拉西地平治疗原发性高血压72例临床观察

目的：观察拉西地平对原发性高血压的降压疗效及其安全性。方法：72例原发性高血压患者，口服拉西地平4－8mg，共6周，不服用其他降压药物。结果：治疗6周后，患者收缩压、舒张压明显降低，与治疗前比较差异显著（P＜0．01）。治疗后心率、血生化与肝肾功能均无改变。结论：拉西地平治疗轻、中度高血压疗效好、安全可靠，且副作用小。     

针刺太冲穴治疗高血压的临床护理

目的：总结针刺太冲穴治疗高血压的疗效及护理。方法：对我科2003年9月至2006年1月针刺太冲穴治疗高血压的疗效及护理进行回顾性分析。结果：患者接受针刺太冲穴前后各时点平均收缩压、舒张压比较．收缩压平均下降约10mmHg，舒张压平均下降约6mmHg（P〈0．01）；通过严格执行操作及护理规程，使针刺不良反应减少。结论：针刺太冲穴治疗高血压配合严格执行操作及护理规程，即时降压疗效显著，起效快速，不良反应少。     

拉西地平对青年原发高血压胰岛素抵抗指数等相关参数的影响

目的 观察拉西地平对青年原发性高血压患者血压、空腹血糖(FBG)、胰岛素抵抗指数(IRI)等相关参数的影响.方法 对我院2008年1月～2009年10月55例初诊为Ⅰ～Ⅱ级青年原发性高血压者予拉西地平2～4 mg,每日1次口服,疗程8周.观察治疗前后血压、FBG、空腹血糖胰岛素(FINS)及IRI的变化.结果 本组治疗前收缩压、舒张压、FBG、FINS及IRI分别为(178.97±13.75)mmHg、(106.07±7.61)mmHg、(5.13±0.61)mmol/L、(18.52±2.38)mU/L、1.65±0.27,治疗后分别为(136.17±11.62)mmHg、(83.65±5.08)mmHg、(4.81±0.24)mmol/L、(16.88±2.14)mU/L、1.26±0.16,差异均有统计学意义(P＜0.05).结论 拉西地平在降压治疗的同时能改善高血压患者的胰岛素抵抗,是理想的抗高血压药物.     

卡维地洛对中国高血压病人的疗效及安全性观察

目的：评价卡维地洛对中国高血压病人的降压疗效及安全性。方法：按照1999年WHO高血压的诊断标准．将62例门诊高血压病人随机分为A组(卡维地洛组)42例，B组(比索洛尔组)20例，服用安慰剂2周后进行药物治疗8周．治疗前后测定血压、生化、血脂、血常规。结果：治疗后血压A组SBP下降18mmHg，DBP下降13．3minHg；B组SBP下降24．5mmHg.DBP下降20．3mmHg，两组间血压下降无显著差异。并且卡维地洛组在降低低密度脂蛋白方面优于比索洛尔组。结论：卡维地洛对中国轻、中型高血压病人使用可达到全日有效的降压效果，无明显不良反应。     

两种钙拮抗药对高血压左心室肥厚患者心率变异的影响

目的：探讨高血压左心室肥厚（ＬＶＨ）患者的心率变异性（ＨＲＶ）以及分别受不同钙拮抗药的影响。方法：高血压左心室肥厚患者７０例随机分为维拉帕米、拉西地平组（各３５例）,分别早上顿服缓释维拉帕米２４０ｍｇ至４８０ｍｇ和拉西地平４ｍｇ至６ｍｇ,疗程１２周。治疗前后测ＵＣＧ、动态血压和动态心电图,观察降压和逆转ＬＶＨ的疗效,以及分析ＨＲＶ时域指标的改变情况。结果：治疗前患者的ＨＲＶ降低;两药降低血压的幅度     

