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1.
王建飞  李天德 《中国基层医药》2006,13(12):1937-1939
目的 观察洛汀新加用两种不同剂量螺内酯对慢性心力衰竭患者心室重塑、TNF-α、血管紧张素Ⅱ(AngⅡ)、醛固酮(Ald)及射血分数(EF)等的影响。方法 心功能Ⅲ-Ⅳ级心力衰竭患者90例,随机分为洛汀新10mg(A组)、洛汀新10mg加螺内酯20mg(B组)、洛汀新10mg加螺内酯40mg(C组)三组,治疗12周,测定治疗前后TNF-α、Ald、AngⅡ、左房直径(LA)、左室舒张末直径(LVEDD)、左室舒张末容积(LVEDV)及EF值的变化。结果 (1)三组TNF-α、Ald、AngⅡ、LA、LVEDD、LVEDV均较治疗前降低(P〈0.01)。(2)心室重塑及EF得到一定改善,EF较治疗前升高(P〈0.01)。(3)C组疗效优于A、B两组。结论 重度心衰患者在常规应用洛汀新的基础上加用螺内酯可通过进一步降低TNF-α、Ald、AngⅡ水平而明显改善心室重塑及EF值,且在小范围内有一定剂量依赖性。  相似文献   

2.
蒲艳  冉迅  吴立荣 《贵州医药》2008,32(2):119-121
目的探讨慢性心力衰竭患者循环细胞因子水平及萘哌地尔干预的影响。方法采用放免法检测47例心力衰竭患者(CHF组)及10例健康者(对照组)血TNF-α、IL-1、IL-6水平,同时用多普勒超声心动图测定左室射血分数(LVEF)。然后将47例心力衰竭患者随机分为两组:常规治疗组(A组)入选24例,给予常规抗心力衰竭治疗;萘哌地尔治疗组(B组)入选23例,在A组药物治疗的基础上加服萘哌地尔50mg,每日2次,共1个月。1个月后重复上述检查。结果(1)心力衰竭患者血TNF-α、IL-1、IL-6水平显著高于对照组(P<0.01)。(2)A组和B组治疗后与治疗前比较血TNF-α、IL-1、IL-6均显著降低;(3)B组治疗后和A组治疗后比较,TNF-α进一步降低(P<0.05),NYHA分级进一步改善P<0.05),而IL-1、IL-6水平下降和LVEF提高差异无显著性(P>0.05);(4)LVEF与TNF-α、IL-6呈负相关(P<0.05)。结论TNF-α、IL-1、IL-6可能与心力衰竭的发生发展有关,萘哌地尔治疗可进一步降低心力衰竭患者TNF-α水平并改善临床症状。  相似文献   

3.
培垛普利联合螺内酯治疗慢性心力衰竭的临床疗效观察   总被引:1,自引:0,他引:1  
目的:观察培垛普利联合螺内酯对慢性心力衰竭(CHF)患者心功能和BNP的影响.方法:84例CHF患者随机分为治疗组和对照组,在常规治疗病情基本稳定的基础上,加用培垛普利4 mg,1次,日和螺内酯20 mg.1次/日.观察治疗前后心功能、左室射血分数(EF)、血清脑钠索(BNP)测定及不良反应等.结果:治疗组的心功能疗效总有效率为71.4%.对照组为52.4%;两组患者用药后的左室EF值均较用药前有明显的提高,其提高值治疗组更显著.血清BNP明显下降(P<0.01).结论:长期应用培垛普利与小剂量螺内酯联合治疗慢性心衰远期临床疗效显著,且使用安全.  相似文献   

