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[高血压患者慢性β受体阻滞剂治疗后心肌肥厚的消退]

[Regression of myocardial hypertrophy in hypertensives on chronic beta-receptor block].

作者信息

Franz I W, Wiewel D, Behr M, Ketelhut R

出版信息

Dtsch Med Wochenschr. 1986 Apr 4;111(14):530-4. doi: 10.1055/s-2008-1068484.

Abstract

25 patients (24 males, 1 female; mean age 43.7 years), with previously untreated essential hypertension and echocardiographically proven left-ventricular hypertrophy, received metoprolol 200 mg daily over a period of 12.7 months, five of them additionally hydrochlorothiazide 25 mg. After four weeks, resting recumbent blood pressure had decreased from 157 +/- 18 systolic and 106 +/- 9 diastolic to 128 +/- 11 and 85 +/- 9, respectively; after 12.7 months to 123 +/- 12 and 83 +/- 8 mm Hg (P less than 0.001). On 100 W exercise the blood pressure fell from initially 206 +/- 13 and 117 +/- 9 168 +/- 12 and 97 +/- 9, after 12.7 months to 170 +/- 14 and 98 +/- 9 mm Hg. Left-ventricular mass fell from 147.0 +/- 26 g/m2 by 14% after 6.1 months, by 22.5% after 12.7 months (P less than 0.001). While the left-ventricular diameter in enddiastole and endsystole remained unchanged, septal thickness decreased from 15.5 +/- 2.1 to 14.2 +/- 2.2 mm after 6.1 months and 13.1 +/- 1.9 mm after 12.7 months (reduction of 15.5%). The corresponding values for the left-ventricular posterior wall were 11.9 +/- 1.6 before and 10.8 +/- 1.8 after 6.1 months and 10.1 +/- 1.4 mm after 12.7 months (reduction of 16%). Thus long-term administration of metoprolol resulted in a significant reduction in myocardial hypertrophy without impairment of ventricular function.

摘要

25例患者(24例男性,1例女性;平均年龄43.7岁),患有未经治疗的原发性高血压且经超声心动图证实有左心室肥厚,在12.7个月的时间里每日服用美托洛尔200毫克,其中5例还加用了25毫克氢氯噻嗪。四周后,静息卧位血压收缩压从157±18降至128±11,舒张压从106±9降至85±9;12.7个月后分别降至123±12和83±8毫米汞柱(P<0.001)。在100瓦运动时,血压最初为206±13和117±9,12.7个月后降至168±12和97±9,之后降至170±14和98±9毫米汞柱。左心室质量在6.1个月后下降了14%,从147.0±26克/平方米降至12.7个月后的22.5%(P<0.001)。虽然舒张末期和收缩末期的左心室直径保持不变,但室间隔厚度在6.1个月后从15.5±2.1降至14.2±2.2毫米,12.7个月后降至13.1±1.9毫米(减少15.5%)。左心室后壁的相应数值在6.1个月前为11.9±1.6,6.1个月后为10.8±1.8,12.7个月后为10.1±1.4毫米(减少16%)。因此,长期服用美托洛尔可显著减轻心肌肥厚,且不损害心室功能。

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