Objective To investigate the effects of bisoprolol on myeloperoxidase levels and high sensitivity C reactive protein (hs-CRP) in the patients with congestive heart failure (CHF) and their relationships with the heart function status. Methods A total of 96 patients with CHF were evaluated in Ⅱ ~ Ⅳ class by NYHA cardiac functional grading. They were randomly divided into two groups: the routine group treated with routine drugs (digoxin,ACE Inhibitors, diuretics, n=46) and the bisoprolol group (additional beta-blocker bisoprolol, n =50). The levels of MPO, hs-CRP and echocardiographic jn above patients with CHF were evaluated before and after 6 months therapy. Results The two groups were significantly different in terms of MPO, hs-CRP and LVEF after 6 mouths treatment. The IeveI of MPO and hs-CRP was decreased more significantly in the bisoprolol group than in the routine group[(38.6±6.4) μg/L vs (46.4 ±7.6) μg/L, (32.5 ±5.4) μg/L vs (47.2 ±6.6) μg/L;(7. 8 ± 1. 3)mg/L, (6.6±1.5)mg/L vs (9.9 ± 1. 4) mg/L; (45. 3 ± 7. 1) vs (38. 3 ±8. 7)%, (48.4 ±6.6)% vs (37.5 ±9. 8)%] [(48.4 ±6.6)% vs (45.3±7.1)% ;(32.5±5.4) μg/L vs (38. 6 ±6. 4) μg/L; (6. 6 ± 1. 5) mg/L vs (7. 8±1. 3) mg/L, P<0. 05]. Conclusions Beta-blockers bisoprolol has suppress neurohumoral over activation in patients with CHF. MPO and hs-CRP level might play an important role in pathogenesis of CHF.%目的 探讨用β受体阻滞剂比索洛尔对充血性心力衰竭(CHF)患者心血管炎症标志物髓过氧化物酶(MPO)、超敏C反应蛋白(hs-CRP)水平以及心功能的影响.方法 按纽约心脏病协会(NYHA)分级标准,96例CHF患者分为Ⅱ～Ⅳ级,完全随机分为常规治疗组(地高辛+血管紧张素转换酶抑制剂+利尿剂,n=46)和比索洛尔组(比索洛尔+常规治疗组药物,n=50),所有受试者分别于治疗前和随访6个月后测定外周血中MPO、hs-CRP的水平并行心脏彩色多普勒超声检测心功能.结果 常规治疗组及比索洛尔组的CHF患者外周血中MPO、hs-CRP的水平治疗后较治疗前均有明显下降[(38.6±6.4)μg/L比(46.4±7.6)μg/L,(32.5±5.4)μg/L比(47.2±6.6)μg/L;(7.8±1.3)mg/L比(10.2±1.6)mg/L,(6.6±1.5)mg/L比(9.9±1.4)mg/L,P＜0.05],左心室射血分数[(45.3±7.1)%比(38.3±8.7)%;(48.4±6.6)%比(37.5±9.8)%]明显增加(P＜0.05),心功能明显改善.但比索洛尔组较常规治疗组在心功能改善和MPO、hs-CRP的水平下降方面更明显,差异有统计学意义(P＜0.05).结论 比索洛尔是一种高选择性β受体阻滞剂,能有效抑制CHF患者神经内分泌的过度激活,控制CHF患者的临床症状,改善预后.
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