卡维地洛对大动脉弹性的影响

Influence of carvedilol on large artery elasticity

目的:探讨卡维地洛对大动脉弹性的影响。方法:入选经血管紧张素转换酶抑制剂、血管紧张素受体拮抗剂、钙拮抗剂或噻嗪类利尿剂使血压达到160/90mmHg以下的原发性高血压病人96例,随机分为卡维地洛组(50例,每日口服卡维地络6.25mg,1次/d,并根据每月随访情况逐渐加量至25mg,2次/d)和常规治疗组(46例,给予常规治疗)。收集所有病例有关临床资料,于治疗前、后6个月内随访测量血压、心率、颈-股动脉脉搏波传导速度(c-fPWV),监测血脂和血糖。结果:治疗后卡维地洛组血压、脉压、c-fPWV较治疗前明显下降(P均<0.05～<0.01),常规治疗组无明显差异(P>0.05);与常规治疗组比较,卡维地洛组治疗后收缩压[(140.63±17.22)mmHg比(127.21±17.02)mmHg]明显降低,c-fPWV值明显减小[(13.65±4.81)m/s比(11.78±5.15)m/s],P<0.05。结论:在经过治疗血压控制稳定的患者再加用卡维地洛可进一步降低血压并能更有效地改善高血压患者的动脉弹性,同时具有很好的安全性。

Objective： To study influence of carvedilol on large artery elasticity. Methods： A total of 48 patients with essential hypertension, whose blood pressure were 〈160/90mmHg after treatment with angiotensin converting enzyme inhibitor, angiotensin II receptor blocker, calcium channel blocker or thiazide diuretics, were randomly divided into carvedilol group （n = 25, received carvedilol 6.25mg oral, once a day, and the dose gradually increased to 25mg, twice a day according to results of monthly follow up） and routine treatment group （n=23, received routine treatment）. Relative clinical data of all cases were collected. Blood pressure, heart rate, carotid-femoral artery pulse wave velocity （c-fPWV） were measured, blood lipids and blood glucose were monitored in all cases before and six months after treatment. Results： Compared with before treatment, there were significant decrease in blood pressure, pulse pressure and c-fPWV in carvedilol group after treatment （P〈0.05-〈0.01 all）, but there were no significant difference in routine treatment group （P〉0.05） ; compared with routine treatment group, there were sig- nificant decrease in systolic blood pressure [ （140.63 ± 17.22） mmHg vs. （127.21 ± 17.02） mmHg], and c-fPWV [ （13.65 ± 4.81） m/s vs. （11.78± 5.15） m/s] in carvedilol group after treatment, P〈0. 05 all. Conclusion： When blood pressure is well controlled after treatment, patients with essential hypertension additionally receive carvedilol can further decrease blood pressure and improve artery elasticity, and it possesses good safety.