硝苯地平缓释片Ⅱ联合替米沙坦治疗原发性高血压的临床观察

目的评价原发性高血压病患者接受硝苯地平缓释片Ⅱ、替米沙坦联用治疗的高血压达标率。方法采用自身对照开放单一治疗试验设计方案。入选132例高血压病患者,均采用口服硝苯地平缓释片Ⅱ20mg,bid;替米沙坦片80mg,qd,疗程8w,观察其降压疗效及达标率。结果治疗2、4、8w后平均血压分别为144.20±11.10mmHg/91.40±5.50mmHg、140.51±10.50mmHg/88.43±6.15mmHg、128.80±9.60mmHg/83.53±5.20mmHg,分别与前一次治疗结果比较,差异均有统计学意义（P〈0.05或0.01）;至8w末时血压〈140/90 mmHg者占93.18%,达标率较高;仅有5例出现轻度头晕、头痛,3例出现轻微踝部水肿等不良反应,未影响治疗,治疗前后所有患者血糖、血脂、肝功能、肾功能及电解质、尿常规检测结果比较差异均无统计学意义（P〉0.05）。结论联用硝苯地平缓释片Ⅱ、替米沙坦降压效果满意,达标率高,且依从性好,对代谢无明显影响,不良反应少,值得基层医院临床进一步推广使用。     

穴位按压降压法治疗高血压疗效观察

目的：观察穴位按压降压法治疗高血压的疗效。方法：由康复中心的技师对所有参加高血压专病疗养的疗养员进行穴位降压按压法教授指导，每天坚持穴位按压2次，贯穿整个疗养期。结果：血压有明显变化，有效率为95．3％[收缩压（SBP）下降10mmHg为显效，收缩压（SBP）下降20mmHg或舒张压（DBP）下降5mmHg为有效]。结论：本套手法中西医结合、标本兼治、可自我操作、简便易学，具有很强的实用性，且降压缓和，无任何不良反应，适合各类高血压病患者长期练习，对养生保健、调节机能大有裨益。     

氯沙坦复方制剂治疗轻中度原发性高血压疗效观察

目的　评价复方氯沙坦的降压疗效及安全性。方法　 30例轻中度原发性高血压患者 ,每天服复方氯沙坦 1～ 2片 ,观察降压疗效和对实验室检验结果的影响 ,在治疗 1、2、4、6、8周末记录血压、心率及不良反应情况。结果　服药 1周血压即下降 ,收缩压 /舒张压由治疗前的 (15 0 0± 16 8/10 3 2± 5 6 )mmHg降至 (138 6± 13 3/93 3± 6 9)mmHg ,8周后降至 (12 9 2± 12 6 /87 4± 7 8)mmHg ,心率无明显改变 ,不良反应少。结论　复方氯沙坦每天 1次口服 ,能有效控制血压 ,作用平稳 ,不良反应少 ,服药方便     

洛汀新对轻中度高血压降压效果及安全性分析

目的 :观察洛汀新对轻中度高血压的降压效果及安全性。方法 :选择原发性高血压病人 5 8例经洛汀新治疗。结果 :治疗 8周后 ,血压由治疗前的 ( 14 3 .7± 18.7) / ( 92 .2± 10 .2 )mmHg降为治疗后的 ( 12 8.1± 15 .5 ) / ( 81.6±8.3 )mmHg。结论 :洛汀新对混合性高血压、单纯性收缩压升高及单纯性舒张压升高均有明显的降压效果 ,不良反应轻微 ,适合临床广泛应用     

尼莫通在急性脑卒中患者中的降压作用及安全性

目的:观察尼莫通静脉滴注对急性脑卒中患者的高血压的降压作用及安全性。方法:选择急性脑卒中46例,患者经脱水、镇静等常规治疗后仍有血压明显升高,治疗前平均收缩压(SBP)≥225mmHg(1mmHg=0.133kPa)和/或舒张压(DBP)≥120mmHg。以恒速输液泵持续静脉滴注尼莫通,初始剂量3ml/小时,根据血压调整输液速度,直至达到目标血压170～180/100～110mmHg后维持静滴24小时。结果:用药后30min、60min、2hr、3hr的平均血压降至218/115mmHg、205/110mmHg、198/108mmHg,188/105mmHg,4小时后达最大效应,血压为175/100mmHg,并稳定至用药结束时的173/98mmHg,未发现严重不良反应。结论:尼莫通静脉滴注对急性脑卒中患者的高血压有明显的降压作用,降压作用平稳,安全性高。     

