比索洛尔联合清肝降压胶囊对高血压患者舒张压增高的临床疗效

[目的]探讨富马酸比索洛尔（洛雅）联合清肝降压胶囊治疗高血压患者舒张压（DBP）增高的机制和疗效.[方法]选择DBP持续在中度以上水平的高血压患者86例,随机分为两组,每组43例,接受洛雅联合清肝降压胶囊治疗的患者为观察组,维持原治疗方案的为对照组,观察周期为12周,比较两组患者血压的变化.[结果]两组患者在治疗前的DBP和收缩压（SBP）水平相比较均无统计学差异（P〉0.05）,治疗后两组均能显著降低患者SBP水平（P〈0.05）,且观察组能显著降低患者DBP水平（P0.05）.[结论]洛雅联合清肝降压胶囊对DBP持续在中度以上水平不降低的高血压患者疗效确切.     

伊贝沙坦治疗高血压病110例临床观察

目的 观察比较单用伊贝沙坦和联合一种小剂量降压药物，如氢氯噻嗪，或尼群地平等治疗高血压病的临床疗效和不良反应。方法 本文对2001年2月至2002年6月来我院就诊的高血压病患者110例，年龄26—78岁。按WHO／ISH高血压分级，一级19例，二级49例，三级42例，随机分为A组(单用伊贝沙坦)和B组(联合用药)两组。临床治疗观察4—12个月以上，观察降压效果，药物不良反应等。结果 治疗4周后A组SBP平均下降28．8mmHg，DBP平均下降22．8mmHg，总有效率81％，B组SBP平均下降29．6mmHg，DBP平均下降23．6mmHg，总有效率96．1％。结论 伊贝沙坦单用和联用治疗各级高血压均有较好的效果，不良反应轻微。对轻中度高血压单用即可取得良好效果，可作为一种较安全可靠的首选药物之一。     

不同类型的降压药物对高血压患者脉搏波速度的影响

目的探讨不同类型的降压药物对高血压患者臂一踝脉搏波速度（brachio—anklepulsewavevelocity,baPWV）的影响。方法健康体检首次确诊的高血压患者120例随机分为四组,每组30例,A组（苯磺酸左旋氨氯地平组）、B组（培多普利组）、C组（琥珀酸美托洛尔缓释片组）、D组（缬沙坦组）,与正常对照组对比分析血压、血糖、血脂和baPWV的变化。分别给予苯磺酸左旋氨氯地平、培多普利、琥珀酸美托洛尔缓释片、缬沙坦治疗12周后重复测量上述指标,前后对比分析血压和baPWV的变化。结果高血压患者与同期健康体检者对比,收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）和baPWV显著高于正常对照组（P〈0．05）。前述药物治疗12周后,患者SBP、DBP和baPWV显著下降（P〈0．05）,苯磺酸左旋氨氯地平收缩压下降幅度（△SBP）（30．6±6．7）mmHgvs（20．7±5．3）mmHg、（19．6±6．1）mmHg、（21.5±4．3nllnHg）和舒张压下降幅度（ADBP）（20．8±7．1）mmHgvs（13．97±7．6）mmHg、（14．1±6．8）mmHg、（14．9±4．2）mmHg明显高于其他三种药物（P〈0．05）。结论常用降压药物可以降低高血压患者的脉搏波速度,改善动脉顺应性。     

穴位按压降压法治疗高血压疗效观察

目的：观察穴位按压降压法治疗高血压的疗效。方法：由康复中心的技师对所有参加高血压专病疗养的疗养员进行穴位降压按压法教授指导，每天坚持穴位按压2次，贯穿整个疗养期。结果：血压有明显变化，有效率为95．3％[收缩压（SBP）下降10mmHg为显效，收缩压（SBP）下降20mmHg或舒张压（DBP）下降5mmHg为有效]。结论：本套手法中西医结合、标本兼治、可自我操作、简便易学，具有很强的实用性，且降压缓和，无任何不良反应，适合各类高血压病患者长期练习，对养生保健、调节机能大有裨益。     

