内关穴注射硝酸甘油治疗心肌缺血的临床观察

观察内关穴注射硝酸甘油 (NTG)治疗心肌缺血的疗效及治疗前后心电图改变 ,与舌下含服NTG组和针刺内关穴组进行对照。结果显示 ,内关穴注射NTG组即时疗效同其它两组 (P >0 0 5 ) ,长时疗效和治愈率优于其它两组 (P <0 0 5及P <0 0 1) ,说明内关穴注射NTG是防治冠心病的一种好方法     

Superoxide dismutase ameliorates impaired nitric oxide synthase-dependent dilatation of the basilar artery during chronic alcohol consumption

The goals of this study were to determine whether chronic alcohol consumption impairs nitric oxide synthase-dependent reactivity of the basilar artery and to determine a potential mechanism which might account for the effects of alcohol on the basilar artery. Sprague-Dawley rats were fed liquid diets with or without alcohol for 8 weeks. Using intravital microscopy, we measured the diameter of basilar artery in response to nitric oxide synthase-dependent agonists (acetylcholine and bradykinin) and a nitric oxide synthase-independent agonist (nitroglycerin). Topical application of acetylcholine (0.1 and 1 microM) and bradykinin (1 and 10 nM) produced dose-related dilatation of the basilar artery in non-alcohol-fed and alcohol-fed rats. However, the magnitude of vasodilatation in response to acetylcholine and bradykinin was significantly less in alcohol-fed rats compared to non-alcohol-fed rats. Dilatation of the basilar artery in response to nitroglycerin was similar in non-alcohol-fed and alcohol-fed rats. Next, we examined whether impaired responses of the basilar artery in alcohol-fed rats in response to acetylcholine and bradykinin may be related to the production of oxygen radicals. We found that topical application of superoxide dismutase (150 U/ml) significantly improved impaired receptor-mediated nitric oxide synthase-dependent dilatation of basilar artery in alcohol-fed rats. However, superoxide dismutase did not alter responses of the basilar artery to nitroglycerin in alcohol-fed rats, and did not alter responses of the basilar artery to nitric oxide synthase-dependent or -independent agonists in non-alcohol-fed rats. Our findings suggest that chronic consumption of alcohol impairs nitric oxide synthase-dependent dilatation of a large cerebral artery which may be related to the receptor-mediated release of oxygen radicals to inactivate nitric oxide.     

醒脑静注射液治疗高血压急症38例疗效观察

目的观察醒脑静注射液在临床高血压急症抢救中的治疗价值。方法将38例高血压急症患者随机分为A、B两组。A组为醒脑静组（观察组）：在应用左旋氨氯地平、卡托普利的基础上加用醒脑静注射液20ml加入5%葡萄糖液250ml或0.9%生理盐水250ml静滴,1次/d,15d为一疗程;B组为硝酸甘油组（对照组）：在应用左旋氨氯地平、卡托普利的基础上加用硝酸甘油注射液5～10mg加入5%葡萄糖液250ml或0.9%生理盐水250ml静脉滴注,10～20μg/min静滴,1次/d,15d为一疗程进行对照。对比观察2组用药一疗程后的血压达标及临床症状的改善情况。结果2组治疗高血压急症均有较好的疗效,2组降压达标总有效率分别为94.74%、100.00%,2组间差异无统计学意义;与对照组比较,A组临床症状改善更优,且副作用较少,A、B两组总有效率分别为94.74%、57.89%,P〈0.05两组间差异有统计学意义。结论醒脑静注射液抢救高血压急症效果明显,临床症状改善更优,且副作用少。     

垂体后叶素联合硝酸甘油治疗食管静脉曲张破裂出血临床观察

目的　探讨并比较垂体后叶素联合硝酸甘油和善得定治疗食管胃底静脉曲张破裂出血的临床疗效和副作用。方法　43例肝硬化并发食管胃底静脉曲张破裂出血患者随机分两组 ,2 2例应用垂体后叶素联合硝酸甘油者为治疗组、2 1例应用善得定者为对照组 ,对两组的疗效和副作用进行对比观察。结果　两组 2 4h内止血率分别为 77.3 %和 81.0 % ,两组差异无显著 ,且临床均无明显副作用发生。结论　垂体后叶素联合硝酸甘油治疗食管胃底静脉曲张破裂出血近期止血疗效确切 ,无严重副作用出现。     

