美托洛尔对高血压病人左室肥厚和心功能的影响

The Effect of Metoprolol on Left Ventricular Hypertrophy and Cardiac Function in Patients with Essential Hypertension

对３０例原发性高血压病合并左室肥厚患者用美托洛尔降压治疗２月，应用超声心动图观察左心结构和心功能的变化．结果：１）服药２月后血压明显降低（Ｐ＜０００１），显效率８０％，６９％的病人血压完全降至正常；２）服药后ＩＶＳＴ和ＰＷＴ均显著降低，各平均降低１２４％（Ｐ＜０００１）和４１％（Ｐ＜００５）．ＬＶＭＩ降低１０６％（Ｐ＜０００１）．ＡＯＤ，ＬＡＤ，ＬＶＥＳＤ及ＬＶＥＤＤ无显著改变．多因素相关分析显示ＬＶＭＩ下降值与血压下降无关．３）服药后左室舒张功能指标Ｅｐ，Ｅｐ／Ａｐ及Ｅａｆ显著增加，而Ａａｆ和Ａａ／Ｅａ显著降低（Ｐ＜００１）．多元逐步回归分析显示左室舒张功能指标改善主要受血压下降，室壁减薄及ＬＶＭＩ降低影响，ＨＲ下降也起一定作用．左室收缩功能指标ＥＦ，ＦＳ及ＰＥＰ／ＥＴ无显著改变，ＣＯ下降１０８％（Ｐ＜００２）．表明：美托洛尔是一种安全有效的抗高血压药，降压时对ＬＶＨ有消退作用，同时对异常的舒张功能有改善作用。

In order to assess the effects of metoprolol on left ventricular hypertrophy and cardiac function in patients with essential hypertension,30 cases of hypertension patients with LVH were treated with metoprolol for 2 months,then,the left ventricular structure and cardiac function were observed by echocardiography.The results showed that:1) after metoprolol treatment,supine and standing blood pressure were significantly decreased ( P <0 01),the effective rate of metoprolol treatment was 80%.The blood pressure of 69% of all the patents reduced to normal level 2) IVST and PWT were reduced significantly by 12 4% ( P <0 001) and 4 1% ( P <0 05) respectively.IVMI was reduced by 10 6% ( P <0 001).There was no significant correlation between the degree of blood pressure decrease and left ventricular mass reduction.3) After metoprolol treatment,the indicators of left ventricular diastolic function - Ep,Ep/Ap and Eaf increaed significantly,Aaf and Aa/Ea decreased significantly.The analysis of multi-variance regression showed the indicators' improvement of diastolic function was influenced by the reduction of blood pressure and left ventricular mass.The reduction of heart rate also played a role in improvement of the diastolic function.The results suggested that metoprolol was an effective,safe and well-tolerated anti-hypertension drug.It leads to a significant regression of IVH,which is accompanied by improvement of abnormal diastolic function.