比索洛尔与美托洛尔降压安全性比较研究

目的 通过比索洛尔与美托洛尔降压安全性比较评价比索洛尔的安全性。方法 186例门诊和住院原发性高血压病患者被随机分为比索洛尔和美托洛尔治疗组，观察患者12周。比索洛尔治疗组首次给予1．25mg的剂量，美托洛尔给予6．25mg的首次剂量。如果不出现低血压和心动过缓，应当根据血压调整比索洛尔和美托洛尔的剂量。结果 比索洛尔治疗组在首次剂量后低血压和心动过缓的发生率低于美托洛尔治疗组，在治疗12周后，比索洛尔治疗组支气管炎和呼吸困难的发生率低于美托洛尔治疗组。结论 比索洛尔在降压方面是一个更安全的β-受体阻滞剂。     

卡维地洛与比索洛尔治疗老年慢性心力衰竭的疗效对比

目的 比较卡维地洛与比索洛尔治疗老年慢性心力衰竭(CHF)的效果差别.方法 华北石油总医院心内科收治的CHF患者126例,随机分为两组,卡维地洛组(n=63),比索洛尔组(n=63).卡维地洛组给予卡维地洛3.125 mg,每天2次,比索洛尔组给予比索洛尔1.25 mg,每天1次,应用超声心动图测量治疗前和治疗6个月后左心室舒张末内径(LVEDD)和左心室射血分数(LVEF)变化,纽约心脏病协会(NYHA)心功能分级,6分钟步行距离,收缩压(SBP)和舒张压(DBP);用放射免疫法测定血浆中脑钠肽(BNP)和N末端B型利钠肽原(NT-proBNP)浓度.结果 卡维地洛组在NYHA心功能分级改善上优于比索洛尔组,总有效率分别为96.9%(62/64)、70.9%(44/62)(P＜0.05).两组治疗后的LVEDD、BNP、NT-proBNP、SBP和DBP比治疗前均有明显降低(P＜0.01或＜0.05),而LVEF及6分钟步行距离较治疗前有明显升高(P＜0.05);两组治疗后各项指标比较差异均有统计学意义(P＜0.01或＜0.05).结论 卡维地洛及比索洛尔均能明显改善心功能,但卡维地洛的疗效更为显著.     

比索洛尔对高血压病患者左室收缩与舒张功能的影响

目的　观察比索洛尔的降压效果及其对高血压病患者左心功能的影响。方法　对 3 6例初诊轻、中度高血压病患者进行 4周的比索洛尔治疗 ,应用超声心动图观察左室收缩及舒张功能的变化。结果　比索洛尔治疗前后诊室收缩压和舒张压的下降幅度分别为 16.2 3mmHg和 7.65mmHg ;降低血压的同时心房收缩期充盈峰值流速及其与舒张早期充盈峰值流速之比值明显降低 (P <0 .0 5及P <0 .0 1)。结论　比索洛尔在有效降压的同时能够显著改善高血压病患者的左室舒张功能。     

尼卡地平和拉贝洛尔对妊娠高血压危象控制有效性临床研究

[摘要]目的：观察比较静脉使用尼卡地平和拉贝洛尔对妊娠高血压危象有效性控制。方法：妊娠高血压危象58例分为两组,A组（28例）使用尼卡地平注射液,以0．5～5μg／（kg·min）速度静脉泵人;B组（30例）使用拉贝洛尔以0．25～2mg／min静脉泵人,两组同时常规使用硫酸镁预防子痫发生,在此期间观察血压心率变化。结果：A组用药4h、24h后安全达标率为96％、48h后目标血压达标率为93％,平均血压为（105±9.1）mmHg（1mmHg=0．133kPa）,11例需联合降压治疗。B组用药4h、24h后安全达标率为90％,48h后目标血压达标率分别为73％,平均血压为（118±10．0）mmHg,23例需联合降压治疗,3例换尼卡地平静脉控制。两组在48h降压疗效差异有统计学意义（P〈O．05）。两组用药前后心率变化无统计学意义。结论：尼卡地平治疗妊娠期高血压危象在降压4h、24h疗效与拉贝洛尔疗效相似,48h控制血压疗效优于拉贝洛尔组,未见有严重不良反应。     

