卡维地洛与美托洛尔治疗原发性高血压的疗效比较及对血管内皮功能的影响

Efficacy of carvedilol and metoprolol for treatment of primary hypertension and their effects on vascular endothelial function

目的 探讨卡维地洛与美托洛尔治疗原发性高血压的疗效及对血管内皮功能的影响.方法 选取70例中轻度原发性高血压患者,其中采用卡维地洛35例（卡维地洛组）及美托洛尔治疗35例（美托洛尔组）.比较两组患者治疗前后血压变化和血浆NO、降钙素基因相关肽（CGRP）、内皮素-1（ET-1）水平的变化,观察两组不良反应情况.结果 与治疗前比较,两组患者治疗后收缩压（SBP）和舒张压（DBP）均显著降低（P＜0.05）,两组间SBP和DBP的差异无统计学意义（P ＞0.05）.卡维地洛组患者治疗后血浆NO和CGRP水平均显著升高,而ET-1水平则显著降低,差异均有统计学意义（均P＜0.05）;与美托洛尔组比较,卡维地洛组NO、CGRP及ET-1水平变化更为明显,差异有统计学意义（P＜0.05）.两组均未发生明显不良反应.结论 卡维地洛与美托洛尔均可有效降低血压,卡维地洛还能明显改善血管内皮功能.

Objective To investigate the efficacy of carvedilol and metoprolol for treatment of primary hypertension and their effects on vascular endothelial function. Methods Seventy patients with primary hypertension were randomly assigned to receive carvedilol （group A, n=35） or metoprolol （group B, n=35） treatment. Changes of blood pressure and plasma nitrogen monoxide（NO）, calcitonin-gene-related peptide（CGRP） and endotheline-1 （ET-1） levels were measured before and after treatment and adverse reactions were observed. Results The systolic and diastolic blood pressures （SBP and DBP） of two groups were significantly reduced after treatment （P〈0.05）; there were no significant differences in decreasing scale of SBP and DBP between two groups （P 〉0.05）. The plasma NO and CGRP levels of group A increased significantly, while ET-1 level decreased after treatment（P〈0.05）; the extend of these changes in group A was more markedly than that in group B（P〈0.05）. No significant adverse reactions were observed in both groups. Conclusion Both carvedilol and metoprolol can decrease blood pressure effectively, and carvedilol can significantly improve vascular endothelial function.