【摘要】 目的:评价美托洛尔和地尔硫缓释胶囊治疗高血压合并无症状性心肌缺血(SMI)患者的效果。方法:将106例轻中度高血压合并SMI患者随机分成2组,分别服用美托洛尔片(美托洛尔组)和地尔硫缓释胶囊(地尔硫组),比较2组治疗前及治疗8周后心率、坐位血压、动态血压、24h动态心电图(AECG)示心肌缺血的情况。结果:服药8周后美托洛尔组和地尔硫组心率分别下降11.3次/min和5.1次/min,二者比较有统计学意义,坐位血压分别下降20.9/18.8mmHg和27.8/20.4mmHg。白昼、夜间平均血压均有明显下降。24hAECG示美托洛尔组和地尔硫组缺血次数分别减少58.9%和86.4%,缺血时间分别减少44.7%和84.6%,两组比较差别有统计学意义。美托洛尔和地尔硫组不良反应发生率分别为5.9%和7.8%。结论:美托洛尔和地尔硫均有较好的降压作用,美托洛尔减慢心率作用优于地尔硫,地尔硫减少心肌缺血的作用优于美托洛尔。更多还原

【Abstract】 Objective: To evaluate the efficacy of metoprolol and diltiazem-SR in hypertension combined with silent myocardial ischemia (SMI). Methods: One hundred and six patients with mild to moderate hypertension and SMI were randomly divided into 2 groups including metoprold group and diltiazem-SR group. The heart rate, office blood pressure (OBP), ambulatory blood pressure (ABP) and SMI displayed by 24-hour ambulatory electrocardiagraphy (AECG) before and 8 weeks after treatment were compared in 2 groups. Results: The heart rates decreased 8 weeks after treatment in metoprold group and diltiazem-SR group. OBP decreased by 20.9/18.8 mm Hg and 27.8/20.4 mm Hg respectively in 2 groups. The average heart rates significantly decreased both in day and night. The frequency of ischemia episodes decreased by 58.9% and 86.4%, and the time of ischemia decreased by 44.7% and 84.6% in 24 h AECG respectively in metoprold and diltiazem-SR groups. Side effects were 5.9% and 7.8% respectively in 2 groups. Conclusion: Metoprold and diltiazem-SR are both good at decreasing hypertension. Metoprold is better than diltiazem-SR in decreasing heart rate, and diltiazem-SR is better than metoprold in decreasing SMI.更多还原