卡维地洛和美托洛尔治疗高血压的疗效及其对糖脂代谢影响的对比分析

Comparative Analysis on the Therapeutic Effect of Carvedilol and Metoprolol in the Treatment of Hypertension and Their Effect on Glucose and Lipid Metabolism

目的对比分析卡维地洛和美托洛尔治疗高血压的临床疗效及其对血脂和糖代谢的影响。方法选择2010年3月—2011年11月就诊于我院的78例Ⅰ、Ⅱ级原发性高血压患者为研究对象,将入组患者按照随机数字表法分为两组,分别接受卡维地洛治疗(研究组)和美托洛尔治疗(对照组),观察并对比两组患者的治疗效果、血压控制情况及治疗前后空腹血糖(Glu)、血脂、胰岛素(INS)和胰岛素敏感性指数(ISI)的变化。结果两组治疗效果间差异有统计学意义(u=4.336,P=0.173)。治疗后,两组患者收缩压和舒张压均较治疗前明显降低,差异有统计学意义(P<0.05)。治疗后,两组患者的Glu、INS、ISI、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平间差异均有统计学意义(P<0.05)。两组患者均未发现严重不良反应。结论卡维地洛降压作用与美托洛尔相似,但其对于调节血糖、血脂代谢疗效更优,更适于合并血脂、血糖代谢功能紊乱的高血压患者。

Objective To investigate the clinical curative effect of carvedilol and metoprolol in the treatment of hyper- tension and their effect on blood lipid and glucose metabolism. Methods 78 patients with stage I and stage Ⅱ primary hyperten- sion admitted to our hospital from March 2010 to November 2011 were randomly divided into carvedilol group （study group） and metoprolol group （control group） . The blood pressure control, Glu, blood lipid, INS and ISI before and after treatment were observed and compared between the two groups. Results The efficacy of the two groups showed statistically significant difference （ u = 4. 336, P = 0. 173 ） . The systolic and diastolic blood pressure of the two groups both significantly decreased after treatment （P 〈 0. 05） . The Glu, INS, ISI, TG, TC, LDL - C and HDL - C between the two groups all showed statistically significant differences after treatment （P 〈 0. 05） . No severe adverse effect was found in the two groups. Conclusion Carvedilol has similar antihypertensive effect as metoprolol, but its efficacy in the regulation of glucose and lipid metabolism is better, besides, it is more suitable for patients with hypertension and metabolic disorders of blood lipids and blood glucose.