卡维地洛对老年高血压非心脏手术病人心肌钙蛋白Ⅰ的影响

目的：观察卡维地洛对老年高血压非心脏手术病人的降压作用和对心肌钙蛋白Ⅰ的影响，比较卡维地洛与尼群地平对老年高血压病人降压和心肌的保护作用的差异。方法：选取择期行腹部手术（胃肠、胆道）的老年高血压病人40例，随机分为尼群地平组和卡维地洛组各20例，分别予以尼群地平10mg Po tid及卡维地洛10mg Po bid治疗1周后行腹部手术，观察服药前后及麻醉前后血压，并以酶联免疫吸附法测定麻醉前及术后2小时血清中心肌钙蛋白Ⅰ水平。结果：两种药物都可以有效控制血压，卡维地洛组麻醉前血压明显低于尼群地平组血压（P＜0．05）；手术后两组病人血清心肌钙蛋白Ⅰ水平较前显著增高（P＜0．05）；卡维地洛组血清心肌钙蛋白Ⅰ水平明显低于尼群地平组（P〈0．05）；结论：与尼群地平相比，卡维地洛可以更有效地控制血压，并且对心肌具有一定的保护作用。     

卡维地洛治疗轻、中度原发性高血压的临床疗效

目的 :观察卡维地洛治疗轻、中度原发性高血压的降压疗效。方法 :60例原发性高血压患者被随机分为卡维地洛组 (卡组 )和阿替洛尔组 (对照组 ) ,各 3 0例 ,分别给予卡维地洛 10～ 40mg/d和阿替洛尔 2 5～ 10 0mg/d ,疗程 8周。治疗前及治疗后 2、4、6、8周末测量坐位血压及心率 ,记录不良反应。结果 :( 1)治疗后两组病人的血压均有明显下降。卡组SBP/DBP降低 2 8.3 / 2 0 .1mmHg( 16.9%/ 19.5 %) ,对照组SBP/DBP降低 2 3 .5 / 16.9mmHg( 14 .3 %/ 16.5 %) ,分别与治疗前比较有显著性差异 (P <0 .0 1) ;两组间差异不显著 (P >0 .0 5 )。 ( 2 )卡组与对照组总有效率分别为 86.7%和 76.7%,总显效率分别为 66.7%和 60 .0 %,两组间差异不显著 (P >0 .0 5 )。 ( 3 ) 8周末 ,两组心率均降低 ,分别与治疗前比较有显著性差异 (P <0 .0 1) ,两组间差异不显著 (P >0 .0 5 )。结论 :卡维地洛治疗轻、中度高血压疗效确切、安全     

Clinical efficacy and safety of telmisartan 80 mg once daily vs. atenolol 50 mg once daily in patients with mild-to-moderate hypertension

The objective of this open-label, parallel-group comparative study was to assess the clinical efficacy and safety of once-daily treatment for 8 weeks with telmisartan 80 mg in comparison with atenolol 50 mg on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with mild-to-moderate hypertension (morning supine SBP 141-199 mmHg, DBP 95-114 mmHg). A total of 58 patients were enrolled. The comparability of the two treatment groups was statistically documented at the beginning of the study. Telmisartan was more effective than atenolol, with a decrease in SBP of 21.7 mmHg vs. 11.8 mmHg (p = 0.03) and a non-significant decrease in DBP of 14.7 mmHg vs. 10.1 mmHg. The safety profiles of both drugs were very similar; both drugs were well tolerated. In conclusion, once-daily telmisartan 80 mg is more effective than once-daily atenolol 50 mg in lowering SBP with no negative chronotropism. Furthermore, telmisartan was as well tolerated as atenolol in the treatment of mild-to-moderate essential hypertension in adults.     

