比索洛尔对充血性心力衰竭患者血浆脑钠肽水平的影响

目的探讨比索洛尔对充血性心力衰竭患者血浆脑钠肽（BNP）水平的影响。方法对84例慢性充血性心力衰竭患者在常规抗心衰治疗的基础上应用比索洛尔，2．5mg／a，治疗2周后根据患者心功能恢复情况调整5—10mg／d，维持治疗3个月，观察患者治疗前后心率、血压、射血分数的变化，并应用ELISA检测检测者血BNP水平变化。结果84例患者中，心功能：Ⅰ级14例，Ⅱ级24例，Ⅲ级28例，Ⅳ级18例，BNP水平分别为：（112．56±14．79）ng／L、（242．69±37．35）ng／L、（452．57±49．66）ng／L、（882．75±163．27）ng／L，随着心功能变差BNP水平逐渐增高，两两比较，差异均有统计学意义（t=4．241、4．573、4．074、7．328，均P〈0．01）。经治疗后，显效28例（33．3％），有效41例（48．8％），无效15例（17．9％），有效率82．1％；治疗后患者心率减慢、血压降低、左室射血分数较治疗前明显升高（t=3．585、3．245、3．347，均P〈0．05），治疗后BNP水平明显降低（（t=4．876，P〈0．01）。结论BNP水平可以反映充血性心力衰竭患者心功能水平，应用比索洛尔治疗充血性心力衰竭可以改善患者心功能，降低患者BNP水平。

Influence of Bisoprolol on plasma brain natriuretic peptide level for congestive heart failure

Objective To investigate the influence of Bisoprolol on plasma brain natriuretic peptide level for congestive heart failure.Methods 84 patients of chronic congestive heart failure were selacted as study object.All patients in the conventional anti-heart failure therapy based on the application of bisoprolol,2.5mg/d,one time of day,adjusting the 5 ～ 10mg/d,one time of day,according to the situation of patients,the heart rate,blood pressure,changes in ejection fraction,and BNP before and after treatment were observed.Results The BNP level of 84 patients decreased as the heart function gradually increased(t =4.241,4.573,4.074,7.328,all P ＜ 0.01).After treatment,heart rate,blood pressure,left ventricular ejection fraction was significantly higher than that before treatment (t =3.585,3.245,3.347,all P ＜ 0.05).After treatment,BNP level was significantly lower(t =4.876,P ＜ 0.01).Conclusion BNP level in patients with congestive heart failure could reflect the level of heart function,the application of bisoprolol in patients with congestive heart failure could improve cardiac function and reduce BNP levels in patients.