巯甲丙脯酸治疗小儿顽固性心力衰竭

我们用巯甲丙脯酸治疗20例小儿顽固性心力衰竭,剂量0.5～2.0mg/kg,一日三次。服药疗程3个月～1年2个月。总有效率90％(显效60％)。本药副作用小,安全可靠。     

Survey of Chlorinated Hydrocarbons and Other Organic Volatile Impurities in Captopril Raw Materials and Tablets

Pharmaceutical Research -     

心痛定与克甫定联合应用对100例高血压降压疗效和冠心病危险因素的影响

联合应用心痛定与克甫定对100例高血压降压疗效和冠心病危险因素的影响观察。用药七天后,总有效率93％,(P<0.01)。81％的患者服药后2—4天就能稳定在下降后的水平。服药后三大常规,肝肾功能无异常发现,血电解质,血尿酸及BUN不受影响。血糖明显降低(P<0.01),总胆固醇(TC)和甘油三脂(TG)降低,低密度脂旦白胆固醇(LDL—ch)降低和高密度脂旦白胆固醇(HDL—ch)升高非常显著(P<0.01)对心功能有良好的改善,血浆肾素(PRA)活性升高,而血管紧张素Ⅱ(AngⅡ)及醛固酮(PAC)降低。服药前后心率无明显变化(P>0.05)。无发现明显和严重副作用。是治疗高血压较理想的配伍方法。     

Effect of central ras on one-kidney Grollman hypertension in rats and its mechanism

Summary The effect of central renin-angiotensin system (RAS) on one-kidney Grollman hypertension during the maintaining phase and its mechanism were investigated in rats. The arterial blood pressure (ABP) and the content of angiotensin II (A II) and norepinephrine (NE) in brain regions was measured respectively. 4 weeks after operation the ABP was elevated significantly, and it sustained at high level 8 weeks post-operatively. However, ABP in the control group underwent no significant changes at the same period. The A II and the NE content in the brain regions of the operated group were significantly higher than in those of the age-matched control group. During the maintaining phase of hypertension captopril (150 μg/10 μ1) was injected into the lateral cerebroventricle at 0.5 h, 1.0 h and 1.5 h respectively, and ABP and content of A II and NE were determined at the corresponding time. The results showed that the above three parameters decreased consistently at 0.5 h and 1.0 h, and increased gradually at 1.5 h, suggesting that the central RAS might play an important role in the maintaining phase of onekidney Grollman hypertension in rats.     

肾血管性高血压大鼠脑室注射γ-氨基丁酸的心血管效应(英文)

GABA(100和200μg,icv)在肾血管性高血压大鼠(RVHR)产生较伪手术鼠更强的降压作用,尤术后4 wk,GABA降压增强的大部分可被预先icv卡托普利所取消,而ip卡托普利作用较弱,GABA icv还明显改善RVHR已下降的压力感受性反射敏感性,提示RVHR脑内GABA抑制功能不足;外源性GABA降压效应增强可能与其抑制脑内血管紧张素系统有关。     

卡托普利对慢性肺心病难治性心力衰竭近期疗效的评价

对３０例心功能Ⅲ～Ⅳ级慢性肺心病难治性心力衰竭患者，应用卡托普利短期治疗后心功能明显改善，总有效率９３．３％，血浆血管紧张素Ⅱ、醛固酮、心钠素浓度明显下降（Ｐ＜０．０１），肺动脉平均压、肺血管阻力、右室平均压、总外周阻力明显下降（Ｐ＜０．０１），心排血量、每搏量、射血分数增加（Ｐ＜０．０５或０．０１），未见明显副作用。提示卡托普利对慢性肺心病难治性心力衰竭患者心功能的改善作用显著。     

卡托普利治疗稳定劳力型心绞痛的临床效果

目的观察卡托普利在稳定劳力型心绞痛治疗中的作用。方法选择稳定劳力型心绞痛患者265例,将其随机分为常规治疗组（阿司匹林、β-受体阻滞剂、钙拮抗剂、硝酸酯类）129例,年龄（57±111）岁,卡托普利组（常规治疗基础上加卡托普利12.5 mg,3次/d）136例,年龄（58±10）岁。观察治疗24周时两组患者心绞痛分级,测量心率、血压,计算心率×收缩压值;并做运动心电图,观察运动中诱发心绞痛时间（s）、ST段下移≥0.1 mV时或心绞痛发作时的心率、ST段下移最大程度（mV）及ST段下移持续最长时间（s）。结果两组治疗24周后心绞痛分级均明显改善,卡托普利组较常规治疗组心率显著减慢,SBP、DBP及心率×收缩压值显著降低,运动中诱发心绞痛的时间延长,ST段下移≥0.1 mV或心绞痛发作时心率增加,ST段下移持续最长时间缩短。结论卡托普利治疗劳力型心绞痛患者能减轻心绞痛症状,增加运动耐量。     

Regression of a Large Congenital Hepatic Arteriovenous Malformation

Congenital hepatic arteriovenous malformations are rarely seen in association with persistent neonatal pulmonary hypertension. We report the case of a full-term female newborn who presented with heart failure and respiratory distress soon after birth. Echocardiographic investigation revealed severe persistent pulmonary hypertension and patent ductus arteriosus. Here we report spontaneous regression in size of both the feeder vessel and the vascular bed of the congenital hepatic arteriovenous malformation. We postulate that our conservative use of oral heart failure therapy, in the form of diuretic agents and captopril, decreased the congestion and diameter of the affected vessels.     

缬沙坦和卡托普利干预高血压左室心肌肥厚与血中某些活性因子的比较研究

目的：比较缬沙坦对心肌肥厚和纤维化的干预作用是否优于卡托普利，两联用是否更为有益，并对作用机理进行分析探讨。方法：79例伴有左室肥厚的轻、中度高血压病患，随机分为3组：缬沙坦组，缬沙坦80－160mg qd；卡托普利组，卡托普利25－50mg bid；卡托普利＋缬沙坦组，卡托普利12．5－25mg bid 缬沙坦40－80mg qd。治疗期为8个月。另设正常对照组。观测室间隔厚度、左室重量指数、左室相关壁厚度、左室射血分数、二尖瓣口舒张早期和晚期血流速度比（VE／VA）、血浆血管紧张素Ⅱ（Ang Ⅱ)、醛固酮（Ald)、血清I型前胶原羧基端肽（PI CP）和Ⅲ型前胶原氨基端肽（PⅢ NP）等指标，进行治疗前后及组间比较。另对各治疗组每组6例患，观察上述指标的动态变化。结果：各组治疗后反映心肌肥厚和纤维化以及左室舒张功能的各项指标均显改善（P＜0．05，P＜0．01），但未达正常。组间比较差异不显。动态观察卡托普利组Ang Ⅱ及Ald先下降，后出现“逃逸”现象，但此后血清PI CP、PⅢ NP及超声心动图改变仍继续好转。结论：（1）缬沙坦和卡托普利单用或联用均能抑制和逆转高血压心肌肥厚与纤维化，改善舒张功能；（2）缬沙坦组短期治疗的益处未见明显优于卡托普利，两联用未见明显优势；（3）卡托普利持续治疗后出现Ang Ⅱ及Ald“逃逸”现象，但心肌重塑却继续好转。其作用机制与降低Ang Ⅱ的确切关系还有待深入研究。