卡维地洛与卡托普利治疗轻中度高血压病的疗效及对肾脏保护作用比较

A comparison Between the Effect of Carvedilol and Captopril on Urinary Albumin,β_2-microglobulin and Blood Pressure in Hypertensive Patients

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白蛋白和 β2 -微球蛋白排泄的影响。方法 随机开放对照试验 ,1 0 5例轻中度高血压病患者进入 1 8周治疗期 ,每日服卡维地洛 2 0mg(53例 ) ,或卡托普利 37.5mg(52例 ) ,6周后血压≥ 1 4 0 / 90mmHg则剂量加倍。测量治疗前后血压、2 4小时尿微量白蛋白及 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、降尿微量白蛋白及 β2 -微球蛋白的排泄(P <0 0 5) ,两药相比 ,卡维地洛作用明显更强 (P <0 0 5)。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 ,同时它还不影响血脂及血糖代谢。

Objective To compare the effect of carvedilol and captopril on urinary albumin,urinary β 2 microglobulin and blood pressure(BP) in hypertensive patients. Methods One hundred and six patients with hypertensive were enrolled into study, 53 patients were randomized to carvedilol treatment group(20 mg/d), 52 patients to captopril treatment group(37.5 mg/d), if BP≥140/90 mmHg was remained after 6 weeks treatment, then the dose was double. Before treatment and after 18 weeks treatment, BP, urinary albumin and urinary β 2 microglobulin of patients were measured. Results Both treatment groups significantly reduced BP,the excretion rate of urinary albumin and urinary β 2 microglobulin ( P <0 05). But the treatment effect of carvedilol group was significantly better than that in captopril group( P <0 05). No change in lipoprotein and blood glucose was found. Conclusion Carvedilol has been shown a better effect on reduction of BP,urinary albumin and β microglobulin than captopril in hypertensive patients.