A、백세포개소－6、혈전소B2、종류배사인자α、내피소、고민C반응단백등신경내분비인자수평적변화，이급불량반응발생솔。결과시험조총유효솔88.46％현저고우대조조60.00％（ P＜0.05）。여치료전비교，치료후2조적B형뇨납태、심방납뇨태、수소、기락립단백A、내피소、고민C반응단백수평명현하강（ P＜0.05）。치료후，시험조혈장B형뇨납태、수소、기락립단백A、내피소、고민C반응단백수평여대조조비교차이유통계학의의（P ＜0.05）。2조불량반응발생솔비교차이무통계학의의（P ＞0.05）。결론좌심실사혈분수보류적심력쇠갈환자재상규치료기출상가용비색락이보조치료，가명현개선심공능화신경내분비인자수평。
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, chromogranin A ( CGA ) , interleukin -6 ( IL-6 ) , thromboxane 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<0.05 ).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.