硝苯啶及其与异搏定联合降压疗效及细胞离子钙的改变

本文观察了24例原发性高血压单服硝苯啶二周及合并服用硝苯啶和异搏定二周后的降压效果及细胞内外钙离子浓度的变化。发现硝苯啶与异搏定合用的降压效果优于单用硝苯啶。细胞外全血离子钙及细胞内血小板离子钙亦比单用硝苯啶时下降更明显,提示细胞内、外离子钙的改变在钙拮抗剂降压中起重要作用。     

动态血压监测临床价值研究

目的：研究动态血压监测在高血压诊断、判断左室肥厚及指导临床用药中的作用。方法：应用动态血压监测和超声心动图检查６２例正常血压,６４例原发性高血压及４例继发性高血压。结果：动态血压均值小于偶测血压均值（Ｐ＜０．０１）,白大衣性高血压占１０％。动态血压负荷可区分不同时期高血压（Ｐ＜０．０５）,血压正常组、高血压Ⅰ期组存在昼高夜低昼夜节律。高血压Ⅱ、Ⅲ期及继发性高血压昼夜节律消失。非杓型高血压与左室重量及重量指数相关性较杓型高血压为好（Ｐ＜０．０５）,硝苯啶时程投药疗效更好（Ｐ＜０．０５）。硝苯啶缓释片不受投药时程限制（Ｐ＞０．０５）。结论：动态血压监测在临床上对高血压诊断、分期、判断左室肥厚及指导用药有重要价值     

晚发性维生素K缺乏症并颅内出血患儿血清电解质的变化及意义

目的 探讨晚发性维生素K缺乏症并颅内出血(简称晚K颅内出血)患儿血清电解质钾、钠、氯、钙、镁离子变化及其临床意义.方法 对65例确诊为晚K颅内出血患儿(出血组)分为清醒组、浅昏迷组、深昏迷组,在入院后2小时内采取静脉血测定血清钾、钠、氯、钙、镁离子浓度.同时选取32例儿保科正常体检的婴儿作对照组.结果 (1)出血组65例的患儿血清钠、氯、钙下降均低于对照组(P＜0.05);出血组间的清醒组、浅昏迷组及深昏迷组患儿钠、氯、钙下降比较有显著性差异(P＜0.05).(2)出血组的清醒组患儿血清镁离子下降与对照组的比较无显著性差异(P＞0.05),而浅昏迷组与清醒组、对照组间血清镁离子下降比较有显著性差异(P＜0.05),深昏迷组与浅昏迷组、清醒组、对照组间血清镁离子下降的比较有非常显著性差异(P＜0.01).(3)出血组的患儿血清钾离子与晚K颅内出血病情无明显相关性.结论 晚K颅内出血病情越重、血清钠、氯、钙、镁离子下降越显著,监测血清钠、氯、钙、镁离子浓度对晚K颅内出血病情判断及治疗有指导意义.     

六味地黄丸与硝苯吡啶联合治疗阴虚阳亢型原发性高血压的临床免疫研究

研究目的探讨六味地黄丸与硝苯吡啶联合治疗阴虚阳亢型原发性高血压（EHT）的疗效。研究方法将75例明虚阳亢型EHT患者随机分为A、B和C三组,每组25例。25例健康人做正常对照。A组服用六味地黄龙,B组服用硝苯吡啶,C组又用上述两种药物。用药10周后检测血清中免疫球蛋白（IgG、IgA和IgM）和科体（C3）的变化及血压的波动。结果75例患者血清中的IgG及C3的平均水平高于对照组（P＜0．01）;A组患者的IgG及C3较治疗前为低（P＜0.05）,而血压无变化;B组患者的免疫学上无明显变化,但血压控制较满意;C组患者血压得以理想控制,且免疫球蛋白水平降低。结论通过免疫检测和血压的理想控制两方面看,六味地黄龙与硝苯吡啶联合用药治疗阴虚阳亢型EHT是有效的,本研究为EHT的治疗提供了客观资料。     

血清镁离子浓度对原发性高血压及其并发症影响的探讨

目的探讨血清镁离子浓度对原发性高血压及其并发症的影响。方法136例原发性高血压患者,用比色法测定血清镁离子浓度。结果高血压患者血清镁离子(0.56±0.12mmol/L)明显低于正常人(0.85±0.25mmol/L),P＜0.05。同时提示血清镁离子浓度与高血压严重程度呈负相关。结论低镁血症在高血压病的发生、发展中起着重要的作用。     