Nitroglycerin-patch induced tolerance is associated with reduced ability of nitroglycerin to increase exhaled nitric oxide

Nitroglycerin (GTN), used in the treatment of ischemic heart disease, acts through the liberation of nitric oxide (NO). However, its clinical use is limited due to tolerance development. Expired NO was used as an indicator of GTN-bioactivation and was measured together with plasma nitrite and mean arterial pressure (MAP) during GTN indicator infusions. The model was applied in rabbits subjected to various time periods of low-dose GTN pretreatment by patch application for 1, 24 and 72 h. Pretreatment with GTN-patch resulted in significant attenuation of expired NO from the GTN indicator infusion in the 24 h and 72 h pretreatment groups compared to placebo (72 h). Dose-response curves with increasing GTN infusions after 24 h GTN-patch pretreatment revealed a significant attenuation of the MAP decrease compared to placebo. GTN-induced changes in plasma nitrite correlated to increases in expired NO and decreases in MAP. This indicates that expired NO could serve as an indicator of NO generation from GTN in the vascular system. We conclude that GTN tolerance is associated with reduced capacity to generate NO from GTN. Care should be taken in using MAP-reduction to evaluate tolerance since high indicator doses could liberate sufficient amounts of NO to elicit maximal MAP decrease even in tolerant animals.     

硝酸甘油贴膜治疗早产的临床效果及机理研究

目的　观察硝酸甘油贴膜治疗早产的临床效果 ,并初步探讨其作用机理。方法　 6 0例先兆早产患者随机分为硫酸镁加舒喘灵常规治疗组 (常规组 ,30例 )和硝酸甘油贴膜治疗组 (贴膜组 ,30例 ) ,两组孕妇治疗前、后分别抽取外周静脉血 ,采用放射免疫分析法测定血浆促肾上腺皮质激素释放激素 (CRH)水平。观察两组孕妇延迟分娩的时间。结果　 (1)贴膜组延迟分娩 4 8h ,有效率为90 % ,平均延长孕期 2 5d。常规组延迟分娩 4 8h ,有效率为 80 % ,平均延长孕期 8d。贴膜组延长先兆早产孕妇孕期效果明显优于常规组 (P <0 0 1)。 (2 )贴膜组孕妇血浆中CRH水平由治疗前的 (2 5 7±6 1)ng/L ,显著下降至治疗后的 (38± 17)ng/L。常规组孕妇血浆CRH水平由治疗前的 (2 4 8± 6 0 )ng/L ,显著降低至治疗后的 (5 6± 2 2 )ng/L ,两组比较 ,差异有极显著性 (P <0 0 1)。结论　硝酸甘油贴膜是一种安全有效的抗早产药物 ,其作用机理可能与降低血浆CRH水平有关     

硝普钠与硝酸甘油治疗急性左心衰竭的疗效观察

目的探讨硝普钠与硝酸甘油治疗急性左心衰竭的临床效果。方法将2008年1月～2010年1月间在我院住院治疗的急性左心衰竭患者70例随机分为观察组和对照组,在综合治疗的基础上对照组给予硝酸甘油治疗,观察组给予硝普钠他汀。结果治疗后两组患者在收缩压、舒张压及心率方面均优于治疗前,两者比较差异具有统计学意义(P<0.05)。治疗后观察组患者在收缩压、舒张压及心率改善方面优于对照组,两组比较差异具有统计学意义(P<0.05)。观察组总有效率为97.14%,对照组为77.14%,两组比较差异具有统计学意义(P<0.05)。两组患者均未见明显的药物不良反应。结论在抢救急性左心衰中硝普钠较硝酸甘油更有优势,值得应用。     

硝酸甘油扩张浅静脉的临床应用研究

为解决临床上因病人血管状态不佳导致的静脉穿刺困难，采用０．０１％的硝酸甘油扩张手背浅静脉。结果显示，外涂药物２ｍｉｎ以内，受试者血管直径明显增宽（Ｐ〈０．０１），且效果较６５４－２更佳，显效率达９３．８％，对临床上４０例因血管条件不佳常规穿刺失败者，实施该方法后再行穿刺，一次成功的３５例，重复给药后成功的４例，总有效率达９７．５％，应用中未发现不良反应，表明硝酸甘油外涂在解决临床静脉穿刺困难方面有     

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。