冠心病患者周围血一氧化氮、肿瘤坏死因子变化的意义及开搏通的影响

本文通过对４８例冠心病（ＣＨＤ）患者外周血一氧化氮（ＮＯ）、肿瘤坏死因子（ＴＮＦ）的测定及开搏通治疗前后的对比，结果显示：ＣＨＤ患者周围血ＮＯ明显降低（Ｐ＜０．０１），ＴＮＦ显著高于正常（Ｐ＜００１），且与病情严重程度相一致，接受开搏通治疗三周后，ＮＯ有所回升，ＴＮＦ明显下降，治疗前后比较有显著差异（Ｐ＜００１），提示ＮＯ，ＴＮＦ参与ＣＨＤ的发病过程开搏通具有治疗意义。     

茶皂甙对自发性高血压大鼠血压的影响研究

目的观察茶皂甙对自发性高血压大鼠血压的影响,为高血压治疗提供新的思路。方法24只雄性自发性高血压大鼠随机分为4组,每组6只:(1)高血压对照组;(2)卡托普利组(150 mg·kg-1·d-1);(3)茶皂甙高剂量组(1600 mg·kg-1·d-1);(4)茶皂甙低剂量组(400 mg·k-g1·d-1);6只雄性WKY大鼠作为正常血压对照组。每天通过灌胃法分别给予卡托普利,高、低剂量的茶皂甙和蒸馏水,每隔两周在上午8~10时用大鼠尾动脉血压无创测量分析系统测量大鼠动脉收缩压一次,共5次。结果给药8周后,茶皂甙高剂量组的动脉收缩压与用药前相比显著下降(P<0.01),明显低于高血压对照组(P<0.01),与卡托普利组接近(P>0.05),茶皂甙低剂量组的动脉收缩压与用药前相比也有一定程度的降低(P<0.05)。结论茶皂甙可以有效降低自发性高血压大鼠的动脉血压。     

氢氯噻嗪与螺内酯或卡托普利长期联用对高血压患者血清高敏C-反应蛋白水平的影响

目的 研究氢氯噻嗪(HCTZ)与螺内酯或卡托普利长期联用对高血压患者血清高敏C-反应蛋白(hsCRP)水平的影响.方法 采用多中心、随机、平行对照研究,选择轻中度高血压患者,经安慰剂洗脱2周和HCTZ12.5 mg口服1 A./d导入6周后随机分为HCTZ(12.5 mg口服1次/d)组、螺内酯组(HCTZ 12.5mg口服1次/d+螺内酯20 mg口服1 K/d)和卡托普利组(HCTZ 12.5 mg口服1冼/d+卡托普利25 mg口服2次/d).随访1年末,因已公认联合治疗效果优于单药治疗,故将HCTZ组患者随机分入螺内酯组和卡托普利组.治疗期间每月随访1次,监测血压,每年行血清hsCRP水平检测.共随访4年.4年末进行分析,将坚持服用试验药物的患者视为治疗组,未坚持服用者视为对照组,比较两组治疗前后血清hsCRP水平的变化.结果 4年末,治疗组患者的血压及血清hsCRP水平较基线显著下降,且与对照组比较下降幅度差异有统计学意义(P<0.05或0.01).多因素分析结果 表明,治疗前收缩压和血清hsCRP水平、治疗后收缩压下降值及年龄是影响血清hsCRP水平下降的主要因素(均P<0.05).结论 HCTZ与螺内酯或卡托普利长期联用在有效降低患者血压的同时,能显著降低其血清hsCRP水平,收缩压下降值是影响血清hsCRP水平的主要因素.     

缬沙坦与卡托普利联合应用对扩张型心肌病的疗效

目的:探讨缬沙坦与卡托普利联合应用对扩张型心肌病的疗效。方法:50例扩张型心肌病患者在应用洋地黄、利尿剂、β-受体阻断剂的基础上,随机分为:观察组(n=25):口服缬沙坦80 mg/d及卡托普利18.75~150mg/d;对照组(n=25):口服卡托普利18.75~150 mg/d。治疗前、后分别行血清电解质、肾功能和超声心动图检查。结果:治疗3个月后两组左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左心室射血分数(LVEF)与短轴缩短率(FS)均有显著改善(P<0.05),但观察组较对照组改善更显著(P均<0.05)。治疗前、后两组血清电解质与肾功能无显著性变化(P>0.05)。结论:缬沙坦与卡托普利联合应用治疗扩张型心肌病的疗效优于单用卡托普利。     

