Clinical research on application of selective β receptor blockers on patients with chronic obstructive pulmonary Disease / 中国综合临床

ABSTRACT

Objective To evaluate the safety and effectiveness of the treatment by selective β 1 receptor blockers on patients with chronic obstructive pulmonary disease (COPD).Methods Eighty cases of COPD Ⅲ (stable period) inpatient with or without coronary heart disease were collected in The Second People's Hospital of Shanghai from September 2012 to November 2013.The patients were randomly divided into testing group (Metoprolol treatment group) and control group (regular treatment group) with 40 cases for each group.Metoprolol group therapy based on the use of conventional metoprolol tablets,an initial dose of metoprolol 12.5 mg/d,titrated to the appropriate dose based on heart rate and tolerance of the morning resting heart rate of 55 to 60 times/min that reached the target dose of metoprolol continuous medication for 12 months.Blood gas analysis were recorded before and after treatment,pulmonary function,and 6 min walk test (6MWT) and were chronic lung disease Assessment Test (CAT) Rating.The control group was administrated regular treatment while the testing group added small dose of Metoprolol with titration to an appropriate dose on this basis.12 months in a row,and assessed the end stage.Results (1) After the application of selective β receptor blockers on testing group,no statistically significant difference (P＞0.05) in the values of FEV1 in anticipation value％ (testing group(45.45 ± 4.68) ％ vs.(43.32 ± 4.84) ％;control group(44.23 ± 4.68) ％ vs.(42.58 ±4.24)％),PaO2(testing group(75.92± 10.78) mmHg vs.(74.86± 11.21) mmHg;control group(70.23 ±6.45) mmHg vs.(72.36±7.28) mmHg) and PaCO2(testing group(46.28±8.28) mmHg vs.(47.46±10.22) mmHg);control group(44.54 ± 8.89) mmHg vs.(42.36 ± 7.45) mmHg) before and after treatment.But the 6MWD (testing group(287 ± 23) m vs.(384± 34) m;control group(284 ± 25) m vs.(295 ±21) m) and COPD appraisal test(CAT) (testing group(21±7) score vs.(17±6) score);control group(22 ±5) score vs.(20± 6) score) had improved significantly compared with that before treatment,with significant difference(t=4.903,4.784;P＜0.05).Conclusion Selective β receptor blockers have no effect on the airway resistance of COPD patients and reduction on pulmonary function.It can also increase the exercise tolerance and enhance the living quality for improving clinical prognosis.