Jiang Gui-Yun, Li Qun, Lv Yun-Xiang
Department of Clinical Laboratory, The Second People's Hospital of Bengbu, Bengbu, Anhui 233000, People's Republic of China.
Department of Respiratory Medicine, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, People's Republic of China,
Int J Chron Obstruct Pulmon Dis. 2018 Dec 20;14:73-80. doi: 10.2147/COPD.S186872. eCollection 2019.
Plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are elevated in subjects with COPD, and high plasma NT-proBNP levels are correlated with a poor prognosis. Thus, it is crucial to decrease the plasma NT-proBNP levels at the early stage of disease. We aimed to assess the effects of short-term treatment of irbesartan and hydrochlorothiazide on plasma NT-proBNP levels and health-related quality of life (HRQOL) in subjects with acute exacerbations of COPD (AECOPD).
Eighty subjects with AECOPD and high plasma NT-proBNP levels, without any clinical evidence of cor pulmonale, were enrolled. The subjects were randomly allocated into two groups of 40 subjects. In addition to standard treatment for AECOPD, the subjects in group I were treated with irbesartan alone, and those in group II were treated with irbesartan and hydrochlorothiazide for a week. Forty subjects with stable COPD were enrolled as a control group. Plasma NT-proBNP concentrations were measured on admission and on the first, fourth, and seventh days. The subjects' health-related quality of life was evaluated applying the 36-item short-form questionnaire on the first day before treatment and on the seventh day after treatment.
Treatment of irbesartan and hydrochlorothiazide significantly decreased plasma NT-proBNP levels in subjects with AECOPD, and this reduction was more significant in group II than that in group I. There were no significant differences in 36-item short-form domain scores between subjects with stable COPD and those with AECOPD who were treated with irbesartan and hydrochlorothiazide.
Treatment of irbesartan and hydrochlorothiazide rapidly decreased plasma NT-proBNP levels in subjects with AECOPD, and the treatment did not impair their physical status.
慢性阻塞性肺疾病（COPD）患者血浆N末端脑钠肽前体（NT-proBNP）水平升高，血浆NT-proBNP水平升高与预后不良相关。因此，在疾病早期降低血浆NT-proBNP水平至关重要。我们旨在评估厄贝沙坦和氢氯噻嗪短期治疗对慢性阻塞性肺疾病急性加重期（AECOPD）患者血浆NT-proBNP水平及健康相关生活质量（HRQOL）的影响。
纳入80例血浆NT-proBNP水平高且无肺心病临床证据的AECOPD患者。将受试者随机分为两组，每组40例。除AECOPD的标准治疗外，I组受试者仅接受厄贝沙坦治疗，II组受试者接受厄贝沙坦和氢氯噻嗪治疗一周。纳入40例稳定期COPD患者作为对照组。在入院时以及治疗第1天、第4天和第7天测量血浆NT-proBNP浓度。在治疗前第1天和治疗后第7天应用36项简短问卷评估受试者的健康相关生活质量。
厄贝沙坦和氢氯噻嗪治疗显著降低了AECOPD患者的血浆NT-proBNP水平，且II组的降低幅度比I组更显著。稳定期COPD患者与接受厄贝沙坦和氢氯噻嗪治疗的AECOPD患者在36项简短问卷领域得分上无显著差异。
厄贝沙坦和氢氯噻嗪治疗可迅速降低AECOPD患者的血浆NT-proBNP水平，且该治疗未损害其身体状况。