4.
目的:探讨慢性充血性心力衰竭(CHF)患者在常规治疗的基础上加用螺内酯对心室重构、心功能的影响。方法:对64例CHF(NYHA分级Ⅲ-Ⅳ级)患者随机分为两组:ACEI加螺内酯(螺内酯组)和不加螺内酯(对照组),分别于入院后1周内和6月后行心脏彩超和6分钟步行距离检查。以左心房直径(LAd)、舒张期末左心室内径(LVEDd)、室间隔厚度(IVST)、左室后壁厚度(LVPW)作为心室重构的指标,以6分钟步行距离、射血分数(EF)值做为评价心功能的指标,对上述指标进行分析。结果:①对照组和螺内酯组经过半年的治疗后,反映心室重构的指标都有所改善。与对照组相比,螺内酯组的LVEDd、IVST、LVPW三项指标的改善更明显(P<0.05)。②两组治疗后步行距离均增加并且有统计学意义。螺内酯组增加了92m,对照组增加了46m,且两组间比较差异有统计学意义(P<0.05)。③经过治疗两组的EF值均显著升高,螺内酯组升高更明显,并且与对照组相比有统计学差别(P<0.01).结论:在常规治疗的基础上加用螺内酯可以改善心室重构及心功能。  相似文献   

5.
瑞舒伐他汀对扩张型心肌病患者心功能及细胞因子的影响   总被引:1,自引:0,他引:1  
目的观察瑞舒伐他汀对扩张性心肌病(DCM)心力衰竭患者心功能及血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)水平的影响。方法选择DCM心力衰竭患者67例,随机分为治疗组(34例)及对照组(33例)。对照组给予常规纠正心力衰竭药物治疗,治疗组在常规治疗基础上加用瑞舒伐他汀10mg,每晚1次。治疗前及治疗6个月后进行心脏彩超检查,测定左心室舒张末内径(LVEDd)、左心室射血分数(LVEF),测定血清TNF-α、IL-6浓度。结果两组患者治疗6个月时LVEDd均较治疗前显著缩小(P<0.05),LVEF较治疗前显著提高(P<0.05)。治疗6个月时治疗组与对照组比较:LVEF较对照组显著提高(P<0.05),LVEDd有进一步缩小趋势,但差异无统计学意义。治疗6个月时,治疗组血清TNF-α[(149.76±1.16)和(177.76±1.39),P<0.05]、IL-6[(24.37±1.45)和3(2.37±1.55),P<0.05]水平较治疗前显著下降,对照组较治疗前无明显变化。结论瑞舒伐他汀可明显改善DCM心力衰竭患者心功能,降低血清TNF-α、IL-6水平,有利于DCM的治疗。  相似文献   

6.
目的:探讨慢性充血性心力表竭(CHF)惠者在常规治疗的基础上加用螺内酯对心室重构、心功能的影响.方法:对64例CHF(NYHA分级Ⅲ-Ⅳ级)患者随机分为两组:ACEI加螺内酯(螺内酯组)和不加螺内酯(对照组),分别于入院后1周内和6月后行心脏彩超和6分钟步行距离检查.以左心房直径(LAd)、舒张期末左心室内径(LVEDd)、室间隔厚度(IVST)、左室后壁厚度(LVPW)作为心室重构的指标,以6分钟步行距离.射血分数(EF)值做为评价心功能的指标,对上述指标进行分析.结果:①对照组和螺内酯组经过半年的治疗后,反映心室重构的指标都有所改善.与对照组相比,螺内醯组的LVEDd、IVST、LVPW三项指标的改善更明显(P<0.05).②两组治疗后步行距离均增加并且有统计学意义.螺内酯组增加了92m,对照组增加了46m,且两组间比较差异有统计学意叉(P<0.05).③经过治疗两组的EF值均显著升高,螺内酯组升高更明显,并且与对照组相比有统计学差别(P<0.01).结论:在常规治疗的基础上加用螺内酯可以改善心室重构及心功能.  相似文献   

7.
目的:观察依那普利和螺内酯联合治疗老年心力衰竭的临床疗效和安全性.方法:68例老年心力衰竭患者随机分为治疗组和对照组.对照组使用洋地黄、利尿剂、硝酸酯类等药物常规治疗,治疗组在常规治疗的基础上加用依那普利10~20mg/d和螺内酯20~40mg/d.治疗前后测量血压、心率、血生化指标、评定心功能,治疗前后检查超声心动图.结果:治疗组血压下降、心率减慢、心功能明显改善(P<0.01).左室射血分数(LVEF)明显升高(P<0.01).左室舒张末期内径(LVEDD)、心肌耗氧指数和左室收缩末期内径(LVESD)明显降低(P<0.01).与对照组比较差异有显著性(P<0.05).结论:依那普利联合螺内酯治疗老年心力衰竭明显改善心功能,改善左室重塑、疗效显著.  相似文献   

