动态血压监测比较两种β_1受体阻滞剂的降压疗效  

Comparison of the Efficacy of Bevantolol and Metoprolol in Patients With Essential Hypertension

作　　者：李一石[1] 黄洁[1] 孙兴昌[1] 王莉[1] 苏琦[1] 华潞[1] 汪芳[1] 成小如[1] 刘力生[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床药理研究室,北京市100037

出　　处：《中国循环杂志》2003年第2期123-125,共3页Chinese Circulation Journal

摘　　要：目的 :用动态血压监测 (ABPM )的方法比较两种 β1受体阻滞剂———贝凡洛尔 (bevantolol)与美托洛尔 (metoprolol)治疗原发性高血压的疗效。方法 :选择原发性高血压患者 5 0例 ,随机分为贝凡洛尔组 2 4例 ,美托洛尔组 2 6例。分别观察服药前和服药后 8周末的 2 4h、白昼、夜间及各时点的动态血压变化。结果 :贝凡洛尔组和美托洛尔组服药前、服药后 8周末的 2 4h、白昼和夜间的平均收缩压、舒张压明显下降 ,有显著性差异(P <0 0 5或P <0 0 1)。贝凡洛尔组服药后 8周末各时点收缩压和舒张压均较服药前下降 ,有显著性差异 (P <0 0 5 )。美托洛尔组服药后 8周末各时点的收缩压和舒张压较服药前下降 ,但服药后的第 2 3～ 2 4h血压下降不明显 (P >0 0 5 )。结论 :贝凡洛尔 ( 10 0～ 2 0 0mg/d ,分两次口服 )可维持 2 4h平稳降压 ;美托洛尔 ( 10 0～ 15 0mg/d ,分两次口服 )仅能维持 2 2h内血压下降。Objective: To compare the clinical efficacy of two β 1-adrenoceptor antagonists(bevantolol and metoprolol) in the treatment of essential hypertension using ambulatory blood pressure monitoring(ABPM). Methods: It was a randomized,double blind,single-center,controlled clinical trial. After 2 weeks of wash-out period,patients with 24h mean diastolic blood pressure(DBP)≥85 mmHg were randomly treated with either bevantolol 100-200 mg/d or metoprolol 100-150 mg/d(twice a day) for 8 weeks. The dosage was titrated at the end of the 4 th week. ABPM was conducted at the end of placebo period and 8 weeks after treatment. Results: At the end of the 8 th week,In bevantolol group the mean of systolic blood pressure(SBP)/DBP of 24h,day-time and night-time dropped by(11.52±8.58)/(7.90±6.95)mmHg,(11.49±10.11)/(7.96±7.67)mmHg,(10.75±9.29)/(7.23±8.04)mmHg (p<0.05),respectively. SBP/DBP were decreased at every time point of 24h-ABPM in treatment. In metoprolol group the mean SBP/DBP of 24h,day-time and night-time was (5.57±10.69)/(4.94±6.78)mmHg,(6.53±11.41)/(5.10±7.47)mmHg,(4.88±11.45)/(5.90±8.02 )mmHg(p<0.05),respectively. DBP and SBP were decreased at every time point of 24h-ABPM in the treatment,but during the 23-24 th hour the decrease had no statistical significance(p>0.05). Conclusion: Bevantolol(100-200 mg/d,twice a day) can keep blood pressure smoothly decreasing for 24h,but metoprolol(100-150 mg/d,twice a day) only for 22h in some patients.

关 键 词：动态血压监测 Β1受体阻滞剂 贝凡洛尔 美托洛尔 治疗 原发性高血压 

分 类 号：R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]