应用动态血压监测分析拉西地平的降压疗效

目的观察拉西地平的降压效应、耐受性、谷峰比值及不良反应.方法选择18例轻、中度原发性高血压患者,在服用安慰剂2周后,对随测舒张压在95～114-mmHg(1-mmHg＝0.133-kPa)的16名患者进行为期4周的药物治疗,给予拉西地平4-mg*d-1口服,治疗第2周末随测舒张压未能降至90-mmHg以下者,则剂量增至6-mg*d-1.于安慰剂导入期末和拉西地平治疗期末分别进行动态血压监测.结果服药后血压与用药前比较有显著下降.动态血压监测结果显示,治疗后总血压负荷、24-h、昼夜平均收缩压和舒张压均明显下降,收缩压和舒张压的谷峰比值均大于50%,心率在用药前后无明显变化.结论拉西地平治疗轻、中度原发性高血压有效、安全.     

心肌梗死伴高血压患者的冠状动脉病变特点

目的探讨心肌梗死合并高血压病的冠状动脉病变特点.方法用冠状动脉造影比较心肌梗死伴高血压病(68例)和心肌梗死血压正常(41例)患者的冠状动脉病变狭窄程度、病变数量及分布特征.结果心肌梗死伴高血压病者多支(双支、3支)血管病变多于心肌梗死血压正常者(P<0.05),重度狭窄、完全堵塞病变数亦较血压正常者多(P<0.05),而病变血管的分布差异无统计学意义(P>0.05).结论心肌梗死伴高血压病患者的冠状动脉病变范围广、病变程度重.     

狐臭柴中精油GC-MS测定及其抑制肺癌细胞增殖的研究

目的 研究狐臭柴Premna puberula叶片精油的化学成分、含量、抗氧化、抑菌及抗肿瘤的能力,为狐臭柴开发利用提供一定的研究基础。方法 采用气相色谱-质谱（gas chromatography-mass spectrometry,GC-MS）联用仪鉴定狐臭柴叶片精油的化学成分;以对1,1-二苯基-2-三硝基苯肼（DPPH）和2,2′-联氮双(3-乙基苯并噻唑啉-6-磺酸)二铵盐（ABTS）自由基的清除能力,结合总还原力为指标评价精油的抗氧化活性;以抑菌圈法探究其对大肠杆菌、金黄色葡萄球菌、铜绿假单胞杆菌、白色念珠菌的抑制作用;采用细胞增殖/毒性检测试剂盒法（Cell Counting Kit-8,CCK-8）测定其对人肺癌A549细胞的抑制作用。结果 狐臭柴叶片精油中共鉴定出72种化合物,约占精油总成分的99.36%,其主要成分为左旋-β-蒎烯（15.27%）、1-辛烯-3-醇（14.46%）、蒎烯（14.29%）、1-石竹烯（6.26%）、α-石竹烯（4.47%）和芳樟醇（3.12%）。抗氧化实验结果表明,狐臭柴叶片精油具有较强的总还原力,且对DPPH及ABTS自由基的半数抑制...     

Effect of repeated measurements of blood pressure on blood pressure in essential hypertension: Role of anxiety

Over the past years, we repeatedly observed that of the hypertensive population entered into our behavioral treatment programs, more than half were actually false hypertensives. With repeated measurements of blood pressure (BP), only one-third remained hypertensive, while two-thirds showed a significant decrease in BP. The purpose of this study was to determine which factors correlate with the decrease in BP and could be useful in distinguishing the true and the false hypertensives. Of the 24 patients in this study, 15 decreased their mean arterial pressure by at least 5 mm Hg during a 6-week period of home and clinic BP measurement, while 9 did not. The 9 patients with BPs that did not change had lower State Anxiety, Trait Anxiety scores, lower diastolic BP, and lower heart rates compared to the group whose BPs decreased. These results suggest that under certain conditions a relationship exists between anxiety and elevated blood pressure. In a segment of the hypertensive population, anxious patients may be placed on inappropriate anti-hypertensive medication if a BP measurement period is not conducted before intervention.     

The effect of ketoconazole and transdermal estradiol on serum sex steroid hormones levels

Summary In this randomized, open-label trial, 24 subjects were studied. There were 12 subjects with essential hypertension and 12 normotensive controls who received, after an initial control period, 48 h of treatment with a transdermal estradiol patch or ketoconazole tablets every 8 h for six doses, or in combination. LHRH (100 g) and ACTH (250 g) were given at 48 h of each treatment. Each treatment was one week apart.In both normotensive and hypertensive men ketoconazole reduced adrenal and gonadal androgens, raised 11-deoxycortisol and 17 -hydroxyprogesterone levels; blunted the rise of cortisol to ACTH and had no effect on the response of LH to LHRH. Transdermal estradiol raised serum estradiol levels, blunted the time to peak plasma concentration of LH to LHRH and produced a normal response to ACTH. Although baseline level of total and free testosterone and DHEA-S were lower in hypertensive men, the response of the pituitary (LH) to LHRH and adrenal axis with ACTH were similar in both normotensive and hypertensive men. Blood pressure was unaffacted by any of the treatment interventions in either normotensive or hypertensive men.Although ketoconazole or transdermal estradiol reduce androgens, there was no evidence that this reduction in androgens was involved with the short term regulation of blood pressure in hypertensive men.     

