卡托普利对高血压大鼠血小板内游离钙和血小板功能的影响

本文建立二肾一夹型肾血管性高血压大鼠(2KIC-RHR)动物模型,观察大鼠在高血压稳定期血小板胞浆内游离钙浓度([Ca~(2+)]_i)及血小板聚集率(PAg)的变化并研究了ACEI—卡托普利对高血压大鼠血小板内[Ca~（2+）]_i及血小板聚集功能的影响.结果发现:高血压大鼠血小板内[Ca~（2+）]_i及血小板聚集率均显著升高(P<0.01),卡托普利显著降低血压同时血小板内[Ca~（2+）]_i、血小板聚集率也明显减小(P<0.01).提示:2KIC—RHR在高血压稳定期存在血小板内钙代谢异常和血小板功能的改变,血小板活性的降低可能参与卡托普利的降压作用.     

普萘洛尔和硝苯地平对男性高血压患者性功能影响

目的:探讨普萘洛尔和硝苯地平对男性高血压患者性功能的影响。方法:选取2008年1月-2011年1月在延安大学附属医院就诊的94例高血压患者作为研究对象,将所有对象随机分为2组,一组采用普萘洛尔治疗,一组采用硝苯地平治疗,观察治疗8周前后血压及性功能的改变。结果:2组患者在药物治疗8周后,血压水平较治疗前均明显降低(P<0.05);采用普萘洛尔治疗前后,患者性功能明显降低(P<0.05),而采用硝苯地平治疗前后,患者性功能无明显变化;普萘洛尔组在治疗后勃起功能障碍发生率明显高于硝苯地平组;普萘洛尔组在治疗后,机体内睾酮含量明显降低(P<0.05),而硝苯地平在治疗后无明显改变(P>0.05)。结论:普萘洛尔能影响患者的性功能,而硝苯地平不影响患者的性功能,因此对于高血压患者在采用降压治疗时,选择硝苯地平较好。     

硝苯地平联合卡托普利治疗原发性高血压的临床观察

目的:观察硝苯地平联合卡托普利治疗原发性高血压的临床疗效。方法:将116例原发性高血压患者随机均分为治疗组和对照组,停用其他降压药2周以上,均调节降压饮食、合理化运动。对照组口服卡托普利治疗,治疗组在对照组的基础上口服硝苯地平控释片治疗,8周后进行疗效评价。结果:治疗组总有效率为89.7%;对照组总有效率为70.7%,治疗组明显高于对照组(P<0.05)。治疗组收缩压和舒张压均较对照组降低,2组比较差异有统计学意义(P<0.05)。结论:硝苯地平联合卡托普利治疗原发性高血压效果优于单用卡托普利。     

卡托普利联合硝苯地平治疗原发性高血压合并2型糖尿病尿微量白蛋白的临床观察

目的:观察卡托普利联合硝苯地平缓释片对原发性高血压合并2型糖尿病尿微量白蛋白的影响。方法:100例原发性高血压合并2型糖尿病微量白蛋白尿阳性住院及门诊患者,在严格控制血糖的基础上,随机分成3组(联合治疗组50例、硝苯地平组26例、卡托普利组24例),分别用卡托普利+硝苯地平缓释片、硝苯地平缓释片、卡托普利治疗6个月,观察治疗前、后3组患者24h动态血压、糖化血红蛋白、24h尿微量白蛋白的变化。结果:3组患者血压均较治疗前降低,联合治疗组比单药治疗组下降明显(P<0.05)。治疗后联合治疗组尿微量白蛋白比单药治疗组下降明显(P<0.05)。结论:卡托普利联合硝苯地平缓释片治疗原发性高血压合并2型糖尿病,既能很好地控制血压,又能明显地降低尿微量白蛋白,保护肾功能。     

卡托普利联合硝苯地平治疗2型糖尿病合并高血压的临床研究

目的：探讨卡托普利联合硝苯地平治疗2型糖尿病合并高血压的临床疗效。方法：采用卡托普利联合硝苯地平治疗2型糖尿病合并高血压患者,并与单独采用卡托普利或硝苯地平治疗的患者进行临床疗效比较。结果：3组治疗后血糖水平和肾功能均明显改善（P〈0.05）;但联合组较对照组改善更为明显（P〈0.05）。联合组的显效率和总有效率均明显高于卡托普利组和硝苯地平组（P〈0.05）。另外,3组患者均未见心、肝、肾等明显不良反应。结论：卡托普利联用硝苯地平治疗2型糖尿病合并高血压病的临床效果与单一使用这两种药物相比效果更为明显,且无明显不良反应,服用方便,治疗依从性好,值得临床推广使用。     

