琥珀酸美托洛尔治疗中青年高血压病的效果及对左室心肌重构的影响

目的 探讨琥珀酸美托洛尔缓释片治疗中青年高血压病患者的效果及对心肌重构的影响。方法 将首次诊断的轻中度的中青年高血压病患者,静息心率＞80次/分,随机分为琥珀酸美托洛尔缓释片治疗组(n=81)和氯沙坦对照组(n=79),共治疗6个月。观察两组治疗前后心率(HR)、舒张压(DBP)、收缩压(SBP)。超声测量治疗前后左房内径(LA)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室收缩未期内径 (LVDs)、左室舒张未期内径 (LVDd),左室舒张未期容量(LVEDV)、左室射血分数(EF)、左室心肌质量指数(LVMI)、二尖瓣舒张早期流速峰值(PFVE)、房缩期最大流速 (PFVA ),计算左室心肌质量指数(LVMI)、E/A比值,并进行统计学分析。结果 两组患者治疗后IVST、LVPWT、LVMI 比治疗前均减小,治疗前后比较均有统计学意义(P＜0.05),提示左室肥厚改善。EF治疗前后比较无变化 (P＞0.05),左室收缩功能未受影响。两组患者治疗后PFVE及E/A增高、PFVA下降,治疗前后比较均有统计学意义 (P＜0.05),左室舒张功能改善。结论 琥珀酸美托洛尔缓释片有效降低中青年高血压患者血压、心率,逆转左室心肌重构,改善左室舒张功能。

Effects of succinic metoprolol on blood pressure and left ventricular myocardial remodeling in young and middle-aged patients with hypertension

Objective To investigate the effects of succinic metoprolol sustained release tablets on blood pressure and myocardial remodeling in the treatment of young and middle-aged patients with hypertension.Methods The young and middle-aged hypertensive patients with mild to moderate first diagnosed with resting heart rate of >80 times /min were randomly divided into the succinate metoprolol sustained release tablet treatment group (n=81) and the losartan control group (n=79) for 6 months of treatment. Heart rate (HR), diastolic blood pressure (DBP) and systolic blood pressure (SBP) were observed before and after the treatment in both groups. Before and after the treatment, ultrasonic measurement was conducted on left atrial diameter (LA), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular systolic immaturity Diameter (LVDs), left ventricular diastolic diameter (LVDd), left ventricular diastolic idle volume(LVEDV), left ventricular ejection fraction (EF), left ventricular myocardial mass index (LVMI), mitral peak early diastolic flow velocity (PFVE), and the largest room velocity (PFVA). Left ventricular mass index (LVMI) and E/A ratio were calculated and analyzed statistically.Results IVST, LVPWT and LVMI in both groups were reduced compared with those before the treatment. The comparison before and after the treatment was statistically significant (P<0.05), suggesting improvement of left ventricular hypertrophy. There was no change in EF before and after the treatment (P>0.05), and left ventricular systolic function was not affected. After the treatment, PFVE and E/A increased, PFVA decreased in both groups, there were significant differences before and after the treatment (P<0.05), and left ventricular diastolic function improved.Conclusion Succinic metoprolol sustained release tablets can effectively reduce blood pressure and heart rate, reverse left ventricular myocardial remodeling and improve left ventricular diastolic function in young and middle-aged patients with hypertension.