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比索洛尔和氨氯地平对慢性阻塞性肺疾病患者运动时心肺反应及症状的影响。

Impact of bisoprolol and amlodipine on cardiopulmonary responses and symptoms during exercise in patients with chronic obstructive pulmonary disease.

机构信息

Department of Internal Medicine, Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China.

School of Medicine, Tzu-Chi University, Hualien, Taiwan, Republic of China.

出版信息

PLoS One. 2023 Jun 1;18(6):e0286302. doi: 10.1371/journal.pone.0286302. eCollection 2023.

Abstract

BACKGROUND

Patients with chronic obstructive pulmonary disease (COPD) often have exercise intolerance. The prevalence of hypertension in COPD patients ranges from 39-51%, and β-blockers and amlodipine are commonly used drugs for these patients.

OBJECTIVES

We aimed to study the impact of β-blockers and amlodipine on cardiopulmonary responses during exercise.

METHODS

A total 81 patients with COPD were included and the patients underwent spirometry, cardiopulmonary exercise tests, and symptoms questionnaires.

RESULTS

There were 14 patients who took bisoprolol and 67 patients who did not. Patients with COPD taking ß-blockers had lower blood oxygen concentration (SpO2) and more leg fatigue at peak exercise but similar exercise capacity as compared with patients not taking bisoprolol. There were 18 patients treated with amlodipine and 63 patients without amlodipine. Patients taking amlodipine had higher body weight, lower blood pressure at rest, and lower respiratory rates during peak exercise than those not taking amlodipine. Other cardiopulmonary parameters, such as workload, oxygen consumption at peak exercise, tidal volume at rest or exercise, cardiac index at rest or exercise were not significantly different between patients with or without bisoprolol or amlodipine. Smoking status did not differ between patients with or without bisoprolol or amlodipine.

CONCLUSIONS

COPD is often accompanied by hypertension, and β-blockers and amlodipine are commonly used antihypertensive drugs for these patients. Patients with COPD taking bisoprolol had lower SpO2 and more leg fatigue during peak exercise. Patients taking amlodipine had lower respiratory rates during exercise than those not taking amlodipine. Exercise capacity, tidal volume, and cardiac index during exercise were similar between patients with and without bisoprolol or amlodipine.

摘要

背景

慢性阻塞性肺疾病(COPD)患者常存在运动不耐受。COPD 患者中高血压的患病率为 39%-51%,β受体阻滞剂和氨氯地平是这些患者常用的药物。

目的

我们旨在研究β受体阻滞剂和氨氯地平对运动时心肺反应的影响。

方法

共纳入 81 例 COPD 患者,行肺功能检查、心肺运动试验和症状问卷。

结果

14 例患者服用比索洛尔,67 例患者未服用。服用β受体阻滞剂的 COPD 患者在峰值运动时血氧浓度(SpO2)较低且腿部疲劳感更明显,但运动能力与未服用比索洛尔的患者相似。18 例患者服用氨氯地平,63 例患者未服用。服用氨氯地平的患者体重较高,休息时血压较低,峰值运动时呼吸频率较低,而未服用氨氯地平的患者则相反。其他心肺参数,如工作负荷、峰值运动时的耗氧量、休息或运动时的潮气量、休息或运动时的心指数,在服用或不服用比索洛尔或氨氯地平的患者之间无显著差异。吸烟状况在服用或不服用比索洛尔或氨氯地平的患者之间无差异。

结论

COPD 常伴有高血压,β受体阻滞剂和氨氯地平是这些患者常用的降压药。服用比索洛尔的 COPD 患者在峰值运动时 SpO2 较低且腿部疲劳感更明显。服用氨氯地平的患者运动时呼吸频率较不服用氨氯地平的患者低。服用或不服用比索洛尔或氨氯地平的患者运动时的运动能力、潮气量和心指数相似。

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