两种β阻滞剂治疗轻、中度原发性高血压的比较

目的:比较国产卡维地洛与柳胺苄心定治疗轻、中度原发性高血压患者的降压疗效和安全性.方法:轻中度原性高血压患者50例,随机分为卡维地洛组(n=25)与柳胺苄心定组(n=25),分别口服卡维地洛10 mg bid ,柳胺苄心定50 mg bid (均8AM与8PM).治疗2 周后卡维地洛组9例与柳胺苄心定组4例因血压降低不满意(舒张压>90 mmHg)而分别增加剂量到 20 mg和100 mg bid.共观察 4 周.结果:卡维地洛组舒张压下降11.2±6.7 mmHg(P<0.01),收缩压下降6.9±16.2 mmHg.柳胺苄心定组舒张压下降1.1±6.2 mmHg(P<0.01).卡维地洛组总有效率88%与柳胺苄心定组84%相似.两组用药前后心率、血糖及血清胆固醇、甘油三酯均无明显变化;卡维地洛组HDL虽明显下降,但仍在正常范围内,不良反应少.结论:国产卡维地洛治疗高血压的疗效与对照药柳胺苄心定相似,其疗效确切,不良反应少,耐受性好.     

卡维地洛与柳安苄心定治疗原发性高血压的对比研究

目的比较卡维地洛(山东齐鲁制药厂)与柳安苄心定(江苏溧阳制药厂)治疗原发性高血压的疗效和安全性.方法60例原发性高血压患者随机分为卡维地洛组(C组,n=30)和柳安苄心定组(L组,n=30).C组给予卡维地洛20～40mg/d;L组给予柳安苄心定100～200mg/d,疗程均为4周.治疗前后分别作血尿常规、血生化及心电图检查;C组10例患者作24h动态血压监测.结果C组与L组的降压有效率分别为73.3%和80%,无明显差异(P＞0.05);不良反应均较少.C组10例作24h动态血压监测的收缩压、舒张压、平均动脉压的谷峰比率值仅为28.3%、36.4%、33.3%.结论卡维地洛是安全、有效的降压药.     

卡维地洛与柳安苄心定治疗原发性高血压的对比研究

目的:比较卡维地洛(山东齐鲁制药厂)与柳安苄心定(江苏溧阳制药厂)治疗原发性高血压的疗效和安全性。方法:60例原发性高血压患者随机分为卡维地洛组(C组,n=30)和柳安苄心定组(L组,n=30)。C组给予卡维地洛20～40mg/d;L组给予柳安苄心定100～200mg/d,疗程均为4周。治疗前后分别作血尿常规、血生化及心电图检查;C组10例患者作24h动态血压监测。结果:C组与L组的降压有效率分别为73.3％和80％,无明显差异(P>0.05);不良反应均较少。C组10例作24h动态血压监测的收缩压、舒张压、平均动脉压的谷峰比率值仅为28.3％、36.4％、33.3％。结论:卡维地洛是安全、有效的降压药。     

美托洛尔与卡维地洛在慢性心力衰竭中耐受性的比较

目的 :探讨美托洛尔与卡维地洛在慢性心力衰竭中的耐受性。方法 :186例慢性心力衰竭患者随机分成美托洛尔组与卡维地洛组 ,在常规抗心力衰竭治疗基础上从小剂量开始逐渐加用美托洛尔与卡维地洛 ,直至目标剂量维持。结果 :美托洛尔组平均维持剂量为 (81.1± 33.5 )mg/d ,坚持维持量者 80例 (84 .2 % ) ,卡维地洛组平均维持剂量为 (34.9± 14 .6 )mg/d ,坚持维持量者 78例 (85 .7% ) ,卡维地洛组较美托洛尔组更易达最大靶剂量 (5 8.2 %∶2 .1% ,P <0 .0 1) ,且剂量调整时间短 [(31.6± 9.4 )d∶(4 6 .7± 17.2 )d ,P <0 .0 1]。美托洛尔组降低心率 (16 .2± 3.5 )次 /min ,卡维地洛组为 (13.8± 4 .1)次 /min(P <0 .0 1)。美托洛尔组降低收缩压 (12 .9± 3.7)mmHg(1mmHg =0 .133kPa) ,舒张压 (6 .7± 2 .6 )mmHg ,卡维地洛组分别为 (14 .4± 4 .1)mmHg和 (7.9± 2 .9)mmHg (P <0 .0 5 )。结论 :慢性心力衰竭患者对美托洛尔和卡维地洛都具有良好的耐受性 ,美托洛尔对心率的影响较大 ,而卡维地洛对血压的影响较大 ,卡维地洛比美托洛尔更易达到最大靶剂量 ,且剂量调整时间短     

