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[长期心脏选择性和非心脏选择性β受体阻滞剂对血压、氧摄取及碳水化合物代谢的影响。高血压患者的测力计研究(作者译)]

[The influence of a long-term cardioselective and noncardioselective beta-receptorblockade on blood pressure, O2-uptake and carbohydrate metabolism. Ergometric investigations in hypertensive patients (author's transl)].

作者信息

Franz I W, Lohmann F W

出版信息

Z Kardiol. 1979 Jul;68(7):503-9.

PMID:473853
Abstract
  1. In 9 male hypertensives the influence of a long-term cardioselective (200 mg Metoprolol) and non-cardioselective (15 mg Pindolol) beta-receptor blockade on the blood pressure, O2-uptake and carbohydrate metabolism was investigated at rest and during a short (6 min, 100 Watt), long (30 min under steady-state conditions with a heart rate of 130/min) and maximal ergometric work and 5 min after that. 2. In this cross-over trial the blood pressure was reduced significantly (p less than 0.01) and in an identical manner by both beta-receptor blockers. 3. Though there was a significant (p less than 0.01) reduction of the heart rate of 26% by Metoprolol (M) and of 21.2% by Pindolol (P), the O2-uptake during submaximal work was unchanged under P with 1.66 +/- 0.4 l/min and under M with 1.7 +/- 0.44 l/min in comparison with the control (C) of 1.71 +/- 0.38 l/min. The maximal O2-uptake was insignificantly reduced by Pincolol (C 2.51 l/min; M 2.46 l/min; P 2.11 l/min). 4. Only under Pindolol we found in all patients a marked and insignificant (p less than 0.01) drop of the blood sugar level in the 30th min of ergometric work (C 76.2 +/- 11; M 72.6 +/- 9; P 55.3 +/- 11 mg/dl), under maximal work (C 74 +/- 12; M 73.2 +/- 10; P 54.2 +/- 11 mg/dl) and 5 min after (C 83.6 +/- 11; M 87.6 +/- 15; 69 +/- 19 mg/dl). 5. The lactic acid level showed under both beta-receptor blockers the same tendency to decrease. 6. The drop of the blood sugar to hypoglycemic values is due to an impaired glycogenolysis in the skeletal muscles and implies a considerable reduction of the physical capacity. Therefore the cardioselective beta-receptor blocker Metoprolol is recommended especially for the treatment of young hypertensives and for all patients who need their physical fitness in order to achieve their work or to perform a preventive and rehabilitative training.
摘要
  1. 对9名男性高血压患者,研究了长期使用心脏选择性(200毫克美托洛尔)和非心脏选择性(15毫克吲哚洛尔)β受体阻滞剂在静息状态、短时间(6分钟,100瓦)、长时间(稳态条件下30分钟,心率130次/分钟)和最大运动负荷以及运动后5分钟时对血压、氧摄取和碳水化合物代谢的影响。2. 在这项交叉试验中,两种β受体阻滞剂均能显著降低血压(p<0.01),且降低方式相同。3. 虽然美托洛尔(M)使心率显著降低(p<0.01)26%,吲哚洛尔(P)使其降低21.2%,但与对照组(C)的1.71±0.38升/分钟相比,次最大运动时吲哚洛尔组的氧摄取量为1.66±0.4升/分钟,美托洛尔组为1.7±0.44升/分钟,无变化。吲哚洛尔使最大氧摄取量略有降低(C组2.51升/分钟;M组2.46升/分钟;P组2.11升/分钟)。4. 仅在吲哚洛尔治疗时,我们发现所有患者在运动负荷30分钟时血糖水平显著且无统计学意义地下降(p<0.01)(C组76.2±11;M组72.6±9;P组55.3±11毫克/分升),在最大运动负荷时(C组74±12;M组73.2±10;P组54.2±11毫克/分升)以及运动后5分钟时(C组83.6±11;M组87.6±15;P组69±19毫克/分升)。5. 两种β受体阻滞剂治疗下乳酸水平均呈现相同的下降趋势。6. 血糖降至低血糖值是由于骨骼肌糖原分解受损,这意味着体力显著下降。因此,心脏选择性β受体阻滞剂美托洛尔尤其推荐用于治疗年轻高血压患者以及所有需要保持身体健康以完成工作或进行预防和康复训练的患者。

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