Diltiazem for treatment of essential hypertension: a double-blind controlled study with reserpine

In a double-blind, parallel, 12-week trial, antihypertensive effects of diltiazem and reserpine were compared in 107 patients with essential hypertension. Diltiazem reduced blood pressure from 176/100 mmHg to 154/86 mmHg after 12 weeks, and reserpine reduced blood pressure from 171/96 mmHg to 155/85 mmHg. The difference between diltiazem and reserpine was not statistically significant. However, among a subset of patients given 180 mg/day of diltiazem, a significantly better antihypertensive effect was achieved than among a subset given 0.3 mg of reserpine. The incidence of side effects and complications in the diltiazem group was about one half that in the reserpine group (12.3% and 27.1%, respectively). Side effects of diltiazem were mild, and the drug was extremely well tolerated. These results show that diltiazem is an effective antihypertensive drug for the treatment of mild to moderate essential hypertension.     

Effects of enalapril in insulin-dependent diabetic subjects with mild to moderate uncomplicated hypertension

The antihypertensive efficacy of enalapril and its effects on the metabolism and kidney function were investigated in 11 insulin-dependent diabetic subjects with uncomplicated mild to moderate hypertension. During a short-term single-blind controlled trial, one daily dose of 20 or 40 mg enalapril significantly reduced both systolic and diastolic blood pressure. In the supine position, mean systolic blood pressure declined from 169 +/- 6 to 142 +/- 6 mmHg (P less than .01) and mean diastolic blood pressure from 101 +/- 1.5 to 85 +/- 2 mmHg (P less than .001). No changes in heart rate or postural hypotension were observed. During 1 yr of treatment, the antihypertensive efficacy of enalapril did not decline, and no clinical side effects were observed. Inhibition by enalapril of angiotensin-converting enzyme did not modify daily insulin requirements, glycemic control, uricemia, or lipid metabolism; kalemia and the markers of diabetic nephropathy were not significantly altered. These results suggest that enalapril once daily should be used as the first step in the treatment of diabetic patients with mild to moderate hypertension.     

多普勒超声心动图评价拉西地平对高血压患者左室肥厚的逆转作用

目的探讨拉西地平对高血压患者左室肥厚（LVH）的逆转作用。方法对53例高血压患者,在服用拉西地平治疗前,持续服药3个月后及持续服药6个月后,观察其对左室肥厚的逆转作用。结果服用拉西地平治疗3个月及6个月后,患者血压显著下降,左室肥厚逆转。结论服用拉西地平不仅能降低血压,长期服用还能逆转高血压引起的左室肥厚。     

Nicardipine hydrochloride injectable phase IV open-label clinical trial: study on the anti-hypertensive effect and safety of nicardipine for acute aortic dissection

We performed a multicentre, phase IV, open-label clinical trial to examine the clinical usefulness of a continuous infusion of nicardipine hydrochloride to control hypertension in 31 patients with acute aortic dissection. Target blood pressure levels were reached within 15 min in 16 patients; in 15-30 min in 10 patients; in 30-45 min in three patients; and in 45-60 min in two patients. Baseline average systolic, diastolic and mean arterial blood pressures were 147 +/- 23 mmHg, 82 +/- 18 mmHg and 104 +/- 18 mmHg, respectively, with third-day pressures significantly reduced at 119 +/- 12 mmHg, 69 +/- 9 mmHg and 86 +/- 8 mmHg. Blood pressures after discontinuation of the infusion were not significantly different from those measured on the third day of infusion and no definite adverse effects attributable to the treatment were observed. Nicardipine hydrochloride was both effective and safe at controlling blood pressure in patients with acute aortic dissection.     

