不同剂型美托洛尔治疗轻度高血压患者疗效分析  

Clinical comparison between two formulations of metoprolol in the treatment of mild hypertension

作　　者：杨东伟[1] 刘新叶[1] 池豪[1] 程勇[1] 赵智琛[1] 

机构地区：[1]郑州大学附属郑州中心医院心内科,河南郑州450007

出　　处：《中国当代医药》2013年第3期74-75,77,共3页China Modern Medicine

摘　　要：目的比较不同剂型的美托洛尔对轻度高血压的临床疗效和安全性分析。方法 64例原发性轻度高血压患者,采取随机单盲法分为常规组及缓释组。常规组(32例):酒石酸美托洛尔片12.5mg,2次/d,可增至25mg,2次/d;缓释组(32例):琥珀酸美托洛尔缓释片23.75mg,1次/d,可增加至47.5mg/d。入组前及治疗6周后测量诊室血压,记录24h动态血压及24h动态心电图,监测肝肾功能、血糖、血脂,记录药物不良反应。结果 6周后两组诊室血压达标率均较高(78.1%vs87.5%),但差异无统计学意义(P>0.05);动态血压显示两组收缩压及舒张压较治疗前均有显著降低(P<0.05),但两组间差异无统计学意义(P>0.05);缓释组晨峰血压增高发生率较对照组显著降低(P<0.05);两组平均心率差异无统计学意义。缓释组全部窦性心搏RR间期(简称NN间期)的标准差(standard diviation of NNintervals,SDNN),相邻正常窦性心搏RR间期之差的平方根值(root mean square values of the standard deviation between adjacent normal number of intervals,RMSSD),相邻RR间期>50ms的百分比(percentage between R-R and the period>50ms,PNN50)较常规组显著增加(P<0.05);两组实验前后肝肾功能及血脂、血糖差异无统计学意义(P>0.05),无明显药物不良反应。结论对轻度原发性高血压,美托洛尔有较高的单药达标率,琥珀酸美托洛尔缓释片较酒石酸美托洛尔片可显著降低晨峰血压,提高心率变异性。Objective To compare the clinical curative effect and safety between different formulation of metoprolol. Methods Sixty-four cases of primary hypertension patients were randomly divided into two groups, conventional group （n = 32） and sustained-release tablets group （n = 32）. Patients in conventional group received oral administration of metoprolol tartrate tablets 12.5 mg twice a day, which can be increased to 25 mg twice a day, and the patients in sustained-release tablets group who received metoprolol succinate sustained-release tablets 23.75 mg daily, or raising dose 47.5 mg daily for same indications. Consulting room blood pressure, 24 hour ambulatory blood pressure monitoring （ABPM）, 24 hours of dynamic electrocardiogram, function of liver and kidney, level of plasma glucose and lipid, and adverse reaction caused by metoprolol were recorded before received therapeutics or after 6 weeks. Results There was no significant difference in the rate of achieving the goal of treatment between the two groups （P 〉 0.05）, in spite of the target BP goal rate were high （78.1% vs 87.5%） after 6 weeks. In two groups, ABPM showed that systolic blood pressure （SBP） and diastolic blood pressure （DBP） were significantly lower than that before treatment （P 〈 0.05）, but there was no significant difference between two groups （P〉 0.05）, while morning blood pressure peak incidence decreased significantly （P 〈 0.05） in release group. There was no significant difference in two groups about the average heart rate. SDNN, RMSSD, PNN50 of sustained-release tablets group significantly increased compared with conventional group （P 〈 0.05）. The liver and kidney function and blood lipids, blood glucose of two groups before and after experiment had no significant difference （P 〉 0.05）, and had no obvious adverse drug reactions. Conclusion Metoprolol monotherapy has a high antihypertensive efficacy for mild hypertension, and metoprolol sustained-release form can significantly red

关 键 词：美托洛尔 原发性高血压 动态血压 心率变异性 

分 类 号：R972.4[医药卫生—药品]