琥珀酸美托洛尔缓释片和酒石酸美托洛尔片对急性心肌梗死患者心率的影响

Comparison of effects of metoprolol succinate sustained-release tablets and metoprolol tartrate tablets on heart rates of patients with acute myocardial infarction

目的比较琥珀酸美托洛尔缓释片和酒石酸美托洛尔片对急性心肌梗死患者心率的影响。方法选择急性心肌梗死患者76例,在除外应用美托洛尔禁忌后,按1∶2比例随机分配到琥珀酸美托洛尔缓释片组25例和酒石酸美托洛尔片组51例。前者给予琥珀酸美托洛尔23.75 mg,日1次口服,后者给予酒石酸美托洛尔12.5 mg,日2次口服。在此基础上,两组均常规予阿司匹林、氯吡格雷、ACEI及他汀类药物治疗,分别记录用药前和用药后24、48、72 h静息状态的心率,比较用药后心率下降的程度和趋势。结果琥珀酸美托洛尔缓释片组在用药后24、48、72 h 3个时间点的心率分别下降了0、1%、9%,次数下降了0.5次/min、1.6次/min、7.6次/min,酒石酸美托洛尔片组心率分别下降了3%、5%、6%,次数下降了3.5次/min、4.1次/min、5.7次/min。P均<0.05,认为不同时间点上患者心率的差异有统计学意义;而因素心率和剂型的交互作用的P值均>0.05,尚不能认为剂型和心率有交互作用。两组患者服药后72 h内,心率变化的趋势无统计学意义,P均>0.05。结论急性心肌梗死患者应用琥珀酸美托洛尔缓释片或酒石酸美托洛尔片,72 h内心率降低的差异有统计学意义,但两组服药后72 h内,心率的降低程度差异无统计学意义,而且72 h内两组心率下降的趋势,差异也无统计学意义。

Objective To compare the heart rates of patients with acute myocardial infarction after taking metoprolol succinate sustained-release tablets or metoprolol tartrate tablets.Methods 76 acute myocardial infarction patients were randomly assigned to group A（n=25） and group B（n=51）.Group A were treated with metoprolol succinate sustained-release tablets 23.75 mg/d,once daily,group B were treated with metoprolol tartrate tablets 12.5 mg,twice a day.Besides,both group was treated with aspirin,clopidogrel,ACEI and statin according to clinical practice.Heart rate in resting state 0,24,48,72 h after the application were recorded respectively,and the degree and trend of decrease in heart rate were compared.Results The heart rate in group A decreased 0,1%,9% at 24,48,72 h after medication respectively,the beats decreased 0.5,1.6,7.6 beats/min at the three time points.In group B,the heart rate decreased 3%,5%,6% respectively.the beats decreased 3.5,4.1,5.7 beats/min at the three time points（P〈0.05）,there were significant differences of heart rates betroeen different time points.In the interaction between heart rate and dosage form,there was no interaction between dosage form and heart rate（P〈0.05）.There was also no significant difference in the trend of heart rats change between the two groups.Conclusion There was significant difference in the decrease of heart rate following the use of metoprolol succinate sustained-release tablets or metoprolol tartrate tablets in the first 72 h,but there was no significant difference in the degree and trend between the two groups.