非洛地平与倍他乐克联用对高血压病心肌缺血的疗效观察

Effects of Felodipine Combination with Metoprolol in Hypertensive Patients with Myocardial Ischemia

目的：观察非洛地平与倍他乐克联用对高血压病伴心肌缺血的疗效。 方法：对 ３２ 例高血压病伴心肌缺血患者运用踏车心电图运动试验观察比较应用非洛地平与倍他乐克联用的疗效，运用 ２４ 小时动态心电图和动态血压同步监测客观评价联用的效果。 结果：踏车心电图运动试验显示非洛地平和倍他乐克联用后进一步使总运动时间延长 １６％ ， Ｓ Ｔ段最大压低深度减少 ２０％ ；最大工作负荷下降 １１％ （ Ｐ＜ ０．０５～０．００１）；联合用药后 ２４ 小时动态心电图监测显示 Ｓ Ｔ段压低总时间减少 ６７％ ，最大压低深度减少 ４６％ ，复杂室性心律失常发生率减少 ２６％ ，平均心率减低 １４％ （ Ｐ＜ ０．０１～０．００１）；２４ 小时动态血压监测显示具有良好的降压作用和谷峰比值。 结论：两药联合应用有良好降压作用和更好的抗心肌缺血效应。

Aim:To assess the therapeutic effects of felodipine combinated with metoprolol in essential hypertensive patients with myocardial ischemia. Methods:Thirty two patients were subjected to exercise ECG, 24 hour Holter and ambulatory blood pressure monitory(ABPM) before and after felodipine metroprolol combination therapy.\ Results:Exercise ECG indicated that after treatment,the total exercise time was prolonged by 16%,maximal ST segment depression and maximal workloads decreased by 20% and 11 % ( P <0.05～0.001). It was demonstrated by 24 hour Holter monitory that total time of ST segment depression, maximal ST segment depression, complex premature ventricular contracts and average heart rate decreased by 67%, 46%,26% and 14% after the combination therapy (P <0.01～0.001),respectively. The results of ABPM also demonstrated that combination therapy had a satisfactory anti hypertensive effecacy and trough to peak(T/P) ratio. Conclusion:Excellent anti hypertensive and anti ischemic efficacy was demonstrated after felodipine and metroprolol combination therapy.