原发性高血压患者的纤维蛋白溶解活性变化

目的 观察未经治疗的原发性高血压患者的纤维蛋白溶解活性的变化及临床意义。方法 用发色底物法测定42例原发性高血压患者和40例血压正常者的血浆组织型纤维蛋白溶酶原激活物（t-PA)及其抑制剂（PAI－1）的活性和纤维蛋白溶酶原（Plg)活性。结果 原发性高血压患者血浆t-PA活性明显低于血压正常者,PAI－1和Plg活性明显高于血压正常者。结论 研究结果提示原发性高血压患者确实存在内源性纤溶功能低下。     

卡维地洛对原发性高血压的降压疗效及对血压变异的影响

目的：应用动态血压监测（ABPM）评价每日口服一次卡维地洛降压疗效的持续性及对血压变异的影响。方法：选择轻、中度高血压患者20例,停用所有降压药物7d,再服安慰剂14d生,对坐位舒张压为95－114mmHg,且HR≥60次／min者进行ABPM,24h平均舒张压（MDBP）≥85mmHg者,（早9时）口服卡维地洛10mg/d,共2周,对疗效满意（舒张压＜90mmHg或下降＞20mmHg)者进行ABPM,如MDBP＜85mmHg,维持原剂量不变,若MDBP≥85mmHg,每2周剂量递增10mg/d并进行疗效评价,增加至40mg/d,连用4周后进行ABPM并结束观察。结果：（1）诊室偶测血压和24h,日间,夜间动态血压平均值及相应的血压负荷均显著降低（P＜0．01）,降压总效率为85％;（2）该药的收缩压和舒张压谷／峰比值分别为79．7％和73．4％;（3）收缩压和舒张压的降压光滑指数分别为1．92和2．65;（4）治疗后24h和日间的收缩压之长时血压变异减少（P＜0．05）。结论：原发性高血压患者口服卡维地洛10mg-40mgQd,可平稳持续控制24h血压,推荐为优选的降压药物。     

依那普利对原发性高血压患者血清胶原及透明质酸浓度的影响

目的　观察原发性高血压（ＥＨ）患者使用依那普利前后血清Ⅲ、Ⅳ型前胶原、透明质酸的浓度变化;探讨依那普利干预血清前胶原生成以及抑制左室肥厚（ＬＶＨ）形成的作用。方法应用放免技术测定３７例ＥＨ患者及２１例体检正常者血清Ⅲ、Ⅳ型前胶原神经末端肽（ＰⅢＰ、ＰⅣＰ）及透明质酸（ＨＡ）浓度。ＥＨ患者口服依那普利治疗１２周后复测上述指标。结果治疗前ＥＨ组血清ＰⅢＰ、ＰⅣＰ、ＨＡ浓度显著高于对照组（Ｐ＜０．０１）;依那普利治疗后ＥＨ组相应指标较治疗前明显降低（Ｐ＜０．０１）。结论血清ＰⅢＰ、ＰⅣＰ、ＨＡ水平与血压升高密切相关;依那普利在降压的同时,降低血清ＰⅢＰ、ＰⅣＰ、ＨＡ的生成,具有抑制ＬＶＨ的作用。     

氨氯地平与非洛地平缓释剂治疗原发性轻、中度高血压的随机、双盲平行对照研究

目的:对比氨氯地平与非洛地平缓释剂治疗轻中度原发性高血压的疗效和安全性;每日1次服药对24小时动态血压的影响;并对比药物漏服对血压控制的影响。方法:76例轻、中度高血压患者被随机、双盲分成两组,分别每日口服1次氨氯地平5～10mg(Ⅰ组)或非洛地平缓释剂5～10mg(Ⅱ组),治疗12周,并用24小时动态血压监测评价用药前后24小时血压变化情况及漏服48小时的血压变化。结果:氨氯地平治疗组舒张压降低15.1mmHg(治疗末为84.8mmHg),非洛地平缓释剂治疗组舒张压降低15.3mmHg(治疗末为85.0mmHg)。总有效率Ⅰ组病人为83.8％,Ⅱ组为87.9％(P=NS)。在药物的初始剂量下即能达到有效血压控制的病人数Ⅰ组为76％,Ⅱ组为52％(P<0.01)。药物漏服24和48h后,Ⅰ组临床血压仍低于140/90mmHg,24小时动态血压与漏服前相比无显著性差异,而Ⅱ组的临床血压高于140/90mmHg,临床血压和24小时动态血压与漏服前相比具有显著性差异。两治疗组的副作用发生率均较低。结论:氨氯地平与非洛地平缓释剂均能有效降低轻、中度高血压病人的血压,安全、疗效可靠,病人耐受性好,但漏服试验表明漏服24与48h氨氯地平仍能较好的控制血压。Ⅰ组的血压波动明显低于Ⅱ组。     

遗传因素对高血压病人群靶器官损害发生的影响

目的探讨血管紧张素Ⅱ1型受体(AT1R)A／C1166多态性、纤溶酶原激活物抑制剂-1(PAl-1)4G／5G多态性与高血压病人群肾脏损害(RD)和脑梗死(CI)发生的关系。方法以高血压病人群为随机研究对象,采用等位基因特异性寡核苷酸探针杂交法分析AT1R基因型和PAI-1基因型。结果(1)AT1R基因型与肾脏功能显著相关,AC基因型肾脏功能显著差于AA基因型,PM-1基因型与肾脏功能无显著性关系;(2)AT1R基因型与CI发生无显著性关系;CI阳性与CI阴性高血压病人群相比,PAI-1基因型分布有显著性差异,前者4G／4G基因型频率显著高于后者。结论AT1RAC基因型和PM-14G／4G基因型分别为高血压病人群RD和CI的危险因素。