Captopril versus placebo in congestive heart failure: effects on oxygen delivery to exercising skeletal muscle

The effects of captopril versus placebo on oxygen consumptionin the exercising leg have been examined Doppler measurementsof femoral flow and arteriovenous oxygen difference. Twentypatients with heart failure were randomized to captopril 25mg (N =10) or placebo (N =10). Maximal supine exercise of onewas performed before treatment and again 1 h and 4 h afterwards.Systemic haemodynamic variables were unaffected by placebo,but captopril increased stroke index at peak exercise from 26±3to 34±3 ml beat^-1 m^-2 and reduced pulmonary artery wedgepressure from 26±3 to 16±3 mmHg (P<0.05). Despitecaptopril-induced improvement in left ventricular function,exercise duration did not increase significantly peak valuesfor femoral flow (1059±178 to 938±134 ml min ^-1,P = NS), and oxygen consumption (134±26 to 111±18ml min^-1, P = NS) in the exercising leg were unaffected. Cutaneousflow, as reflected skin temperature (27.5±0.4 to 27.6±0.4°C,P = NS), was also unaffected. In the patients randomized captopril,the acute improvement in left ventricular function was abbreviatedand, after 4 h, all variables had returned towards baseline.Moreover, when the invasive studies were repeated after fourweeks chronic treatment responsiveness to converting enzymeinhibition had attenuated and there were no detectable differencesbetween the captopril and placebo groups.These data have demonstratedan acute captopril-induced improvement in left ventricular functionpatients with congestive heart failure. Nevertheless the beneficialacute response was abbreviated predicting the development ofearly tolerance. Oxygen delivery to the exercising leg showedno tendency to increase acutely when left ventricular functionwas significantly improved, or chronically when systemic responsivenesshad attenuated. Thus irrespective of its effects on left ventricularfunction, captopril does not increase nutritive flow to exercisingskeletal muscle in congestive heart failure.     

卡托普利对冠心病患者胰岛素抵抗的影响

目的：探讨卡托普利对冠心病患者胰岛素抵抗的影响，以及不同剂量卡托普利对胰岛素抵抗作用的差异。方法：５９例冠心病患者分为３组，分别服卡托普利６．２５ｍｇ／ｄ、１２．５０ｍｇ／ｄ、１８．７５ｍｇ／ｄ，另２０例冠心病患者为对照组不服卡托普利，４组均于试验前、试验第１、２、４周做７５ｇ葡萄糖耐量试验，测血糖、血胰岛素，计算空腹胰岛素与血糖比值、糖耐量曲线下面积及胰岛素释放曲线下面积，用配对资料ｔ检验进行数据处理。结果：服卡托普利后，血糖、血胰岛素、空腹胰岛素与血糖比值、糖耐量曲线下面积、胰岛素释放曲线下面积较试验前下降。服卡托普利剂量在１２．５０ｍｇ／ｄ和１８．７５ｍｇ／ｄ两组于服药第４周作用更明显，但两组作用相似，而服６．２５ｍｇ／ｄ组作用不明显。结论：卡托普利能改善冠心病患者的胰岛素抵抗。     

辛伐他汀联合卡托普利治疗对糖尿病大鼠心功能和心肌纤维化的影响

目的了解辛伐他汀和卡托普利对糖尿病大鼠心功能和心肌纤维化的影响。方法糖尿病大鼠模型随机分为糖尿病对照（DM）组、辛伐他汀（DM-S）组、卡托普利（DM-C）组、辛伐他汀＋卡托普利（DM-CS）组,分别给药4周后测量左室平均心室峰压（LVSP）、平均心室舒张末压（LVEDP）、平均左室内压最大上升（＋dp/dtmax）和下降速率（-dp/dtmax）等心功能参数。结果 DM-CS组LVSP、＋dp/dtmax、-dp/dtmax及其较正值较DM组明显增加（p〈0.05）,心肌间质纤维化受抑。结论辛伐他汀联合卡托普利可改善糖尿病大鼠心肌间质结构和心脏舒缩功能。     

