卡维地洛与卡托普利治疗轻中度高血压病的疗效比较

Comparative Study on Therapeutic Efficacy of Carvedilol and Captopril in Treatment of Patients with mild or moderate Grade Hypertension

目的：比较卡维地洛与卡托普利治疗轻中度高血压病的降压疗效及其对尿微量蛋白和β2－微球蛋白排泄的影响。方法：采用随机开放对照试验，105例轻中度高血压病患者进行为期18周治疗，每日服卡维地洛20mg(53例），或卡托普利37．5mg(52例），6周后血压≥140／90mmHg则剂量加倍。测量治疗前后血压、24h尿微量白蛋白及β2－微球蛋白的排泄。并比较它们之间的相互关系。结果：两组均能明显降压，降尿微量白蛋白β2－微球蛋白的排泄（P＜0．05）；两药相比，卡维地洛作用明显更强（P＜0．05）。同时，两组中血脂及空腹血糖均无明显变化。结论：卡维地洛治疗轻中度高血压病是一种有效、安全、同时减少尿白蛋白和β2－微球蛋白排泄，对肾脏具有保护作用的较理想降压药，同时它还不影响因脂及血糖代谢。

ObjectiveTo compare the hypotensory efficacy of carvedilol and captopril and their effects on urinary excretion of trace albumin and microglobulin in the treatment of patients with mild or moderate grade hypertension.MethodsOne hundred and five patients with mild or moderate grade hypertension were treated for 18 weeks. Fifty-three patients out of them were randomized to carvedilol group (treated by 20mg/d); while other 52 patients to captopril group (37.5mg/d).If blood pressure (BP)>140/90 mmHg was detected 6 wks after treatment, then the dosage was doubled. Their BP and urinary excretion of trace albumin and microglobulin within 24 hours were measured before and 18 wks after treatment. The correlations among these parameters were also compared. ResultsBP and urinary excretion rate of trace albumin and microglobulin were significantly lowered in both groups (P<0.05), but therapeutic efficacy of carvedilol was prominently better than that of captopril (P<0.05). Fasting blood levels of lipoprotein and glucose in both groups showed no distinct changes.ConclusionsCarvedilol is a hypotensor better than captopril, displaying efficacy and safety in treatment of mild or moderate grade hypertension. It can decrease the urinary excretion of albumin and microglobulin, protect the renal function and does not affect metabolism of blood lipoprotein and glucose.