8.
目的探讨不同剂量的螺内酯在难治性心力衰竭患者中的疗效差异。方法入选的2011年1月至2015年5月期间80例难治性心力衰竭患者随机分为观察组和对照组。两组患者除了给予螺内酯治疗外,其他抗心力衰竭药物相同。对照组患者给予小剂量螺内酯治疗,每天服用剂量为20 mg,每天服用1次。观察组患者给予大剂量螺内酯治疗,每天服用剂量为40 mg,每天服用1次。观察两组心功能指标改善情况。结果观察组患者治疗前左心射血分数、心排血量和对照组患者治疗前的左心射血分数与心排血量比较,差异无统计学意义(P<0.05);观察组患者治疗6周后的左心射血分数、心排血量和对照组患者治疗6周后的左心射血分数、心排血量比较,差异有统计学意义(P<0.05);观察组患者治疗12周后的左心射血分数、心排血量和对照组患者治疗12周后的左心射血分数、心排血量比较,差异有统计学意义(P<0.05)。结论大剂量螺内酯在改善难治性心力衰竭患者心功能方面效果显著,优于小剂量螺内酯,值得借鉴。  相似文献   

9.
目的探讨螺内酯联合地尔硫?治疗舒张性心力衰竭的临床疗效。方法选取2011年1月2012年12月本院收治的舒张性心力衰竭患者共60例,随机分为治疗组(A组)和对照组(B组),2组患者均采用常规药物治疗,而A组在此基础上加用螺内酯和地尔硫?。结果治疗后A患者的E/A比值明显高于B组患者,差异存在统计学意义(P<0.05);A组患者的6 min步行试验结果明显高于B组患者,且差异存在统计学意义(P<0.05);2组患者的脑钠肽水平均明显低于治疗前,且治疗后A组患者的脑钠肽水平明显低于B组患者(P<0.05)。结论螺内酯联合地尔硫?治疗舒张性心力衰竭能够更好改善舒张性心功能不全,且无明显的不良反应及肝肾功能损伤,安全性好,故值得在临床上推广应用。  相似文献   

10.
目的 观察大剂量螺内酯治疗收缩性心力衰竭的疗效和安全性.方法 70例患者随机分为小剂量螺内酯组34例和大剂量螺内酯组36例,观察2组用药量、用药前后心功能指标和不良反应发生情况.结果 大剂量螺内酯组螺内酯、氢氯噻嗪的使用量均多于小剂量螺内酯组,差异有统计学意义(P<0.01).大剂量螺内酯组呋塞米的使用率为30.5%高于小剂量组的5.9%,差异有统计学意义(P<0.05).治疗1、3个月时,2组左室射血分数(LVEF)、左心室质量指数(LVMI)、左室舒张末期容积(LVEDVI)、左室收缩末期容积(LVESVI)均较治疗前均有所改善,差异有统计学意义(P<0.05);治疗6个月时较治疗前有明显改善(P<0.01),且大剂量螺内酯组改善情况均优于小剂量螺内酯组,差异均有统计学意义(P<0.05).2组均未发生严重高血钾,无严重肾功能损害.结论 大剂量螺内酯治疗收缩性心力衰竭安全有效.  相似文献   

11.
12.
Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.  相似文献   

13.
The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.  相似文献   

14.
Nestorov I 《Toxicology letters》2001,120(1-3):411-420
Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.  相似文献   

15.
骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制(内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等)及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。  相似文献   

16.
益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.  相似文献   

17.
[6,7-3H] Estrone (E) and [6,7-3H]estradiol-17 (E2) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E2 were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E2, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E2, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 103–104 have been found for potent, 102 for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983  相似文献   

18.
The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.  相似文献   

19.
Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.  相似文献   

20.
Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.  相似文献   

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