Tsvetkova O A, Veselovskaia M V
Ter Arkh. 2007;79(3):25-9.
To study effects of a selective beta1-adrenoblocker (B1AB) bisoprolol fumarate (conkor, Nikomed, Germany) on severity of pulmonary hypertension (PH), bronchial obstruction and bioelectric activity of the myocardium in patients with chronic obstructive pulmonary disease (COPD) associated with ischemic heart disease (IHD).
Effects of an 8-week course of bisoprolol therapy on pulmonary hypertension, its efficacy and safety were studied in 30 IHD patients with COPD of stage III-IV on broncholytic therapy. The comparison group consisted of 45 IHD patients with COPD untreated with basic bisoprolol therapy. The following parameters were assessed: chest x-ray data, mean pulmonary artery pressure (MPAP) by echocardiography findings, frequency of anginal attacks by ECG monitoring, bronchial permeability by investigation of external respiration function, partial pressure and carbonic gas in blood, oxygen blood saturation (pO2, pCO2 and SaO2).
Bisoprolol has decreased MPAP from 23.8 +/- 0.8 mmHg to 21.9 +/- 1.0 mmHg, by 8%, p < 0.05; frequency of anginal attacks, heart rate from 82.2 +/- 1.4 to 73.2 +/- 1.5 b/min; number of episodes of ST segment depression from 2.35 +/- 0.43 to 0.95 +/- 0.22, p < 0.01; total duration of ST segment depression from 10.1 +/- 2.54 to 2.89 +/- 0.76 min, p < 0.01; number of supraventricular and ventricular extrasystoles for 24 hours from 194.5 +/- 74.4 to 96.2 +/- 27.4 and from 239.1 +/- 124.9 to 111.3 +/- 44.1, respectively. Parameters of a 6 min walk test improved from 326.7 to 442 m, p < 0.01. Bisoprolol had no negative effect on bronchial obstruction.
Bisoprolol is well tolerated, effective and safe in COPD patients with IHD.
研究选择性β1-肾上腺素能阻滞剂（B1AB）富马酸比索洛尔（康可，德国尼科美公司）对合并缺血性心脏病（IHD）的慢性阻塞性肺疾病（COPD）患者肺动脉高压（PH）严重程度、支气管阻塞及心肌生物电活动的影响。
对30例接受支气管扩张治疗的III-IV期COPD合并IHD患者，研究了为期8周的比索洛尔治疗对肺动脉高压的影响、疗效及安全性。对照组由45例未接受比索洛尔基础治疗的COPD合并IHD患者组成。评估了以下参数：胸部X线数据、超声心动图测定的平均肺动脉压（MPAP）、心电图监测的心绞痛发作频率、通过肺功能检查评估的支气管通透性、血液中的分压和二氧化碳、血氧饱和度（pO2、pCO2和SaO2）。
比索洛尔使MPAP从23.8±0.8 mmHg降至21.9±1.0 mmHg，降低了8%，p<0.05；心绞痛发作频率、心率从82.2±1.4降至73.2±1.5次/分钟；ST段压低发作次数从2.35±0.43降至0.95±0.22，p<0.01；ST段压低总时长从10.1±2.54降至2.89±0.76分钟，p<0.01；24小时室上性和室性早搏次数分别从194.5±74.4降至96.2±27.4以及从239.1±124.9降至111.3±44.1。6分钟步行试验参数从326.7米提高到442米，p<0.01。比索洛尔对支气管阻塞无负面影响。
比索洛尔在COPD合并IHD患者中耐受性良好、有效且安全。