原发性高血压110例血浆心房利钠因子水平的观察

本文报告30例健康人及110例原发性高血压患者血浆心房利钠因子(ANF)水平及其与高血压性心脏病、原发性高血压的肾素分型,疾病分期及巯甲丙脯酸治疗前后的关系。结果表明,健康人及患者组基础值均显著高于激发值;患者组基础值显著高于健康组;高心病组显著高于非高心病组;低肾素型组显著高于正常肾素型及高肾素型组;使用巯甲丙脯酸治疗后,血浆ANF水平显著低于治疗前;但与原发性高血压病情的严重程度则无明确的关系。原发性高血压血浆ANF水平的升高,主要与心、肺血容量的变化密切相关。     

食盐及钙对大鼠血压、血浆钙调素和红细胞膜ATP酶活性的影响

观察高、低钠和高、低钙摄入对大鼠血压、血浆钙调素(CaM)和红细胞膜ATP酶活性的影响。结果表明,高钠摄入8周可使大鼠血压显著升高,血清钠和24h尿钠明显高于对照组(P<0.01),血浆CaM水平亦明显升高。高钙摄入能降低血压,24h尿钙和血浆CaM水平明显升高(P<0.05),红细胞膜钙泵活性也提高;而低钙摄入则血压升高,24h尿钙降低(P<0.01)。     

硝苯吡啶用于胃镜术前准备300例观察

目的观察口服硝苯吡啶用于胃镜术前准备,对用药前、后及胃镜术后的血压、心率、口干及视物感觉的反应。方法采用随机对照的方法,将620例患者的胃镜术前准备用药分成两组(实验组和对照组),实验组300例口服硝苯吡啶,对照组320例肌肉注射阿托品。结果两组患者胃镜检查前后心率变化经U检验差别极显著,(P≤0.01)按α=0.05水平,拒绝假设,以实验组病人心率次数变化小于对照组;以实验组中高血压患者平均动脉压变化大于对照组(BP在正常范围内),二组患者中,高血压患者胃镜检查前后平均动脉压变化经U检验,差别显著(P≤0.01)说明含服硝苯吡啶显著放宽了胃镜检查的相对适应证。结论两组的血压、心率、口干、视物模糊通过统计学数据处理,差别显著。     

含服硝苯吡啶在高血压患者胃镜检查时的应用

目的 观察舌下含服硝苯吡啶在高血压患者胃镜检查时的治疗效果。方法 胃镜检查前常规给予高血压患者舌下含服硝苯吡啶10mg,待血压降至正常后才进行胃镜检查,并于检查后5min之内复查血压情况。结果 发现患者在检查后血压基本稳定。结论 舌下含服硝苯吡啶可以较好地控制血压,使检查能够安全顺利地进行。     

硝苯啶、开搏通对原发性高血压患者的疗效对比

硝苯啶、开搏通对比治疗46例原发性高血压患者,开搏通降压疗效优于硝苯啶。二药对血脂、血糖皆无不良影响。     

阿托伐他汀钙对高血压患者的治疗作用及血清中细胞因子TNF-a、CRP、IL-4和IL-10的影响

目的 观察阿托伐他汀钙对高血压患者治疗前后血清中细胞因子的影响及其降压效果.方法 82例高血压病(EH)患者,随机分为2组:治疗组41例,每日晨服硝苯地平控释片30mg,晚睡前服阿托伐他汀钙20mg;对照组41例,服用硝苯地平控释片30mg,疗程均12周.于治疗前后采用酶联免疫法测定细胞因子TNF-a、IL-4和IL-...     

PLATELET FREE CALCIUM AND SERUM FREE CALCIUM IN ESSENTIAL HYPERTENSION

Intracellular free calcium of platelets and serum free calcium were studied in human essential hypertension. Intracellular free calcium of platelets was significantly higher in hypertensive patients than that in normotensive subjects, and this was correlated with blood pressure. There was no difference of serum free calcium between hypertensives and normotensive controls. Antihypertensive treatment with nifedipine resulted in a reduction of platelet free calcium, and this was correlated with the fall of blood pressure. In patients treated with clonidine, although there was no difference of platelet free calcium between hypertensives and normotensive controls, serum free clacium was significantly reduced. These results indicated that intracellular free calcium may be regulated by same hormonal or pharmacological factors which determined the height of blood pressure, calcium channel blockers may be more effective in prevention of cardiovascular and cerebrovascular complications caused by platelet hyperfunction in essential hypertension.     

