地尔硫卓和卡维地洛治疗高血压合并冠心病的疗效观察  

Comparative study of therapeutic effects of Diltiazem and Carvedilol in hypertension assoiciated with CHD

作　　者：吴文利[1] 梅霞[1] 郑向清[1] 李晓丽[1] 

机构地区：[1]重庆市中山医院心内科,400013

出　　处：《重庆医学》2004年第11期1692-1693,1695,共3页Chongqing medicine

摘　　要：目的　观察地尔硫卓和卡维地洛对高血压合并冠心病患者的降压、减少心肌缺血事件及抗室性早搏的效果。方法　10 2例轻、中度高血压合并冠心病患者被随机分成两组 ,分别服用地尔硫卓缓释胶囊 (地尔硫卓组 )和卡维地洛片 (卡维地洛组 )。比较治疗 8周后对心率、坐位血压 ,2 4h动态心电图中心肌缺血事件及室性早搏的影响。结果　服药 8周后地尔硫卓组和卡维地洛组心率分别下降 (9.1± 6 .3)次 /min和 (6 .1± 4 .2 )次 /min ,坐位血压分别下降 (2 7.9± 8.5 / 2 0 .1± 6 .9)mmHg和 (2 1.0± 7.3/18.7± 5 .6 )mmHg(1mmHg =0 .133kPa) ,2 4hHolter示地尔硫卓组和卡维地洛组缺血事件次数分别减少 86 .5 %和 5 8.5 % ,缺血时间分别减少 84 .8%和 4 3.7% ,缺血时间减少两组间比较P <0 .0 5 ,抗室性早搏总有效率分别为 72 .2 %和 33.0 % (P <0 .0 5 )。结论　地尔硫卓和卡维地洛均有较好的降压作用 (P >0 .0 5 ) ,但地尔硫卓减慢心率、减少心肌缺血事件及抗室性早搏的作用优于卡维地洛。Objective To evaluate and compare the anti-hypertension, anti-ischemia and anti-premature ventricular beats effects of Diltiazem and Carvedilol on essential hypertension (EH) assoiciated with coronary heart disease (CHD). Methods One hundred two patients with EH and CHD were randomly divided into Diltiazem treatment group (52 cases) and Carvedilol treatment group (50 cases). The indexes of observation included variety of heart rate, blood pressue and cardiac arrhythmias and myocardial ischemia in Holter gram after 8 weeks treatment in both groups.Results The reduced rest heart rate were (9.1±6.3) bests/min in Diltiazem treatment group,(6.1±4.2) bests/min in Carvedilol treatment group. The reduced blood pressue were (27.9±8.5/20.1±6.9)mm Hg and (21.0±7.3/18.7±5.6)mm Hg respectively. The bests of myocardial ischemia were reduced by 86.5% and 58.5%respectively. The time of myocardial ischemia were reduced by 84.8% and 43.7% (P<0.05). The effective rates were 72.2% and 33.0% on premature ventricular beats. Conclusion Both groups diltiazem and Carvedlol reduced blood pressue effectively. In reducing heart rates, anti-ischemia and anti- premature ventricular beats, the efficacy of Diltiazem was better than Carvedilol.

关 键 词：地尔硫卓 卡维地洛 高血压 心肌缺血 

分 类 号：R544.1[医药卫生—心血管疾病] R541.4[医药卫生—内科学]