Second Geriatric Cardiology Division, Beijing, People's Republic of China.
Clin Interv Aging. 2013;8:1157-65. doi: 10.2147/CIA.S49644. Epub 2013 Sep 10.
This study was undertaken to determine the association between cardiac function and therapy with beta2-adrenoceptor agonists (β2-agonists), β-blockers, or β-blocker-β-agonist combination therapy in elderly male patients with chronic obstructive pulmonary disease (COPD).
This was a retrospective cohort study of 220 elderly male COPD patients (mean age 84.1 ± 6.9 years). The patients were divided into four groups on the basis of the use of β-blockers and β2-agonists. N-terminal fragment pro-B-type natriuretic peptide (NT pro-BNP), left ventricular ejection fraction (LVEF), and other relevant parameters were measured and recorded. At follow-up, the primary end point was all-cause mortality.
Multiple linear regression analysis revealed no significant associations between NT pro-BNP and the use of β2-agonists (β = 35.502, P = 0.905), β-blockers (β = 3.533, P = 0.989), or combination therapy (β = 298.635, P = 0.325). LVEF was not significantly associated with the use of β2-agonists (β = -0.360, P = 0.475), β-blockers (β = -0.411, P = 0.284), or combination therapy (β = -0.397, P = 0.435). Over the follow-up period, 52 patients died, but there was no significant difference in mortality among the four groups (P = 0.357). Kaplan-Meier analysis showed no significant difference among the study groups (log-rank test, P = 0.362). After further multivariate adjustment, use of β2-agonists (hazard ratio [HR] 0.711, 95% confidence interval [CI] 0.287-1.759; P = 0.460), β-blockers (HR 0.962, 95% CI 0.405-2.285; P = 0.930), or combination therapy (HR 0.638, 95% CI 0.241-1.689; P < 0.366) were likewise not correlated with mortality.
There was no association between the use of β2-agonists, β-blockers, or β-blocker-β2-agonist combination therapy with cardiac function and all-cause mortality in elderly male COPD patients, which indicated that they may be used safely in this population.
本研究旨在确定心脏功能与β2-肾上腺素受体激动剂（β2-agonists）、β-受体阻滞剂或β-受体阻滞剂-β2-激动剂联合治疗在老年男性慢性阻塞性肺疾病（COPD）患者中的相关性。
这是一项回顾性队列研究，共纳入 220 名老年男性 COPD 患者（平均年龄 84.1±6.9 岁）。根据β-受体阻滞剂和β2-激动剂的使用情况，将患者分为四组。测量并记录 N 末端片段脑钠肽前体（NT pro-BNP）、左心室射血分数（LVEF）和其他相关参数。随访时，主要终点是全因死亡率。
多线性回归分析显示，NT pro-BNP 与β2-激动剂（β=35.502，P=0.905）、β-受体阻滞剂（β=3.533，P=0.989）或联合治疗（β=298.635，P=0.325）的使用均无显著相关性。LVEF 与β2-激动剂（β=-0.360，P=0.475）、β-受体阻滞剂（β=-0.411，P=0.284）或联合治疗（β=-0.397，P=0.435）的使用也无显著相关性。在随访期间，有 52 名患者死亡，但四组间死亡率无显著差异（P=0.357）。Kaplan-Meier 分析显示，各组间无显著差异（对数秩检验，P=0.362）。进一步进行多变量调整后，β2-激动剂（HR 0.711，95%CI 0.287-1.759；P=0.460）、β-受体阻滞剂（HR 0.962，95%CI 0.405-2.285；P=0.930）或β-受体阻滞剂-β2-激动剂联合治疗（HR 0.638，95%CI 0.241-1.689；P<0.366）与死亡率也无相关性。
在老年男性 COPD 患者中，β2-激动剂、β-受体阻滞剂或β-受体阻滞剂-β2-激动剂联合治疗与心脏功能和全因死亡率之间无关联，这表明在该人群中使用这些药物可能是安全的。