桡动脉压迫期间血压波动对经皮冠状动脉介入治疗后患者术侧手掌肿胀的影响

目的 探讨经皮冠状动脉介入治疗 (percutaneous coronary intervention,PCI) 患者在桡动脉压迫期间血压变化与术侧手掌肿胀的关系。 方法 选取2018年5月—2020年12月入住南昌市某三级甲等综合医院冠心病病区行桡动脉PCI的患者作为研究对象,对其一般资料和压迫器解压相关指标进行回顾性分析,描述患者在桡动脉压迫期间的血压波动情况,采用单因素回归分析术侧手掌肿胀的影响因素,对患者桡动脉压迫期间血压进行节点分组,分层分析不同血压对术侧手掌肿胀的影响,进一步采用趋势回归分析术侧手掌肿胀发生最高风险时对应的血压范围。 结果 共纳入788例桡动脉PCI患者。对危险因素进行多变量分层分析发现,在有糖尿病史患者中,桡动脉压迫期间收缩压≥130 mmHg (1 mmHg=0.133 kPa) 会增加术侧手掌肿胀发生风险 (OR=1.09,P<0.001),在无论有或无心力衰竭体征和高血压史的患者中,桡动脉压迫期间收缩压>130 mmHg,两组患者术侧手掌肿胀发生风险较一致。趋势回归发现,桡动脉压迫期间平均收缩压为130~149 mmHg时,收缩压每升高10 mmHg,术侧手掌肿胀发生风险增加3.52倍[95%CI (1.37,13.22) ]。 结论 桡动脉压迫期间,患者平均收缩压为130~149 mmHg,发生术侧手掌肿胀的风险最高,建议临床护理人员在制订术侧手掌肿胀并发症预防方案时,应综合考虑患者收缩压变化的因素。     

Comparative evaluation of captopril and methyldopa monotherapy for hypertension: double-blind study in Indians

A double-blind, parallel-group study was conducted in 41 Indian men and women with hypertension to compare the antihypertensive effects of captopril and methyldopa. Twenty patients received 150 mg of captopril and 21 patients received 750 mg of methyldopa daily. The drugs were administered in three equally divided doses for four weeks. Blood pressure was measured after one, two, and four weeks of therapy. Relevant clinical and biochemical investigations were carried out before and after treatment. Sixteen patients given captopril and 11 given methyldopa responded to therapy. Among the captopril responders, initial mean systolic blood pressure (+/- SE) was 155 +/- 5.0 mmHg and diastolic blood pressure was 105 +/- 2.1 mmHg. These values were reduced to 119 +/- 9.8 and 80 +/- 6.1 mmHg, respectively, after four weeks of therapy. Similarly, among the methyldopa responders, initial mean systolic blood pressure was 180 +/- 7.4 mmHg and diastolic blood pressure was 112 +/- 3.8 mmHg. These values were reduced to 138 +/- 7.0 and 92 +/- 3.8 mmHg, respectively, after four weeks of therapy. The fall in the blood pressure in both groups was highly significant (P less than 0.001). None of the patients in either group had any clinically significant side effects. The results of this study suggest that monotherapy with captopril may be more effective than monotherapy with methyldopa in Indian hypertensives.     