Clinical efficacy and safety of telmisartan 80 mg once daily compared with enalapril 20 mg once daily in patients with mild-to-moderate hypertension: results of a multicentre study

The efficacy and safety of once-daily telmisartan 80 mg vs. once-daily enalapril 20 mg in the treatment of essential hypertension were evaluated in a multicentre, single-blind, placebo-controlled, randomised trial. In total, 68 patients (49 females, 19 males) with mild-to-moderate hypertension, defined as morning supine systolic blood pressure (SBP) 141-149 mmHg, diastolic blood pressure (DBP) 95-114 mmHg, were enrolled. After a 4-week placebo run-in phase, patients were randomly assigned to treatment with telmisartan or enalapril administered once daily in the morning for 8 weeks. No statistically significant differences were found in the baseline characteristics of patients in either group. Both SBP and DBP were decreased in both treatment groups, but the reductions were statistically different in favour of telmisartan (SBP, p = 0.013; DBP, p = 0.002). The incidence of adverse effects was lower in the telmisartan group, with the absence of cough. In conclusion, telmisartan is more effective and better tolerated than enalapril for the treatment of hypertension and has the advantage that it does not cause cough.     

多沙唑嗪治疗轻中度高血压疗效和安全性的临床研究

目的 评价新一代α_1受体拮抗剂甲磺酸多沙唑嗪的降压疗效及安全性,并与盐酸特拉唑嗪相比较。方法 采用随机分组平行对照方法,将226例轻、中度高血压患者分成两组:多沙唑嗪组(111例)口服甲磺酸多沙唑嗪2mg/d;盐酸特拉唑嗪组(115例)口服盐酸特拉唑嗪2mg/d。疗程8周。每两周一次上午监测诊室谷值坐位舒张压、心率,立位舒张压,并观察不良反应。用药前及治疗第8周后检测血液生化指标。第2周末谷值坐位舒张压仍大于90mmHg者加量至4mg/d,第4周末谷值坐位舒张压仍大于90mmHg者加量至6mg/d,第6周末谷值坐位舒张压仍大于90mmHg者,终止试验,改服其它药物。结果 治疗8周后甲磺酸多沙唑嗪组与盐酸特拉唑嗪组治疗有效反应率分别为74.77％和76.52％,(P>0.05);治疗后两组平均谷值坐位舒张压均有明显降低(P<0.05)。两组均无严重不良反应发生。结论 甲磺酸多沙唑嗪与盐酸特拉唑嗪降压疗效相似,不良反应发生率均较低,是一种安全、有效的治疗轻、中度原发性高血压的药物。     

氯沙坦复方制剂治疗轻中度原发性高血压疗效观察

目的　评价复方氯沙坦的降压疗效及安全性。方法　 30例轻中度原发性高血压患者 ,每天服复方氯沙坦 1～ 2片 ,观察降压疗效和对实验室检验结果的影响 ,在治疗 1、2、4、6、8周末记录血压、心率及不良反应情况。结果　服药 1周血压即下降 ,收缩压 /舒张压由治疗前的 (15 0 0± 16 8/10 3 2± 5 6 )mmHg降至 (138 6± 13 3/93 3± 6 9)mmHg ,8周后降至 (12 9 2± 12 6 /87 4± 7 8)mmHg ,心率无明显改变 ,不良反应少。结论　复方氯沙坦每天 1次口服 ,能有效控制血压 ,作用平稳 ,不良反应少 ,服药方便     

Effectiveness and safety of eprosartan on pulse pressure for the treatment of hypertensive patients

