美托洛尔、比索洛尔对不同心率高血压病人心率控制及血管内皮功能的影响

Effects of Metoprolol and Bisoprolol on Heart Rate Control and Vascular Endothelial Function in Patients with Hypertension

目的探讨美托洛尔、比索洛尔对不同心率高血压病人心率控制及血管内皮功能的影响。方法选择2016年2月—2017年2月就诊于我院的高血压病人280例,根据基础心率将所有病人分为3组:A组(心率70次/min～79次/min)90例,B组(心率80次/min～89次/min)116例,C组(心率≥90次/min)74例;A组、B组、C组再随机分为美托洛尔组与比索洛尔组两个亚组。美托洛尔组与比索洛尔组分别服用美托洛尔、比索洛尔治疗。比较各亚组的心率与血管内皮功能。结果治疗前,A组、B组、C组美托洛尔组与比索洛尔组两亚组间心率、内皮素水平及一氧化氮浓度比较,差异均无统计学意义(P>0.05);治疗后,两亚组病人心率均明显下降,内皮素水平明显降低,一氧化氮浓度明显增高,差异有统计学意义(P<0.05);比索洛尔组心率与内皮素水平明显低于美托洛尔组,一氧化氮浓度明显高于美托洛尔组,差异有统计学意义(P<0.05);比索洛尔组不良反应发生率明显低于美托洛尔组,差异有统计学意义(P<0.05)。结论比索洛尔对不同心率高血压病人心率控制与血管内皮功能改善效果均优于美托洛尔,且安全性更高。

Objective To investigate the effects of metoprolol and bisoprolol on heart rate control and vascular endothelial function in patients with hypertension. Methods Two hundreds and eighty patients with hypertension in our hospital from February 2016 to February 2017 were selected,and divided into three groups by basic heart rate （HR）：group A （ n =90,HR with 70/min to 79/min）,group B （ n =116,HR with 80/min to 89/min）,and group C （ n =74,HR with more than 90/min）.Then patients in group A,group B,and group C were randomly divided into metoprolol subgroup and bisoprolol subgroup.The patients in metoprolol subgroup and bisoprolol subgroup were treated with metoprolol and bisoprolol,respectively.The heart rate and vascular endothelial function were observed. Results Before treatment,there was no significant difference in heart rate,endothelin level and nitric oxide concentration between metoprolol subgroup and bisoprolol subgroup in group A,group B and group C （ P 〉0.05）.After treatment,the heart rate in group A,group B and group C decreased significantly,endothelin level decreased significantly,and nitric oxide concentration increased significantly in metoprolol subgroup and bisoprolol subgroup in group A,group B and group C （ P 〈0.05）.The heart rate and endothelin levels in bisoprolol subgroup were significantly lower than those in metoprolol subgroup,and the nitric oxide concentration in bisoprolol subgroup was significantly higher than that in metoprolol subgroup （ P 〈0.05）.The incidence of adverse reactions in bisoprolol subgroup was significantly lower than that in metoprolol subgroup （ P 〈0.05）. Conclusion Bisoprolol is superior to metoprolol in improving heart rate control and endothelial function in hypertensive patients with different heart rate,and it has higher safety.