高龄冠心病患者美托洛尔治疗观察  

作　　者：陈明[1] 沈炳权[1] 劳迪波[1] 张丽[1] 谢建洪[1] 黄慧芳[1] 

机构地区：[1]浙江省人民医院干部科,310014

出　　处：《浙江临床医学》2010年第11期1174-1176,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 研究美托洛尔及其缓释片治疗高龄老年冠心病的疗效和安全性.方法 76例夹杂有多种慢性疾病的老年冠心病患者（男60、女16）,年龄75～93岁,平均（86.5±3.8）岁.随机分为2组,分别给予美托洛尔普通片或美托洛尔缓释片,观察临床疗效及血压、心率、心脏超声检查、血脂等各项指标.结果 治疗3个月后2组临床表现均有改善：胸闷、心悸、胸痛等症状减轻或消失,收缩压、心率比治疗前下降,舒张压及心超无明显差异;血糖、血脂、血肌酐、血尿酸等指标治疗前后未见明显差别.结论 美托洛尔及缓释片治疗老年冠心病疗效确切,耐受性良好,无明显心率及代谢不良反应.Objective To explore tile clinical study on the therapeutic effects of Metoprolol on coronary heart disease in elder people. Method There were 76 eases of coronary heart diseases with 75 to 93 ages,60 males and 16 females （the average age was 86.5 ± 3.8）. Everybody was administered randomly of Metoprolol controlled - release （CR） or extended release （XL） tablet from small dosage. The dosage of metoprolol CR was 12.5rag once diary and which of XL was 6. 25mg twice diary at first. Then we studied the symptoms and signs of CHD two weeks later and increased the dosage as well. All of the patients were treated for over 3 months. The blood pressure, heart rate, ultrasound, electrocardiogram, FPG, TC, TG, LDL, HDL, Cr, Ua were examined before administering and after 3 months＇ treatment. Results All the patients were treated for over 3 months and the symptom of angina was decreased or almost disappeared. The dosage of metaprolol CR was 12. 5mg to 37.5mg and the metaprolol XL was 12.5mg to 32.5rag. Both group of patients were improwes in symptom and signs, the systolic blood pressure, heart rate were decreased compared with those before treatment in each group（P 〈0. 01 ）. The diastolic blood pressure was lower after treatment, but not significantly （ P = NS） in each. There were no significance in changes of SBP, DBP,HR in two groups after treated（ P = NS）. There were no significance in changes of ultrasound, FPG, UA, CR,TC,TG, LDL, HDL in each groups. Conclusion The treatment of CHD in elder patients should begin with smaller dosage than that in adult. The elderly CHD was always associated with essential hypertension, diabetes, heart failure,chronic kidney disease,etc. The effects in blood pressure and heart rate in elderly people are similar with those in adult. Most elderly people can have symptoms released at lower dosage than that for the adult.

关 键 词：高龄老年人 冠心病 美托洛尔 

分 类 号：R541.61[医药卫生—心血管疾病]