摘要
目的探讨高度选择性13．受体阻滞剂美托洛尔缓释片治疗对原发性高血压伴稳定性心绞痛患者血管内皮功能及存活心肌功能的影响。方法选取行冠状动脉造影检查的高血压患者182例，根据造影结果分为四组：单支病变（冠状动脉狭窄≥50％，47例）组，双支病变（49例）组，多支病变（44例）组和对照（为高血压组，无冠状动脉狭窄或狭窄〈50％，42例）组；常规药物加美托洛尔缓释片（阿斯利康有限公司，47．5mg／片），经过12个月治疗，对比治疗前后患者的一般临床资料、实验室检查结果、超声心动图和放射性核素的变化。结果高血压伴稳定性心绞痛患者随着冠脉病变程度逐渐增加、病变支数越多，负荷后1h及负荷后4h的FMD、99Tom—MIBI摄取分数越小。美托洛尔缓释片治疗12个月后，单支病变、双支病变及多支病变组的负荷后1h、负荷后4hFMD和^99Tcm—MIBI摄取分数与高血压组比较差异减少，仅双支病变及多支病变组有统计学意义（P〈0．05）；双支病变及多支病变组治疗后^99Tcm，MIBI摄取分数较治疗前分别增加（0．54±0．07）及（0．68±0．16），负荷后1h及负荷后4hFMD分别增加（2．72±0．51）、（4．20±1．47）及（2．50±0．65）、（4．31±1．85），△99TOm—MIBI及△FMD在常规组和美托洛尔组之间的差异均有统计学意义，多支病变组更加明显（P〈0．01）。结论对原发性高血压伴稳定性心绞痛患者，美托洛尔缓释片治疗可以显著改善血管内皮功能及存活心肌功能。
ObJective To explore the effect of metoprolol sustained-release tablets on vessel endothelial func- tion and survival myocardium in hypertensive patients with stable angina pectoris. Methods 182 patients with hyperten- sion who had received coronary angiography were involved in the study. According to the results of angiography （ coronary stenosis=50% ）, the patients were divided into three groups： single-vessel disease group （ single-vessel group, n = 47 ）, double-vessel disease group （ double-vessel group, n = 49 ）, multi-vessel disease group （ multi-vessel group, n= 44 ）, and control group （ no coronary stenosis or 〈 50%, n= 42 ）. After a 12-month treatment with conventional drugs plus metoprolol sustained-release tablets, the clinical presentations, laboratory findings, blood pressure, clinical features, echocardiography, and radionuclide ventriculography were measured and analyzed. Results As the degree of coronary artery lesions increased, FMD at hours 1 and 4 and 99Tcm-MIBI uptake fraction were worse in hypertensive patients with stable angina pectoris. 12 months after using of metoprolol sustained-release tablets, a significant improvement in FMD at hours I and 4 and 99Tcm-MIBI uptake fraction were observed in more increased vessel coronary disease groups （ double- vessel group and multi-vessel group ）, which increased （ 2.72 ± 0.51 and 4.20 ± 1.47 ）, （ 2.50 ±0.65 and 4.31±1.85 ） and （ 0.54 ± 0.07 and 0.68 ± 0.16 ）. Conclusions For hypertensive patients with stable angina pectoris, metoprolol sustained-release tablets can effectively improve vessel endothelial function and survival myocardium.
出处
《国际医药卫生导报》
2012年第15期2187-2190,共4页
International Medicine and Health Guidance News
关键词
高血压
心绞痛
肱动脉
存活心肌
美托洛尔缓释片
Hypertension
Angina pectoris
Brachial artery
Survival myocardium
Metoprolol sustained- release tablets
