pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2015-25-4-440-446pulmo-601Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESКомбинированная терапия бисопрололом и амлодипином у больных хронической обструктивной болезнью легких с артериальной гипертензиейCombination therapy with bisoprolol and amlodipine in patients with chronic obstructive pulmonary disease and hypertensionНикитинВ. А.NikitinV. A.

к. м. н., ассистент кафедры терапии ИДПО ГБОУ ВПО "Воронежская государственная медицинская академия им. Н.Н.Бурденко" Минздрава России; тел.: (920) 4147652

PhD, Assistant Lecturer at the Department of Therapy, State Institution "N.N.Burdenko Voronezh State Medical Academy", Healthcare Ministry of Russia; tel.: (920) 4147652

v.nikitin1@bk.ruГостеваЕ. В.GostevaE. V.

к. м. н., доцент кафедры пропедевтики внутренних болезней ГБОУ ВПО "Воронежская государственная медицинская академия им. Н.Н.Бурденко" Минздрава России, врач функциональной диагностики БУЗ ВО "Воронежская городская клиническая больница № 20"; тел.: (910) 3485797

PhD, Associate Professor at the Department of Propaedeutics of Internal Diseases, State Institution "N.N.Burdenko Voronezh State Medical Academy", Healthcare Ministry of Russia; function al diagnostics specialist at the Voronezh City Clinical Hospital N20; tel.: (910) 3485797

yanavrn@yandex.ruПышнограеваЛ. В.PyshnograevaL. V.

к. м. н., зам. главврача по медицинской части, врачкардиолог БУЗ ВО "Воронежская городская клиническая больница № 20"; тел.: (473) 2368020

PhD, Deputy Chief Medical Officer, cardiologist at the Voronezh City Clinical Hospital N20; tel.: (473) 2368020

mdm112@mail.ruВасильеваЛ. В.Vasil'evaL. V.

д. м. н., профессор, зав. кафедрой терапии ИДПО ГБОУ ВПО "Воронежская государственная медицинская академия им. Н.Н.Бурденко" Минздрава России; тел.: (910)3473687

MD, Professor, Head of Department at the Department of Therapy, State Institution "N.N.Burdenko Voronezh State Medical Academy", Healthcare Ministry of Russia; tel.: (910) 3473687

ludmilvasil@mail.ruГБОУ ВПО "Воронежская государственная медицинская академия им. Н.Н.Бурденко" Минздрава России: 394622, Воронеж, ул. Студенческая, 10РоссияState Institution "N.N.Burdenko Voronezh State Medical Academy", Healthcare Ministry of Russia: 10, Studencheskaya str., Voronezh, 394622, RussiaRussian FederationГБОУ ВПО "Воронежская государственная медицинская академия им. Н.Н.Бурденко" Минздрава России: 394622, Воронеж, ул. Студенческая, 10 БУЗ ВО "Воронежская городская клиническая больница № 20": 394055, Воронеж, ул. Депутатская, 15РоссияState Institution "N.N.Burdenko Voronezh State Medical Academy", Healthcare Ministry of Russia: 10, Studencheskaya str., Voronezh, 394622, Russia Voronezh City Clinical Hospital N20: 15, Deputatskaya str., Voronezh, 394055, RussiaRussian FederationБУЗ ВО "Воронежская городская клиническая больница № 20": 394055, Воронеж, ул. Депутатская, 15РоссияVoronezh City Clinical Hospital N20: 15, Deputatskaya str., Voronezh, 394055, RussiaRussian Federation201521102015254440446Copyright © Никитин В.А., Гостева Е.В., Пышнограева Л.В., Васильева Л.В., 20152015Никитин В.А., Гостева Е.В., Пышнограева Л.В., Васильева Л.В.Nikitin V.A., Gosteva E.V., Pyshnograeva L.V., Vasil'eva L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/601

Целью исследования явилась оценка эффективности применения фиксированной комбинации бисопролола и амлодипина (Конкор АМ, Takeda, Япония) у больных хронической обструктивной болезнью легких (ХОБЛ) в сочетании с артериальной гипертензией (АГ).

Материалы и методы

Материалы и методы. В исследовании приняли участие больные ХОБЛ (n = 38) II степени в стадии ремиссии в сочетании с АГ I–II степени. В качестве антигипертензивного препарата использовалась фиксированная комбинация бисопролола и амлодипина. Исходно и после 12 нед. терапии у больных проводились суточное мониторирование АД (СМАД), электрокардиография (мониторирование по Холтеру), эхокардиография, оценивалась функция внешнего дыхания (ФВД).

Результаты

Результаты. Через 12 нед. терапии продолжили прием препарата 34 (89,5 %) пациента. При терапии фиксированной комбинацией бисопролола / амлодипина в средней дозе 7,5 / 10 мг в сутки целевые значения АД достигнуты у 32 (84,2 %) пациентов. При анализе СМАД продемонстрированы стабильность антигипертензивного действия и значимое улучшение показателей при длительном применении препарата Конкор АМ. При длительной терапии фиксированной комбинацией бисопролола и амлодипина нормализовались большинство показателей вариабельности ритма сердца. На фоне лечения отмечена тенденция к нормализации диастолической функции сердца. При оценке показателей ФВД до и через 12 нед. терапии статистически значимых различий не получено, что свидетельствует об отсутствии негативного влияния фиксированной комбинации бисопролола и амлодипина на бронхиальную проходимость.

Заключение

Заключение. Подтверждена целесообразность использования комбинированной терапии (Конкор АМ) у больных ХОБЛ с сопутствующей АГ.

The purpose of this study was to assess efficacy of a fixed combination of bisoprolol and amlodipine (Concor AM, Takeda) in patients with chronic obstructive pulmonary disease (COPD) and hypertension (H).

Methods

Methods. Thirty eight stable patients with stage 2 COPD and stage I–II H were treated with a fixed combination of bisoprolol and amlodipine. 24h ambulatory blood pressure monitoring (ABPM), electrocardiography, echocardiography, and lung function were performed at the baseline and in 12 weeks of therapy.

Results

Results. Thirty four (89.5%) patients continued the treatment after 12 weeks. The therapy with the fixed combination of bisoprolol and amlodipine in average dose of 7.5 / 10 mg/day provided a target blood pressure (BP) level in 32 (84.2%) patients. ABPM analysis demonstrated stable significant improvement in BP parameters including the heart rate variability. A trend toward normalization of the left heart diastolic function was noted during treatment. Lung function did not differ significantly before and after 12 weeks of the treatment indicating that the fixed combination of bisoprolol and amlodipine did not impact negatively on bronchial obstruction.

Conclusion

Conclusion. The results confirm the rationale of therapy with the fixed combination of bisoprolol and amlodipine in patients COPD

and H

and H.

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The authors declare that there are no conflicts of interest present.