阿替洛尔和地尔硫治疗高血压疗效分析  

Evaluation of efficacy of atenolol and diltiazem-SR in the treatment of hypertension

作　　者：姚雪艳[1] 陈君柱[1] 朱建华[1] 陈宝仙[1] 刘晓健[1] 范维琥[2] 

机构地区：[1]浙江大学医学院附属第一医院心内科,杭州市310003 [2]上海复旦大学医学院附属华山医院心内科

出　　处：《中华心血管病杂志》2002年第12期743-746,共4页Chinese Journal of Cardiology

摘　　要：目的　评价阿替洛尔片和地尔硫缓释胶囊治疗高血压合并无症状性心肌缺血 (SMI)患者的降压、减少心肌缺血的效果。方法　 73例轻中度高血压病合并SMI患者被随机分成 2组 ,分别服用阿替洛尔片 (阿替洛尔组 )和地尔硫缓释胶囊 (地尔硫组 )。比较治疗前及治疗 8周后对心率、坐位血压、动态血压、48h动态心电图 (AECG)中心肌缺血的影响。结果　服药 8周后阿替洛尔组和地尔硫组心率分别平均下降 1 1 2次 /min和 8 8次 /min ,坐位血压分别平均下降 2 1 1 /1 9 1mmHg(1mmHg =0 1 33kPa)和 2 8 1 /2 0 7mmHg ,白昼、夜间平均血压均有明显的下降。 48hAECG示阿替洛尔组和地尔硫组缺血次数分别减少 59 9%和 86 6 % ,缺血时间分别减少 44 9%和 84 7% ,缺血时间减少两组间比较P <0 0 5。阿替洛尔组和地尔硫组不良反应发生率分别为 2 1 6 %和 1 1 1 %。结论　阿替洛尔和地尔硫均有较好的降压作用 ,阿替洛尔减慢心率作用强于地尔硫 ,地尔硫减少心肌缺血的作用优于阿替洛尔。Objective To compare the efficacy of atenolol and diltiazem SR in the treatment of silent myocardial ischemia (SMI) and hypertension Methods Seventy three patients with mild to moderate hypertension and SMI were randomly allocated to be treated by atenolol 25 mg/d (group A, n =37) or diltiazem SR 90 mg/d (group D, n =36) for eight weeks The changes of heart rate, office blood pressure(OBP), ambulatory blood pressure(ABP) and SMI during 48 hour ambulatory electrocardiography were compared before and eight weeks after treatment Results OBP and ABP were lower under both regimes During 48 hour ambulatory electrocardiography, the frequency of ischemic episodes decreased by 59 9% with atenolol, 86 6% with diltiazem SR Total ischemic duration decreased by 44 9% with atenolol, 84 7% with diltiazem SR Side effects were 21 6% in group A and 11 1% in group D, respectively Conclusion Diltiazem SR is more effective and better tolerated in the treatment of the silent myocardial ischemia and hypertension

关 键 词：阿替洛尔 地尔硫卓 疗效 钙通道阻滞药 高血压 无症状性心肌缺血 合并症 SMI 

分 类 号：R544.1[医药卫生—心血管疾病]