比索洛尔及美托洛尔在主动脉夹层应用中的对比分析

目的：探讨主动脉夹层（AD）患者中不同类型β受体阻滞剂对心率、血压的影响及不良反应的发生。方法将72例患者按随机数字表法分为美托洛尔组（37例）和比索洛尔组（35例）。在其他治疗相同的基础上，美托洛尔组给予美托洛尔25-50 mg·d^-1，口服，12个月为1个疗程；比索洛尔组给予比索洛尔5-15 mg·d^-1，口服，12个月为1个疗程。观察比较2组患者治疗后心率、血压的变化及并发症（缓慢型心律失常、传导阻滞、药源性低血压、心功能不全或心功能不全加重等）的发生情况。结果美托洛尔组的心率、血压达标率分别为89.2%、86.5%；比索洛尔组心率、血压达标率分别为91.4%、83.2%。2组心率、血压达标率比较差异均无统计学意义（均P＞0.05）。2组均无缓慢型心律失常、传导阻滞、药源性低血压、心功能不全或心功能不全加重等并发症的发生。结论比索洛尔组在心率控制方面稍优于美托洛尔，血压控制方面稍差于美托洛尔，但差异均无统计学意义。

Comparison of Bisoprolol and Metoprolol for Aortic Dissection

Objective To investigate the influences of different types of β-receptor blockers on heart rate and blood pressure and their side effects in patients with aortic dissection.Methods Seventy-two patients were randomly assigned to receive either metoprolol（25-50 mg·d^-1, metoprolol group, n=37） or bisoprolol （5-15 mg·d^-1, bisoprolol group, n=35） orally for 12 months. The heart rate, blood pressure and complications （bradyarrhythmia, conduction block, drug-induced hypotension, cardiac insufficiency, aggravation of cardiac insufficiency, etc.） were observed after treatment in both groups. Results The proportions of patients achieving heart rate and blood pressure targets were, respectively, 89.2% and 86.5% in metoprolol group, and 91.4% and 83.2% in bisoprolol group. There were no significant differences between the two groups（P〉0.05）.No bradyarrhythmia, conduction block, drug-induced hypo-tension, cardiac insufficiency, aggravation of cardiac insufficiency and other complications occurred in both groups. Conclusion The bisoprolol is superior to metoprolol for controlling heart rate, but inferior to metoprolol for controlling blood pressure. However, the differences in efficacies were not significant between bisoprolol and metoprolol.