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目的:研究美托洛尔缓释片对原发性高血压患者心率变异性的影响。方法:94例原发性高血压患者,洗脱2周后,随机口服富马酸美托洛尔缓释片(95 mg.d-1,qd)或酒石酸美托洛尔缓释片(100 mg.d-1,qd)8周。服药前和药后8周行24 h动态心电图检查各1次,分析2组及全部患者的24 h时域和5 min频域指标。结果:2组患者药前、药后的长程时域指标和短程频域指标组间比较均无统计学差异。94例全部患者药前/药后24 h平均心率为(76.27±8.18)/(69.29±6.48)次.min-1(P<0.000 1),药后长程时域指标PNN50显著增加(5.6±4.8)ms vs(8.5±7.2)ms(P<0.000 1);短程频域指标HF增加(88.8±92.8)Hz vs(127.3±127.1)Hz(P=0.007),LF/HF明显下降(2.9±2.0)vs(2.1±2.1)(P=0.002)。结论:美托洛尔缓释片有益于原发性高血压患者心率变异性的恢复,2种不同酸根美托洛尔缓释片的作用无明显差异。
Objective: To study the effect of metoprolol sustained-release tablets on heart rate variability in patients with essential hypertension. Methods: 94 patients with essential hypertension were randomly assigned to receive metoprolol fumarate sustained-release tablets (95 mg.d-1, qd) or metoprolol tartrate sustained-release tablets (100 mg.d-1, qd) for 8 weeks. The 24 h dynamic electrocardiogram (ECG) test was performed 1 time before and 8 weeks after drug administration, and 24 h time domain and 5 min frequency domain index were analyzed in both groups and all patients. Results: There was no significant difference between the two groups in long-term and short-range frequency domain indexes before and after treatment. The mean heart rate at 24 h was (76.27 ± 8.18) / (69.29 ± 6.48) .min-1 (P <0.0001) in all 94 patients. The long-term time domain index of PNN50 was significantly increased (5.6 ± 4.8 (P <0.0001). Short-range HF increased significantly (88.8 ± 92.8) Hz vs (127.3 ± 127.1) Hz (P = 0.007) ) vs (2.1 ± 2.1) (P = 0.002). CONCLUSION: Metoprolol sustained-release tablets are beneficial to the recovery of heart rate variability in patients with essential hypertension. There is no significant difference between the two different metoprolol-modified tablets.