佩尔地平与硝酸甘油治疗高血压急症的临床对比研究

目的　将佩尔地平和临床常用的硝酸甘油进行比较，探讨佩尔地平治疗高血压急症的疗效及其副反应。方法　共２４ 名收缩压高于２６７ ｋＰａ（２００ ｍｍＨｇ） 或舒张压高于１６０ ｋＰａ（１２０ ｍｍ Ｈｇ） 的高血压急症病人随机的接受佩尔地平或硝酸甘油静脉注射治疗，其中佩尔地平组１３ 例，硝酸甘油组１１ 例。两组均记录用药前及用药后５ 、１０ 、１５ 、３０ 、６０ 分钟时的心率和血压。以ＳＰＳＳ软件对用药前后的变化及两组间的变化值进行了比较。结果　与硝酸甘油相似，用药后５ 分钟起，佩尔地平即开始起效，用药后５ 、１０ 、１５ 、３０ 、６０ 分钟的血压较用药前均有明显的下降（ Ｐ 值均小于０００１） 。血压的变化值在两组间没有明显差异（ Ｐ 值均≥００５） 。但佩尔地平组的心率变化小于硝酸甘油组。佩尔地平组在６０ 分钟后的降压幅度为收缩压下降了２４ ％ ，舒张压下降了２５ ％ 。除１ 例出现面色潮红外，没有发现明显的副反应。结论　佩尔地平治疗高血压急症的降压效果与硝酸甘油相似，但心率变化较少。降压幅度符合ＪＮＣＶＩ的建议，是较理想的控制高血压急症的药物。     

Management of hypertension in patients with coronary artery disease

The management of hypertensive patients with coronary artery disease (CAD) should be started with lifestyle modification for reduction of coronary risk factors. As the principle of drug therapy, rapid decrease in blood pressure below the limits of coronary auto-regulation must be avoided. Clinical trials showed J-curved relationship between diastolic pressure and mortality was not found above 75 mmHg. The current desired goal of blood pressure in patients with CAD might be suggested as 125-140/85-75 mmHg. Pulse pressure should be recognized as a strong predictor for CAD as well as systolic and diastolic blood pressure, especially in elderly patients. The choice of drug therapy have to be based on efficiency in clinical trials, side effects, and also particular condition of each patient.     

拉西地平联合比索洛尔治疗老年高血压的疗效观察

目的观察拉西地平与比索洛尔联合治疗老年高血压的临床疗效。方法用药前停服其他任何降压药物1周,给予口服拉西地平4mg,1次/日,比索洛尔5mg,1次/日。两种药物根据血压情况可调整剂量至:拉西地平8毫克/日,比索洛尔10毫克/日,口服,直至血压降至正常。用药时间均连续4周。结果治疗后收缩压(140.1±12.6)mm Hg、舒张压(91.2±5.4)mm Hg、心率(63.2±5.7)次/分与治疗前(163.3±18.7)mm Hg、(108.2±7.6)mm Hg、(74.3±8.3)次/分比较差异有统计学意义(P<0.01);空腹血葡萄糖、胆固醇、三酰甘油、低密度脂蛋白胆固醇、丙氨酸氨基转移酶、血清肌酐治疗后与治疗前比较差异无统计学意义(P>0.05)。结论拉西地平与比索洛尔联合应用治疗老年高血压,在控制收缩压、舒张压、心率方面能发挥各自优势,起到协同作用。     

Hypertension in the elderly: a study of a combination of atenolol and nifedipine

The antihypertensive effects and tolerability of a once-daily, fixed combination of atenolol 50 mg and nifedipine retard 20 mg ('Nif-Ten') were monitored in a 12-month open study in 30 elderly hypertensive patients, whose blood pressure was inadequately controlled after four weeks treatment with atenolol 50 mg once daily. Sitting (and standing) blood pressure and heart rate one to four hours after dosing were recorded at entry (191/95 mmHg) and at the end of the run-in period (186/93 mmHg). After one month's therapy with the fixed combination the mean sitting blood pressure fell to 169/89 mm Hg and was maintained at this level for the entire 12-month period of observation. During the study four patients complained of side effects on fixed combination therapy with one patient withdrawn due to flushes and hot sweats. One other patient suffered flushes and hot sweats and two patients complained of mild dizziness. There were no demonstrable effects of fixed combination therapy upon the biochemical parameters measured. We conclude that the fixed combination of atenolol plus nifedipine retard was well tolerated over a 12-month period in the group of elderly hypertensive patients studied. The combination appears to exert a greater antihypertensive effect than the beta-blocker monotherapy with no evidence of tachyphylaxis, although these findings require confirmation in a controlled trial.