替米沙坦对高血压合并糖尿病患者早期肾损害的影响

目的探讨替米沙坦对高血压合并糖尿病患者血清胱抑素C(CystatinC,CysC)、微量白蛋白尿(Microalbuminuria,MAU)的影响。方法将80例原发高血压合并糖尿病伴早期肾损害患者按就诊顺序随机分为替米沙坦组40例和硝苯地平控释片组40例,均服药12周。观察两组用药前后血压、血肌酐、血钾、空腹血糖、血清胱抑素C(CysC)、尿白蛋白与肌酐比值(Urinary albumin to creatinine ratio,UACR)的变化。结果两组经12周治疗后血压均较治疗前明显降低(P<0.01),但两组治疗后血压比较,差异无统计学意义(P>0.05);两组治疗前后血肌酐、空腹血糖比较,差异无统计学意义(P>0.05);两组血清胱抑素C(CysC)、尿白蛋白与肌酐比值(UACR)均较治疗前降低(P<0.05),替米沙坦组优于硝苯地平控释片组(P<0.05)。结论替米沙坦可降低高血压合并糖尿病患者血清CysC及微量白蛋白尿水平,减轻肾脏损害,保护肾脏功能。     

Comparison of chlorthalidone and spironolactone in low--renin essential hypertension

Nineteen patients with uncomplicated essential hypertension and low activity of plasma renin in response to a change from recumbency to an upright posture along with furosemide administration were given spironolactone, 400 mg/d, or chlorthalidone, 100mg/d, in a double-blind, random-sequence, crossover trial. The sequence of treatments was placebo for 2 months, one active drug for 2 months, placebo again for 1 month and the other active drug for 2 months. With both active treatments the average systolic, diastolic and mean arterial pressures decreased significantly. The two agents were equally efficacious in lowering the blood pressure regardless of the severity of hypertension during placebo treatment. Body weight, 24--hour urinary excretion of sodium, the plasma renin activity and the plasma aldosterone level at the end of the initial placebo period did not allow us to predict the response to either drug. Both drugs reduced the body weight and increased the stimulated plasma renin level activity. Chlorthalidone significantly increased the serum uric acid level and significantly reduced the serum potassium level. Three patients experienced orthostatic dizziness during spironolactone therapy, but no adverse symptoms were observed with chlorthalidone therapy. Thus, spironolactone is an effective alternative to thiazide-type drugs in patients with low-renin essential hypertension.     

新肾康宁胶囊治疗早期高血压肾病的临床疗效观察

[目的] 观察新肾康宁胶囊治疗早期高血压肾病的临床疗效。[方法] 选取早期高血压肾损害患者60例,随机分为治疗组及对照组各30例,两组均予血管紧张素转换酶抑制剂（ACEI）/血管紧张素Ⅱ受体阻滞剂（ARB）或钙离子拮抗剂降压治疗,治疗组同时予新肾康宁胶囊,4粒/次,每日3次,1个月为1个疗程,3个疗程后观察中医症状积分及治疗前后尿微量白蛋白（mAlb）、血清胱抑素C（Cys-C）指标的变化,并进行统计学分析。[结果] 治疗组在中医症状的改善、mAlb、Cys-C指标的变化均优于对照组（P<0.05）。[结论] 联合应用新肾康宁胶囊能够改善早期高血压肾病患者的临床症状,降低mAlb、及Cys-C指标,可能与改善肾脏缺血、缺氧状态有关,从而减轻肾小球硬化,延缓高血压肾病。     

