比索洛尔对充血性心力衰竭患者髓过氧化物酶和超敏C反应蛋白的影响

目的 探讨用β受体阻滞剂比索洛尔对充血性心力衰竭（CHF）患者心血管炎症标志物髓过氧化物酶（MPO）、超敏C反应蛋白（hs-CRP）水平以及心功能的影响.方法 按纽约心脏病协会（NYHA）分级标准,96例CHF患者分为Ⅱ～Ⅳ级,完全随机分为常规治疗组（地高辛＋血管紧张素转换酶抑制剂＋利尿剂,n=46）和比索洛尔组（比索洛尔＋常规治疗组药物,n=50）,所有受试者分别于治疗前和随访6个月后测定外周血中MPO、hs-CRP的水平并行心脏彩色多普勒超声检测心功能.结果 常规治疗组及比索洛尔组的CHF患者外周血中MPO、hs-CRP的水平治疗后较治疗前均有明显下降[（38.6±6.4）μg/L比（46.4±7.6）μg/L,（32.5±5.4）μg/L比（47.2±6.6）μg/L;（7.8±1.3）mg/L比（10.2±1.6）mg/L,（6.6±1.5）mg/L比（9.9±1.4）mg/L,P＜0.05],左心室射血分数[（45.3±7.1）%比（38.3±8.7）%;（48.4±6.6）%比（37.5±9.8）%]明显增加（P＜0.05）,心功能明显改善.但比索洛尔组较常规治疗组在心功能改善和MPO、hs-CRP的水平下降方面更明显,差异有统计学意义（P＜0.05）.结论 比索洛尔是一种高选择性β受体阻滞剂,能有效抑制CHF患者神经内分泌的过度激活,控制CHF患者的临床症状,改善预后.

Effects of Bisoprolol on myeloperoxidase and high sensitivity C reactive protein in congestive heart failure

Objective To investigate the effects of bisoprolol on myeloperoxidase levels and high sensitivity C reactive protein (hs-CRP) in the patients with congestive heart failure (CHF) and their relationships with the heart function status. Methods A total of 96 patients with CHF were evaluated in Ⅱ ~ Ⅳ class by NYHA cardiac functional grading. They were randomly divided into two groups: the routine group treated with routine drugs (digoxin,ACE Inhibitors, diuretics, n=46) and the bisoprolol group (additional beta-blocker bisoprolol, n =50). The levels of MPO, hs-CRP and echocardiographic jn above patients with CHF were evaluated before and after 6 months therapy. Results The two groups were significantly different in terms of MPO, hs-CRP and LVEF after 6 mouths treatment. The IeveI of MPO and hs-CRP was decreased more significantly in the bisoprolol group than in the routine group[(38.6±6.4) μg/L vs (46.4 ±7.6) μg/L, (32.5 ±5.4) μg/L vs (47.2 ±6.6) μg/L;(7. 8 ± 1. 3)mg/L, (6.6±1.5)mg/L vs (9.9 ± 1. 4) mg/L; (45. 3 ± 7. 1) vs (38. 3 ±8. 7)%, (48.4 ±6.6)% vs (37.5 ±9. 8)%] [(48.4 ±6.6)% vs (45.3±7.1)% ;(32.5±5.4) μg/L vs (38. 6 ±6. 4) μg/L; (6. 6 ± 1. 5) mg/L vs (7. 8±1. 3) mg/L, P<0. 05]. Conclusions Beta-blockers bisoprolol has suppress neurohumoral over activation in patients with CHF. MPO and hs-CRP level might play an important role in pathogenesis of CHF.