不同剂量美托洛尔联合胺碘酮对轻中度高血压患者颈动脉内膜中层厚度的影响

The carotid intima-media thickness effects of different doses of Metoprolol combined with Amiodarone for patients with mild to moderate hypertension

目的 探讨不同剂量美托洛尔联合胺碘酮对轻中度高血压患者颈动脉内膜中层厚度的影响.方法 选择2012年8月到2015年2月在我院进行诊治的轻中度高血压患者120例,根据随机抽签原则分为治疗组与对照组,各60例.对照组给予小剂量美托洛尔联合胺碘酮治疗,治疗组给予大剂量美托洛尔联合胺碘酮,治疗2个月.结果 治疗组的美托洛尔每天平均剂量为（77.33±10.34）mg,对照组为（23.09±8.92）mg.治疗组与对照组的治疗总有效率分别为98.3％和86.7％,治疗组的治疗总有效率明显高于对照组（P＜0.05）.治疗后两组患者的收缩压、舒张压、LVEDD和LVESD值都明显下降,治疗后治疗组的收缩压、舒张压、LVEDD和LVESD值均明显低于对照组（P＜0.05）.治疗后治疗组与对照组的颈动脉内膜中层厚度分别为（0.87±0.32）mm和（1.21±0.45）mm,都明显低于治疗前的（1.88±0.41）mm和（1.84±0.54）mm（P＜0.05）,组间对比差异有统计学意义（P＜0.05）.结论 相对于小剂量,大剂量美托洛尔联合胺碘酮治疗对轻中度高血压患者能更加有效发挥降压作用,促进心功能恢复,降低颈动脉内膜中层厚度,从而提高总体治疗效果.

Objective To investigate the effects of different doses of Metoprolol combined with Amio- darone on carotid intima-media thickness for patients with mild to moderate hypertension. Methods From August 2012 to February 2015 in our hospital, 120 patients with mild to moderate hypertension were equally divided into the treatment group and the control group randomly. The control group were given small dose of Metoprolol com- bined with Amiodarone therapy, and the treatment group received large dose of Metoprolol combined with Amio- darone. Results The average daily doses of Metoprolol in the treatment group and the control group were （77.33± 10.34）rag and （23.09±-8.92）mg, while the treatment group and the control group total effective rate were 98.3% and 86.7% respectively and the treatment group has higher total effective rate （P〈0.05）. After treatment, the sys- tolic and diastolic blood pressure, LVEDD and LVESD values were significantly decreased, while systolic and di- astolic blood pressure, LVEDD and LVESD values in the treatment group after treatment were significantly lower than the control group （P〈0.05）. The carotid intima-media thickness after treatment group and the control group were （0.87±0.32）mm and （1.21±0.45）mm that were significantly lower than before treatment （1.88±0.41）ram and （1.84±0.54）mm （P〈0.05）, while groups compared between were statistically significant differences （P〈0.05）. Conclusion Compared with low-dose, large dose of Metoprolol combined with Amiodarone in patients with mild to moderate hypertension can play a more effective role in reduce high blood pressure, promote the recovery of car- diac function, help reduce carotid intima-media thickness, thereby improve overall treatment efficacy.