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目的:观察美托洛尔联合非洛地平治疗方案对高血压并冠心病患者的心率变异性(HRV)指标及血压晨峰的影响。方法:将广州市花都区狮岭镇卫生院2014年12月至2016年12月收治的116例高血压并冠心病患者分为A、B两组,每组58例。两组均用非洛地平进行治疗,B组在此基础上加用美托洛尔。比较治疗前后两组的血压(BP)昼夜节律[收缩压(SBP)、舒张压(DBP)]、HRV指数及血压晨峰出现频率的差异。结果:治疗6周后,两组各HRV指标水平均较治疗前提高,差异具有统计学意义(P<0.05),且B组的增幅显著高于A组,差异具有统计学意义(P<0.05);昼夜血压水平及晨峰出现率则较治疗前显著下降,差异具有统计学意义(P<0.05),且B组降幅大于A组,差异具有统计学意义(P<0.05)。结论:美托洛尔合用非洛地平方案可改善高血压并冠心病患者的HRV,于控制患者的昼夜BP水平及晨峰出现率有益。
Objective: To observe the effects of metoprolol combined with felodipine on heart rate variability (HRV) and blood pressure morning peak in patients with hypertension and coronary heart disease. Methods: A total of 116 patients with hypertension and coronary heart disease admitted from December 2014 to December 2016 in Shiling Town Huadu District of Guangzhou City were divided into two groups (A and B), 58 cases in each group. Both groups were treated with felodipine, B group on the basis of the application of metoprolol. The circadian rhythm of blood pressure (SBP), diastolic blood pressure (DBP), HRV index and the peak frequency of morning blood pressure were compared between the two groups before and after treatment. Results: After 6 weeks of treatment, the HRV indexes in both groups were significantly higher than those before treatment (P <0.05), and the increase in group B was significantly higher than that in group A (P <0.05) ). The levels of diurnal blood pressure and morning peak were significantly lower than those before treatment (P <0.05), and the decrease in group B was greater than that in group A (P <0.05). Conclusion: The combination of metoprolol and felodipine can improve HRV in patients with hypertension and coronary heart disease. It is helpful to control the BP level and the incidence of morning peak in patients with hypertension.