A multicentre, prospective, non-comparative open-label study was conducted to assess the effect of eprosartan, 600 mg/day, on pulse pressure (PP) in patients with hypertension (stage I or II, Joint National Committee, sixth report) treated in the primary care setting, as well as safety and compliance. The duration of treatment was 16 weeks. Eprosartan decreased PP (-13 mmHg), systolic blood pressure (SBP) (-26 mmHg), diastolic blood pressure (DBP) (-13 mmHg) and mean arterial pressure (MAP) (-17.4 mmHg) significantly (p < 0.0001). The PP/MAP ratio changed significantly from 62 to 59%, so that the reduction of PP was 3% higher than the overall decrease in MAP. Twenty adverse events, mostly gastrointestinal complaints, were recorded in 12 patients (1.9%). Compliance with treatment at the end of the study was 94%. Eprosartan was a well-tolerated and an effective drug in reducing PP, SBP and DBP below the recommended levels in patients with mild-to-moderate essential hypertension, allowing a high therapeutic compliance.     

The efficacy and tolerability of barnidipine hydrochloride in Thai patients with hypertension

This open-label, blinded study was performed to evaluate the efficacy and tolerability of barnidipine at a titrated dose of 10-15 mg once daily for 8 weeks in the treatment of essential hypertension in 40 Thai patients. 'Office' blood pressure (BP) and 24-h ambulatory BP measurements were recorded. A systolic BP/diastolic BP (SBP/DBP) reduction of 18.0 +/- 13.6/9.1 +/- 6.6 mmHg was obtained. The full response rate among patients with systolic and diastolic hypertension was 63% using either SBP or DBP criteria, and 54% using both SBP and DBP criteria. One of the two patients with isolated systolic hypertension had a full response, and the BP in two of the three patients with isolated diastolic hypertension was normalized. The trough-to-peak ratio and smoothness index for SBP/DBP were acceptable (0.76 +/- 0.63/0.55 +/- 0.26 and 1.2 +/- 0.4/1.2 +/- 0.3, respectively). In conclusion, once-daily barnidipine monotherapy provides effective 24-h BP control and is generally well tolerated in ambulatory patients.     

Valsartan vs. other angiotensin II receptor blockers in the treatment of hypertension: a meta‐analytical approach

Objective: To compare the efficacy of valsartan in systolic (SBP) and diastolic blood pressure (DBP) reduction with other angiotensin II receptor blockers (ARBs) in essential hypertension. Methods: Systematic literature search of databases between October 1997 and May 2008. Meta‐analysis of short‐term, double‐blind, parallel group, randomised controlled trials (RCTs) for treatment of adult hypertension (DBP: 90–115 mmHg). Random‐effects meta‐regression adjusting for baseline blood pressure (BP) was used to analyse the data. Mean change in SBP and DBP was estimated for each individual drug and dose combination. Results: In all, 31 RCTs (n = 13,110 patients) were included in the analysis. Six studies include trial arms with candesartan, six irbesartan, 13 losartan, two olmesartan, five telmisartan and 12 valsartan. The weighted average reduction in mean SBP and DBP for valsartan 160 mg was ?15.32 mmHg (95% CI: ?17.09, ?13.63) and ?11.3 mmHg (95% CI: ?12.15, ?10.52) and for 320 mg was ?15.85 mmHg (95% CI: ?17.60, ?14.12) and ?11.97 mmHg (95% CI: ?12.81, ?11.16); these are statistically significantly greater reductions compared with losartan 100 mg, which was ?12.01 mmHg (95% CI: ?13.78, ?10.25) and ?9.37 mmHg (95% CI: ?10.18, ?8.54) for SBP and DBP respectively. There is evidence that valsartan 160 mg reduces SBP and DBP more than irbesartan 150 mg and reduced DBP more than candesartan 16 mg. No other statistically significant difference in efficacy is demonstrated. Conclusion: Valsartan administered at 160 or 320 mg is more effective at lowering BP than losartan 100 mg and shows comparable efficacy to other ARBs in patients with essential hypertension.     

