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目的比较培哚普利和美托洛尔对轻中度高血压病患者中心动脉压与肱动脉压的影响。方法在冠状动脉造影结束后,分别同步测量145例高血压病或(和)冠心病患者升主动脉根部(直接测量法)和肱动脉(袖带加压法)的血压,其中单药降压治疗二周以上的轻中度高血压病患者分为培哚普利组(4mg/d,62例)、美托洛尔组(25mg/d,39例)。结果升主动脉收缩压高于袖带加压法测量的肱动脉收缩压9.6mmHg(P<0.01),升主动脉舒张压低于袖带加压法肱动脉舒张压2.0mmHg(P<0.01),升主动脉脉压较肱动脉脉压大11.6mmHg(P<0.01)。虽然培哚普利组和美托洛尔组袖带加压法测得的肱动脉压相同,但是培哚普利组的升主动脉收缩压低于美托洛尔组(P<0.05)。结论升主动脉压与袖带加压法测得的肱动脉压差异有非常显著意义。虽然培哚普利和美托洛尔降低肱动脉压效果相似,但培哚普利降低升主动脉收缩压较美托洛尔更显著。
Objective To compare the effects of perindopril and metoprolol on central and brady-arterial pressure in patients with mild to moderate essential hypertension. Methods After the end of coronary angiography, the blood pressure of the ascending aortic root (direct measurement method) and the brachial artery (cuff pressure method) in 145 patients with essential hypertension or (or) coronary heart disease were measured simultaneously. Patients with mild to moderate hypertension who were treated for more than two weeks were divided into perindopril group (4 mg / d, 62 cases) and metoprolol group (25 mg / d, 39 cases). Results The systolic blood pressure of ascending aorta was higher than brachial systolic pressure 9.6mmHg (P <0.01) measured by cuff pressure method, diastolic blood pressure of ascending aorta was lower than brachial artery diastolic pressure 2.0mmHg (P <0.01) Ascending aortic pulse pressure brachial artery pulse pressure greater than 11.6mmHg (P <0.01). Although the brachial artery pressure measured by cuff pressure was the same in both the perindopril group and the metoprolol group, the systolic pressure in the ascending aorta of the perindopril group was lower than that of the metoprolol group (P <0.05). Conclusions The difference of brachial artery pressure measured by ascending aortic pressure and cuff pressure is very significant. Although the effects of perindopril and metoprolol on lowering brachial artery pressure were similar, lowering of aortic systolic pressure by perindopril was more pronounced than that of metoprolol.