氨氯地平联合阿托伐他汀钙片治疗高血压合并冠心病的临床价值

目的 探讨高血压合并冠心病患者应用氨氯地平联合阿托伐他汀钙片治疗的临床效果.方法 选取玉溪市人民医院2012年1月至2013年1月收治的120例高血压合并冠心病患者为研究对象,依据随机数字表法分为两组：观察组（60例）患者应用氨氯地平联合阿托伐他汀钙片治疗,对照组（60例）患者应用硝苯地平控释片治疗,对比分析两组患者治疗前后血液、心率以及生活质量的变化.结果 观察组治疗后临床总有效率显著高于对照组（95% vs 80%）（P＜0.05）;观察组患者治疗后血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、舒张压低于治疗前,且均低于对照组,差异均有统计学意义（P＜0.05）;两组高密度脂蛋白胆固醇水平治疗后显著高于治疗前,且观察组高于对照组,差异均有统计学意义（P＜0.05）;治疗后1个月,观察组患者生活质量总评分显著高于治疗前,且高于对照组,差异有统计学意义（P＜0.05）.结论 高血压合并冠心病患者应用氨氯地平联合阿托伐他汀钙片治疗能有效改善患者心率、血压情况,减轻患者症状,有利于提高患者生活质量,效果显著,值得临床推广应用.     

Relation between arterial pressure, dietary sodium intake, and renin system in essential hypertension

Forty-one patients with mild essential hypertension, 36 patients with severe hypertension, and 28 normotensive subjects were studied on a high sodium intake of 350 mmol/day for five days and low sodium intake of 10 mmol/day for five days. The fall in mean arterial pressure on changing from the high-sodium to the low-sodium diet was 0.7 +/- 1.7 mm Hg in normotensive subjects, 8 +/- 1.4 mm Hg in patients with mild hypertension, and 14.5 +/- 1.4 mm Hg in patients with severe hypertension. The fall in blood pressure was not correlated with age. Highly significant correlations were obtained for all subjects between the ratio of the fall in mean arterial pressure to the fall in urinary sodium excretion on changing from a high- to a low-sodium diet and (a) the level of supine blood pressure on normal diet, (b) the rise in plasma renin activity, and (c) the rise in plasma aldosterone. In patients with essential hypertension the blood pressure is sensitive to alterations in sodium intake. This may be partly due to some change either produced by or associated directly with the hypertension. A decreased responsiveness of the renin-angiotensin-aldosterone system shown in the patients with essential hypertension could partly account for the results.     

联合用药治疗糖尿病并高血压临床疗效观察

目的：探讨替米沙坦联合硝苯地平治疗糖尿病并高血压的临床疗效。方法：在控制血糖用药基础上,58例糖尿病并高血压患者服用替米沙坦（替米沙坦组）,57例患者服用硝苯地平（硝苯地平组）,64例患者服用替米沙坦和硝苯地平进行治疗（联合治疗组）。检测三组患者治疗前后血压、血脂四项、尿微量蛋白（ mAlb）、空腹血糖。记录患者不良反应。结果：与治疗前比较,三组患者治疗后的血压、TC、TG、mAlb和空腹血糖明显降低（P＜0．05或P＜0．01）;治疗后三组之间比较发现,联合治疗组患者血压、mAlb以及空腹血糖低于替米沙坦组和硝苯地平组（ P＜0．05）。联合治疗组显效率（67．2％）高于替米沙坦组（48．3％）和硝苯地平组（47．4％）（P＜0．05）,且其总有效率达96．9％,明显高于另两组（P＜0．05或P＜0．01）。单独用药的两组总有效率之间差异无统计学意义（P＞0．05）。三组均出现轻微不良反应,可自行恢复。结论：替米沙坦与硝苯地平联合治疗糖尿病肾病能有效降低患者血压,改善血脂水平,并降低因血压增高所致的靶器官损害,疗效优于单一用药,联合用药治疗方案合理,值得在临床上推广。     

中年男性2型糖尿病患者促甲状腺激素与尿钙/肌酐比值的相关性研究

目的：探讨中年男性2型糖尿病患者促甲状腺激素与尿钙/肌酐比值的相关性。方法：根据血促甲状腺激素（TSH）水平将516例中年男性2型糖尿病患者分为低TSH组、正常TSH组和高TSH组,测量身高、体质量、血压、空腹血糖、血肌酐、碱性磷酸酶、血钙、血磷、TSH、24 h尿钙、尿磷、尿肌酐。结果：随着TSH水平升高,中年男性2型糖尿病患者尿钙及尿钙/肌酐比值逐步降低（均P趋势〈0.05）。多元线性回归分析经年龄、糖尿病病程等因素调整后仍显示TSH是影响尿钙/肌酐比值的相关因素（β=-0.024,P〈0.05）。结论：中年男性2型糖尿病患者TSH与尿钙/肌酐比值呈负相关,TSH是影响尿钙排泄率的独立影响因素。