腹腔镜胆囊切除术中二氧化碳气腹对肥胖患者呼吸和循环的影响

目的 探讨腹腔镜胆囊切除术中CO2气腹对肥胖患者呼吸和循环系统的影响。方法 择期行腹腔镜胆囊切除手术患者80例，其中体质量正常组（A组）20例，术中气腹压力设定为14mmHg；肥胖患者组（B组）60例，根据气腹压力不同又分为B，组（12mmHg）、B2组（14mmHg）和风组（15mmHg），每组20例。首先观察A组和B2组气腹前5min、气腹后10min，以及术毕10min时的各项血气指标，然后观察B1、B2和B3组在气腹前5min、气腹后10min，以及术毕10min时的各项血气指标和各组手术时间。结果 A组与B2组，两者分别与气腹前相比较：HR、SBP、DBP和PETC02明显上升（P〈0.01）。B2组与A组相比较，在气腹前5min，两者各指标间并无统计学意义；而在气腹后10min，B2组HR、SBP和PETC02明显增高（P〈0．01或P〈0．05），DBP、PH和SaO2指标间则无统计学意义。在B组中，各组分别与气腹前比较，HR差异有显著性（P〈0.01），而在PETCO2、SBP和DBP指标上，B1组与气腹前比较并无统计学意义，而B2和B3组则差异有显著性（P〈0.01）。在各组的组间比较中，B2和B3组与B1组相比，其HR、SBP、DBP和PETCO2各指标均有显著性增高（P〈0.01）。B2和风组的组间比较无统计学意义。手术时间比较三组间无统计学意义。结论 腹腔镜胆囊切除术中CO2气腹对肥胖患者呼吸和循环系统的影响较体重正常患者显著，术中如能选用低压气腹（12mmHg），则能明显减轻气腹对肥胖患者上述系统的影响。     

Differential time effect profiles of amlodipine, as compared to valsartan, revealed by ambulatory blood pressure monitoring, self blood pressure measurements and dose omission protocol

Amlodipine and valsartan are once-daily antihypertensive agents. To date, no comparison between these agents given as monotherapies was reported. This study was aimed to evaluate the therapeutic coverage and safety of amlodipine and valsartan in mild-to-moderate hypertensive patients. Multicenter, double-blind, randomized, comparative study. After a 4-week placebo wash-out period, 246 outpatients with office diastolic blood pressure 95 < or = DBP < or =110 mmHg and systolic blood pressure (SBP) < 180 mmHg, in addition to a mean daytime SBP and/or DBP > 135/85 mmHg on 24-h ambulatory blood pressure monitoring (ABPM), were randomly allocated to once-daily amlodipine 5-10 mg or valsartan 40-80 mg, for 12 weeks. In a subgroup of patients, 48-h ABPM were performed at the end of the treatment period. Dose omission was simulated by a single-blind placebo dosing. The primary efficacy end-point was the 24-h trough office BP after 12 weeks of active therapy. The reductions in 24-h trough BP were more pronounced in amlodipine compared with valsartan group as well in office [SBP: -17.8 +/- 10.9 vs. -14.6 +/- 11.2, P = 0.025, DBP: -12.7 +/- 7.2 vs. -10.9 +/- 7.8 mmHg, P = 0.06) as in ambulatory BP (SBP/DBP: -13.0 +/- 13.7/-10.8 +/- 9.1 vs. -7.2 +/- 19.4/-4.9 +/- 13.4 mmHg, P < 0.05). Forty-eight hours after the last active dose, the slope of the morning BP surge (4-9 h) was less steep with amlodipine vs. valsartan [DBP (P < 0.04), SBP (n.s.)]. Ankle edema were more often reported in amlodipine group. These results suggest a superior BP lowering and a longer duration of action with amlodipine compared with valsartan.