肥胖、糖脂代谢障碍对美托洛尔降压疗效的影响

The Influence of Obesity and Disorder of Glucolipide Metabolism on Antihypertensive Effect of Metoprolol

目的探讨肥胖、糖脂代谢障碍对选择性β1肾上腺素能受体阻滞剂美托洛尔降压疗效的影响。方法筛选血压分级为1级或2级的原发性高血压患者300例,给予美托洛尔治疗8周,根据血压的降低判断其疗效,并分析肥胖或中心性肥胖、糖尿病和高脂血症对美托洛尔疗效的影响。结果肥胖或中心性肥胖、糖脂代谢障碍可显著影响美托洛尔的降压疗效,正常体质指数组的降压有效率(68.4%)均高于超重组(47.4%)和肥胖组(39.4%),非中心性肥胖组的有效率(62.8%)也高于中心性肥胖组(46.6%),高脂血症和糖尿病对疗效的影响有性别差异。Logsitic回归分析发现,体质指数是对美托洛尔疗效影响最大的因素。结论肥胖、糖脂代谢障碍可影响美托洛尔的降压疗效,后者对男性影响更大。

Aim To determine whether obesity and glucolipide metabolism could influence the antihypertensive effect of selective β1 adrenergic receptor blocker, metoprolol. Methods 300 Patients with 1 or 2 grade essential hypertension were enrolled and treated with metoprolol for 8 weeks, with analysis of the relationship between total effective rate rate and obesity or centre obesity, diabetes mellitus and hyperlipoidemia. Results Patients with normal body mass index had greater effective rate of metoprolol treatment than patients who were overweight or obesity, patients without centre obesity had greater effective rate than the ones with centre obesity, and sex difference existed in the influence of diabetes mellitus and hyperlipoidemia to metoprolol treatment (P<0.05). Body mass index were the most influential factors to effect of metoprolol through Logistic analysis. Conclusion Obesity or centre obesity, diabetes mellitus and hyperlipoidemia were related with antihypertensive treatment of metoprolol, specifically in men.