雷公藤多甙并卡托普利治疗小儿肾病型紫癜性肾炎疗效分析

目的 观察雷公藤多甙并卡托普利对小儿肾病型紫癜性肾炎的治疗效果.方法 将101例诊断为肾病型紫癜性肾炎的患儿随机分为治疗组58例(口服雷公藤多甙和卡托普利)和对照组43例(口服单剂强的松),观察药物对两组患儿水肿、高血压、血尿、蛋白尿的疗效,采用SPSS10.0软件进行统计学分析.结果 治疗组治愈51例(88%),有效7例(12%);对照组治愈26例(61%),有效17例(39%),两组治愈率比较差异有统计学意义(P<0.01),对水肿、血尿、高血压的疗效比较差异有统计学意义(P<0.05或P<0.01),对蛋白尿的疗效比较差异亦有统计学意义(P<0.01).结论 雷公藤多甙并卡托普利治疗小儿肾病型紫癜性肾炎疗效优于单剂强的松,值得临床应用. Abstract： Objective To observed the efficacy of tripterygium wilfordii polyglycoside and captopril in the treatment of children with Henoch-Schonlein purpura nephritis kidney disease model. Methods One hundred and one children diagnosed with kidney-type purpura nephritis from May 1996 to June 2009 in our hospital, were respectively, randomly divided into treatment group (58 cases,oral tripterygium wilfordii polyglycoside and captopril) and the control group (43 patients, single-dose oral prednisone), observation of therapeutic effects of drugs in the two groups of children with edema, hypertension, hematuria, proteinuria efficacy, using SPSS10.0 software for statistical analysis. Results Fifty-one patients were cured (88%), effective in 7 patients (12%) in the treatment group, the control group cured 26 cases (61%), effective in 17 cases (39%), there was significant difference between the two groups (P<0.01). Pairs of edema, hematuria, hypertension were significantly different between the two groups(P<0.05 or P<0.01), and the efficacy of proteinuria was also significantly different (P<0.01). Conclusions Tripterygium wilfordii polyglycoside and captopril treatment of children with Henoch-Schonlein purpura nephritis kidney disease model is superior to single-dose prednisone, it is worth clinical application.     

小檗碱抑制胰岛素抵抗-高血压大鼠心室重构作用

目的观察小檗碱（berberine,Ber）和卡托普利（captopril,Cap）对高糖-高盐-高果糖诱导胰岛素抵抗-高血压（IRH）模型大鼠血压、血糖、胰岛素抵抗和心室重构作用。方法 Sprague-Dawley大鼠,雌雄各半,除空白对照组食用标准饲料外,其余动物随机喂饲富含高盐（4%）、高脂肪（25%）和高蔗糖（10%）饲料,并交替饮用5%蔗糖-1%食盐水与6%果糖水造模8周;当造模动物出现高血压、糖耐量减退,即建立IRH病理模型。然后将大鼠随机分为模型对照、卡托普利（Cap）25 mg/kg和Ber 300 mg/kg、150 mg/kg两个剂量组;分别灌胃给药或蒸馏水,每天1次共4周,测定大鼠血压及血清胰岛素（Fins）、血糖（FSG）,并计算胰岛素敏感指数（ISI）;计算心脏重量系数（CMI）和心肌增殖系数（MPI）以及作左心室组织学检测。结果 IRH大鼠血压升高,FPG和Fins含量增高,ISI减弱,MPI升高,与正常对照组比较,差异有显著性（P〈0.05或P〈0.01）,以及左心室组织呈心肌肥厚、重构和纤维化等病理改变。Ber 300 mg和150 mg/kg或Cap处理IRH大鼠后,降低IRH大鼠血压和FSG,纠正高胰岛素血症,增强ISI,差异有高度显著性（P〈0.01）;降低MPI（P〈0.01）,以及不同程度地改善左心室组织的病理改变。结论 Ber和Cap能对抗IRH大鼠胰岛素抵抗、增强胰岛素敏感性、纠正高胰岛素血症,降低血糖,降低血压,抑制心室重构。Ber上述效应呈量效关系。     

美托洛尔联合卡托普利治疗慢性心力衰竭70例疗效观察

目的:探讨美托洛尔联合卡托普利治疗慢性心力衰竭的临床效果。方法:选择慢性心力衰竭患者140例,随机分为两组,观察组70例,对照组70例。对照组采用常规治疗,强心药、利尿剂、硝酸酯类等。观察组在对照组用药基础上给予美托洛尔,最初剂量为6.25 mg,2次/d,在服用美托洛尔过程中,要根据患者血压等情况调整剂量,最大剂量可增加到25 mg,2次/d。同时给予卡托普利,最初剂量为12.5 mg,3次/d,最大剂量可增加到50 mg,3次/d。两组共治疗1个月。结果:对照组总有效率为71.4%,观察组总有效率为92.8%,两组患者总有效率比较,差异有统计学意义(P<0.05)。结论:美托洛尔联合卡托普利治疗慢性心力衰竭临床效果显著,值得借鉴。