【摘要】：目的:1.探討β受體阻滯劑酒石酸美托洛爾對高血壓病患者和正常血壓者中心動脈收縮壓的影響;2.探討不同用藥方案及不同心率水平對高血壓病患者中心動脈收縮壓的影響。方法:1、入選受試者86例(高血壓病患者46例,正常血壓者40例),測量肱動脈壓、心率、中心動脈壓,服用酒石酸美托洛爾25mg,30分鐘后再次測量,比較分析用藥前后各數(shù)據(jù)改變;2、根據(jù)患者用藥情況,將患者分為不同單用藥組及不同聯(lián)合用藥組,分別比較各組間心率、中心動脈收縮壓及肱動脈收縮壓與中心動脈收縮壓差值;3、根據(jù)心率情況將入選的371例受試者平均分為四組,分別比較各組間中心動脈收縮壓及肱動脈收縮壓與中心動脈收縮壓差值。結(jié)果:1.口服酒石酸美托洛爾30分鐘后,高血壓病患者心率、肱動脈收縮壓、中心動脈收縮壓均有下降,但肱動脈收縮壓與中心動脈收縮壓差值減小(9.55±4.47比7.60±3.85 mm Hg,P0.05);正常血壓者有相同的趨勢。2.鈣離子通道阻滯劑組、腎素-血管緊張素系統(tǒng)抑制劑組、β受體阻滯劑組三組間心率、肱動脈收縮壓與中心動脈收縮壓差值差異無統(tǒng)計學(xué)意義(HR:74.39±10.70、72.95±10.41和71.08±8.90次/分,P0.05;SBP-CASP:9.21±5.58、10.29±4.19和8.38±3.59mm Hg,P0.05);含β受體阻滯劑的聯(lián)合用藥組和不含β受體阻滯劑的聯(lián)合用藥組間心率、肱動脈收縮壓與中心動脈收縮壓差值差異無統(tǒng)計學(xué)意義(HR:71.45±11.19比71.56±9.66次/分,P0.05;SBP-CASP:8.92±4.66比8.97±3.05mm Hg,P0.05)。3.心率≤64次/分、65-72次/分、73-80次/分、≥81次/分四組間肱動脈收縮壓與中心動脈收縮壓差值分別為7.07±2.97 mm Hg、6.94±3.05 mm Hg、8.74±3.40 mm Hg和11.94±5.40mm Hg,在≤64次/分及65-72次/分組間肱動脈收縮壓與中心動脈收縮壓差值差異無統(tǒng)計學(xué)意義,余各組間差異有統(tǒng)計學(xué)意義。4.肱動脈收縮壓與中心動脈收縮壓差值與心率及身高有關(guān),心率每下降1次/分,肱動脈收縮壓與中心動脈收縮壓差值減少0.176mm Hg;身高每增加1cm,肱動脈收縮壓與中心動脈收縮壓差值增加0.184mm Hg。結(jié)論:1.口服酒石酸美托洛爾能快速降低高血壓病患者的外周肱動脈血壓、心率和中心動脈壓,但隨著心率下降,肱動脈收縮壓與中心動脈收縮壓之間差值減小。2.影響肱動脈收縮壓與中心動脈收縮壓差值的是心率,而不是藥物本身,當(dāng)心率≤72次/分時,肱動脈收縮壓與中心動脈收縮壓差值較小且趨于穩(wěn)定。
[Abstract]:Objective: 1. To investigate the effect of 尾 -blocker metoprolol tartrate on systolic blood pressure of central artery in patients with hypertension and normal blood pressure. To investigate the effects of different drug regimen and heart rate on systolic blood pressure of central artery in patients with hypertension. Methods: 1. The brachial artery pressure, heart rate, central artery pressure were measured in 86 subjects (46 patients with hypertension and 40 patients with normal blood pressure). After taking metoprolol tartrate for 30 minutes, the blood pressure of brachial artery was measured again. 2, according to the drug use, the patients were divided into two groups: single drug group and different combination group, and the heart rate was compared among each group. The systolic blood pressure of the central artery and the difference between the systolic blood pressure of the brachial artery and the systolic blood pressure of the central artery. 3. According to the heart rate, 371 subjects were divided into four groups on average. The systolic blood pressure of the central artery and the difference between the systolic blood pressure of the brachial artery and the central artery were compared. The result is 1: 1. After oral administration of metoprolol tartrate for 30 minutes, the heart rate, systolic blood pressure of brachial artery and systolic pressure of central artery were all decreased in patients with hypertension. However, the difference between the systolic blood pressure of brachial artery and that of central artery was decreased (9.55 鹵4.47 vs 7.60 鹵3.85 mm Hg,P0.05). The heart rate of calcium channel blocker group, renin-angiotensin system inhibitor group and 尾 receptor blocker group were compared. There was no significant difference between the systolic blood pressure of brachial artery and that of central artery (HR:74.39 鹵10.70 鹵72.95 鹵10.41 and 71.08 鹵8.90 beats / min, P0.05 鹵SBP-CASP: 9.21 鹵5.58 鹵10.29 鹵4.19 and 8.38 鹵3.59mm Hg,P0.05). There was no significant difference between the systolic blood pressure of brachial artery and the systolic blood pressure of central artery (HR:71.45 鹵11.19 vs 71.56 鹵9.66 beats / min, P 0.05 SBP-CASP: 8.92 鹵4.66 vs 8.97 鹵3.05mm Hg,P0.05). Heart rate 鈮，

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