氨氯地平和依那普利对老年纯收缩期高血压患者动态血压的影响

目的　比较氨氯地平和依那普利对老年纯收缩期高血压患者的 2 4h动态血压的影响。方法　将 6 0例轻中度纯收缩期高血压老年患者随机分为两组 ,每组 30例。分别选用氨氯地平片 5mg和依那普利片 10mg ,每日一次 ,共 4周。用药前后进行 2 4h动态血压监测。结果　两组药物治疗第 4周末 2 4h动态血压发现 ,2 4h平均收缩压、脉压、舒张压、平均动脉压均较服药前明显降低 ,统计学上有显著性差异。氨氯地平组治疗后总体收缩压和舒张压分别下降 17.0 3± 8.5 5mmHg和 4 .83± 4 .82mmHg ;平均动脉压下降了 8.86± 4 .76mmHg ,依那普利组治疗后总体收缩压和舒张压分别下降 14 .30± 7.2 6mmHg和 5 .97± 2 .87mmHg ,平均动脉压下降了 8.74± 3.0 7mmHg ,组间比较收缩压下降幅度无差异 (P =0 .187) ,脉压下降幅度有统计学意义 (P =0 .0 0 5 )。氨氯地平组脉压差下降幅度大于依那普利组 (16 .97± 14 .0 6mmHg比 8.33± 7.84mmHg ,P =0 .0 0 5 ) ,两药对舒张压的影响组间比较无统计学差异。两组有效率相似 (76 .7%比 73.3% ,P =0 .76 6 ) ,达标率的差异无统计学意义 (6 6 .7%比 5 6 .7% ,P =0 .4 2 6 )。氨氯地平组发生胫前水肿 2例 ,依那普利组咳嗽 5例。结论　氨氯地平与依那普利对老年纯收缩期高血压均有效 ,尤其     

卡维地洛治疗顽固性高血压的长期临床随访研究

目的探讨卡维地洛治疗顽固性高血压的临床疗效和安全性.方法采用随机入选其他药物治疗无效或疗效欠佳的高血压患者共48例,其中男性26例,女性22例,平均年龄57.2±9.4岁(24～67岁).结果服药4周后卡维地洛总有效率%,收缩压和舒张压分别由治疗前168.8±21.1mmHg,109.3±14.0mmHg降至治疗后137.9±11.2mmHg,89.8±8.7mmHg,心率从治疗前77.5±14.8次/分降至66.7±7.2次/分;服药8周后卡维地洛总有效率91.7%,收缩压和舒张压分别降至治疗后134.1±10.5mmHg,85.3±7.6mmHg,心率平均为65.4±6.9次/分.有效病例继续服药至24周.卡维地洛治疗后使收缩和舒张负荷均有下降,与用药前有显著的差别;无严重的不良反应.结论卡维地洛是一种安全和有效的治疗顽固性高血压的药物.     

正常高值血压人群动脉弹性功能的变化

目的　观察正常高值血压人群大小动脉弹性功能指数C1、C2的变化。方法　本研究分三组 ,(1)正常血压组 :收缩压 (SBP) <130mmHg ,且舒张压 (DBP) <85mmHg ,入选 72例 ,男 37例 ,女 35例 ;(2 )正常高值血压组 :SBP130～139mmHg和 /或DBP85～ 89mmHg ,入选 6 0例 ,男 31例 ,女 2 9例 ;(3)高血压组 :SBP≥ 14 0mmHg和 /或舒张压≥ 90mmHg ,入选 6 3例 ,男 31例 ,女 32例。采用HDICVProfilorDO - 2 0 2 0动脉功能检测仪测定大小动脉弹性功能指数C1、C2。结果　正常高值血压人群的C1、C2比正常血压组低 (C1:11 9± 3 4VS 15 3± 4 5 ;C2 :4 0± 2 1VS 5 6± 2 6 ) ,P <0 0 1;比高血压组高 (C1:11 9± 3 4VS 9 4± 3 1;C2 :4 0± 2 1VS 2 8± 1 3) ,P <0 0 1。C1、C2与血压呈负相关 ,即随着血压的升高而下降。结论　正常高值血压人群的动脉弹性功能下降 ,与血压水平呈负相关 ,随着血压的升高而降低     

