β受体阻滞药治疗轻中度原发性高血压的对比观察

 目的 对比观察卡维地洛与比索洛尔治疗轻中度原发性高血压的临床疗效及安全性.方法 采用随机、双盲、平行对照的研究方法,选择轻中度原发性高血压患者60例,口服安慰药2周后坐位舒张压仍在95～110 mmHg,分别随机给予卡维地洛(卡组)和比索洛尔(比组)口服治疗,每组30例,疗程为24周.如降压效果未达标,则每2周递增剂量至卡组12.5～50 mg;比组2.5～10 mg.观察诊室坐位血压及心率并记录不良反应,血生化等指标.结果 (1)两组在治疗2周时诊室血压均有所下降,在治疗6～8周末下降最明显,并维持至24周;(2)24周末卡组诊室收缩压(SBP)/舒张压(DBP)降低幅度为19.7/11.4 mmHg,比组SBP/DBP降低16.6/9.1 mmHg,各组内与治疗前相比差别具有统计学意义(P＜0.01),而组间差异无统计学意义.两组心率均在正常范围内降低,比组较卡组心率下降明显;(3)卡组和比组降压总有效率分别为93.3%和90.0%,总显效率分别为70.0%和56.7%,两组差异无统计学意义;(4)两组治疗前后血生化指标变化差别也无统计学意义.结论 不同类型β受体阻滞药治疗轻中度原发性高血压均有较好的疗效,卡维地洛降压幅度更大.两药依从性及安全性好.

Comparison of different beta-blockers in treatment of mild to moderate essential hypertension

Objective To evaluate the efficacy and safety of bisoprilol/carvedilol in patients with mild or moderate essential hypertension.Methods A randomized, double - blind, parallel - controlled study was conducted to evaluate the efficacy and safety of bisoprilol/ carvedilol in sixty outpatients with mild or moderate essential hypertension. Patients were randomly assigned to take 12.5- 50 mg carvedilol tablets once daily or bisoprolol tablets 2.5 - 10 mg once daily for 24 weeks.Every 2 weeks,the dosage was increased if there was inadequate respanse.At each of two- week visits,sitting blood pressure and heart rate were measured in triplicate,adverse effects, symptoms and signs were recorded, laboratory tests and electrocardiography were performed during the trial. Results ①The blood pressure began to decrease at the end of two weeks,markedly decreased at the end of 6-8 weeks, and maintained sure to the end of 24 week. ② The reduction of blood pressure was 19.7/11.4 mmHg in carvedilol group, and 16.6/9. 1mmHg in bisoprolol group. ③The overall effectice rates for cavedilol and b isopro!ol were 93.3 % and 90 %, respecticely. The rates of marked response were 70% and 56.7 %, respectively, but there was no significant difference between the two groups（ P 〉 0.05）. ④There were no effects on blood glucose, lipids, serum electrolytes,and hepatic and renal functions. Conclusion Both bisoprilol and carvedilol have favourable effects on delaying the progression of hypertension,and carvedilol shows better effects on preventing hypertension. Both bisoprilol and carvedilol have favourable tolerance and safety.