| Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of theairways. Persistent airway inflammation leads to not fully reversible airflow limitation andlung structural damage, and it shows progressive development. At the final stage it is oftenaccompanied by hypoxia and carbon dioxide retention. And the hypoxia and hypercapnia canstimulate the carotid sinus and aortic body chemoreceptor reflex, and then caused sympatheticnerve excited, resulting in increased heart rate, thereby reducing the quality of life andexercise tolerance. Currently clinicians have realized, COPD patients should be controlledheart therapy, reducing myocardial oxygen consumption, and thus achieve improved qualityof life and prolong the life of purpose. Currently clinicians have realized that COPD patientsshould be controlled heart therapy, reducing myocardial oxygen consumption, and improvedquality of life and prolong the life span.Objective: This study established on the basis of randomized controlled clinical trials,To explain bisoprolol can control the resting heart rate safely and effectively, improveexercise tolerance and quality of life, reduce cardiovascular events and all-cause mortality andimprove prognosis by monitoring changes of various clinical indicators, functional checks andinflammatory mediators in COPD patients before and after oral administration bisoprolol.Method:1. Selected patients diagnosed with COPD (GLOD grade2-3) in stable stagerandomly from June2011to December2011in Changchun city hospital, the patients weredivided into two groups randomly: the patients in control group were treated with phlegmtablets, and the patients from experimental group were treated with bisoprolol. COPDdiagnosed according to American Thoracic Society and European Respiratory Society2007standards.2. In this study, a cross-sectional observation with longitudinal study methods were used,and according to a randomized controlled study criteria, the patients recruited were acceptedclinical assessment and examination, including lung function, lung CT, BODE score, 6-minute walk test, resting heart rate, serum inflammatory mediators C-reactive protein (CRP),serum amyloid A (SAA). After screening, patients who meet the standards were randomlydivided into groups. For the observation group, the patients were treated with oral bisoprolol1.25mg, and then added the dosage to2.5mg if the patients had no adverse reaction, and atthe same time the patients were treated with oral phlegm tablets at a dose of0.5,3times/day.For the control group, the patients were treated with oral phlegm tablets only. The re-examineperiod was1month, and the re-examined items were the same as those in the screeningbesides lung CT. Comparative results are observed before and after treatment.3. Serum classic expression levels of inflammatory mediators (including SAA and CRP)was detected by the ELISA. Comparison of expression differences between the experimentaland control groups in clinical characteristics and inflammatory mediators.4. To analyze the correlation among the patients clinical indicators resting heart rate,lung function, levels of inflammatory mediators, and clarify the clear dependence among theindexes.Results:1.160patients were recruited,94patients were invited into this study after thestandard screening:35including24men and11women in control group;59including34men and25women in the observation group. Before treatment, the clinical data showed nosignificant difference（P<0.05） in treatment group and the control group, lung function,BODE score, etc.2. Resting heart rate (beats/min), FEV1(liters), BODE score, CRP expression (mg/L)and SAA expression (mg/L) of the patient with COPD experimental group were81±5.3、1.33±0.05、2.6±0.23、8.5±0.44and52±5.4, respectively before treatment. And after treatment,the index were74±5.2、1.5±0.05、1.7±0.18、7.4±0.44and36±3.9, so there was significantdifference between before and after bisoprolol treatment（P<0.05）. Among these indexes,resting heart rate, BODE score and CRP expression were lower than before, but FEV1washigher than before. Resting heart rate (beats/min), FEV1(liters), BODE score, CRPexpression (mg/L) and SAA expression (mg/L) of the patient with COPD control groupwere81±6.0、1.41±0.07、2.4±0.25、8.2±0.64and53±7.6before treatment and82±6.0、 1.39±0.06、2.3±0.25、8.6±0.59and56±8.0after treatment. So there was no significantdifference between before and after bisoprolol treatment（P>0.05.3. We used the Pearson test to analyze the correlation for clinical indicators of heart rate,pulmonary function, levels of inflammatory mediators, and found that heart rate wassignificantly positive correlation with patients FEV1and FEV1/expected value (%)(P<0.05). In addition, COPD patients with FEV1/predictive value of serum SAA, serum CRPlevels showed a significant negative correlation (P <0.05)Conclusion:1. Stable COPD patients treated with bisoprolol can be controlled with theresting heart rate safely and effectively, and improve exercise tolerance and quality of life.2. Bisoprolol may reduce the blood CRP, SAA levels of patients with COPD, it suggestthat bisoprolol can reduce the level of systemic inflammation, has anti-inflammatory activity. |
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