卡维地洛治疗轻中度高血压的临床疗效观察

目的 :观察卡维地洛治疗轻、中度原发性高血压 (EH)的疗效及安全性。方法 :以倍他乐克作为对照 ,对 85例EH患者进行为期 8周的服药观察。经 2周安慰剂冲洗期后随机分组 ,治疗组给予卡维地洛 10mgbid ,服药 2周末血压下降未达有效标准者增加至 2 0mgbid ,疗程共 8周。对照组给予倍他乐克 2 5mgbid ,服药 2周末血压下降未达有效标准者增加至 5 0mgbid ,疗程共 8周。 结果 :与用药前相比 ,两组用药后 2～ 8周的血压均较用药前明显下降 (P <0 .0 5 )。卡维地洛降压总有效率 80 .1% ,显效率 6 1.4 % ;对照组总有效率 76 .3% ,显效率 5 3.7% ,两组疗效比较 ,差异无显著性意义 (P >0 .0 5 )。卡维地洛服药前、后患者肝肾功能、空腹血糖、血脂、血常规、尿常规、心电图均无明显改变 (P >0 .0 5 ) ,不良反应轻 ,心动过缓、头晕、乏力各 1例。结论 :卡维地洛治疗轻、中度EH有效且安全性良好。     

柳胺心定和依那普利单一疗法对老年高血压疗效比较

老年高血压的特征是总外周血管阻力增加,心排血量和肾血流量减少,血浆肾素活性下降。α_1和β受体阻滞剂柳胺心定,降低外周血管阻力和血压,对老年高血压有效。血管紧张素转换酶(ACE)抑制剂依那普利,也降低外周血管阻力和血压,对老年高血压同样有效。 79例高血压,男51、女28例,年龄62～79岁。安慰剂治疗4周后,随机口服柳胺心定100～200mg每日2次(39例)、或依那普利5～40mg每日1次(40例)。治疗8周后作24小时动态血压监测。结果发现,两药皆能明显降压(P<0.01)。治疗结束时,柳胺心定组心率减慢7次/分(P<0.01),依那普利组则无明显变化,前者的有效抗高血压剂     

国产尼卡地平治疗高血压急症的疗效观察

目的观察静脉注射尼卡地平对高血压急症的疗效。方法选择45例高血压住院患者使用静脉注射尼卡地平治疗,并记录0·5、1、2、4、6、12h血压和心率。结果45例中除1例不能耐受退出外,44例患者在0·5h内血压明显下降,收缩压由(191·0±11·5)mmHg降至(164·5±9·6)mmHg(P<0·01),舒张压由(110·0±7.5)降至(96·9±12·5)mmHg(P<0·01),显效率100%,副作用少见。结论静脉注射尼卡地平降低血压疗效肯定,使用安全,简单。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

Preservation of the pylorus in resection of the head of the pancreas

Pylorus preservation has been advocated to decrease the morbidity associated with the classical or standard pancreaticoduodenectomy. The proposed advantages are decreased incidence of peptic ulceration, dumping syndrome, and nutritional problems. However, after an initial period of enthusiasm for the procedure, it is now being found that marginal ulceration at the duodenojejunal anastomosis is encountered with increasing frequency. Delay in gastric emptying occurs frequently, with an overall incidence of 30%. With the availability of better pancreatic enzyme supplements, the current incidence of nutritional problems and weight loss after the standard Whipple procedure is unknown. Whether there is a difference in long-term survival after the two procedures performed for adenocarcinoma of the head of the pancreas is still debatable. A controlled trial is needed to answer many of these questions, and pylorus-preserving pancreaticoduodenectomy should be used cautiously until further data become available.     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.