联合应用降压药治疗原发性高血压的临床疗效观察

目的:探讨联合应用降压药治疗原发性高血压的临床疗效。方法:分别用卡托普利、硝苯地平和二者联合治疗在我院就诊的原发性高血压患者,观察并比较三者的临床疗效。结果:联合用药组患者的治疗总有效率为95.4%,明显高于卡托普利组和硝苯地平组患者(P0.05);治疗后的舒张压和收缩压分别为(88.8±5.9)mmHg和(133.6±7.5)mmHg,均明显低于卡托普利组和硝苯地平组患者(P0.05);治疗期间的不良反应发生率为10.8%,明显低于卡托普利组和硝苯地平组患者(P0.05)。结论:联合应用降压药治疗原发性高血压的临床疗效和安全性均优于单一用药。     

卡托普利联合硝苯地平治疗高血压的临床效果观察

目的分析卡托普利联合硝苯地平治疗高血压患者的临床效果。方法随机抽取2011年7月~2014年8月期间,我院收治高血压患者78例,按临床治疗意愿分成两组,对照组患者单纯服用卡托普利,治疗组患者给予卡托普利与硝苯地平联合治疗,比较两组患者临床疗效。结果治疗组患者临床好转率、不良反应发生率及血压改善情况均优于对照组患者,差异有统计学意义(P<0.05)。结论卡托普利联合硝苯地平治疗高血压患者,降压作用优于单纯使用卡托普利,且两组药物均为临床一线用药,联合使用具备协同降压作用,副反应少,经济负担轻,适合在当下经济欠发达的农村地区推广应用。     

卡托普利硝苯地平治疗老年高血压临床研究

报道卡托普利、硝苯地平治疗老年单纯收缩期(ISH)高血压56例,用随机单盲对照方法分为A、B两组,结果发现对老年ISH患者选择卡托普利更优越。     

卡托普利对胰岛素抵抗-高血压综合征大鼠TNF-α、NO和SOD水平的影响

目的:研究卡托普利对胰岛素抵抗-高血压综合征大鼠动物模型的影响.方法:用高糖高盐高脂喂饲大鼠的方法建立胰岛素抵抗-高血压(IRH)病理模型,随机分为空白对照组、模型组和卡托普利组.正常对照组和模型对照组均肌注5%丙二醇,0.8 ml·kg-1·d-1,qd×4周,卡托普利组肌注卡托普利7 mg·kg-1·d-1,qd×4周,以上各组在给药后第2和第4周,各测血压一次,在第4周末,全部大鼠禁食过夜,末次给药2 h后,全部大鼠眼眶放血,离心分离血清,用酶联免疫分析仪测定肿瘤坏死因子(TNF-α),空腹血糖,一氧化氮(NO)、超氧化物歧化酶(SOD)含量及给药前后的血压变化.结果:给药4周后,卡托普利组大鼠的血压为(126±4.5)mmHg,2 h血糖(2 hBG)为(6.81±0.52)mmol·L-1,与模型对照组比较有明显降低(P<0.01).同时,卡托普利能明显降低IRH大鼠的TNF-α含量(P<0.01),并明显降低胰岛素抵抗(IR)大鼠NO的含量,而使SOD水平有所上升.结论:卡托普利有效降低血糖值,有抗高血压,改善胰岛素抵抗作用.     

卡托普利联合硝苯地平治疗原发性高血压60例疗效观察

目的探讨卡托普利与硝苯地平联合方案治疗原发性高血压的临床疗效及安全性。方法采用单盲前瞻性随机对照实验方法,选取120例原发性高血压作为调查对象,给予对照组(n=60)单纯硝苯地平缓释片治疗,观察组(n=60)患者接受卡托普利联合硝苯地平方案治疗,对比两组患者的治疗效果、不良反应发生情况。结果所有患者均顺利完成12周的药物治疗,观察组的总有效率明显高于对照组,差异有显著性(P<0.05);对照组不良反应发生率16.7%(10/60),观察组不良反应发生率3.3%(2/60),观察组显著低于对照组(P<0.05)。结论卡托普利联合硝苯地平缓释片治疗原发性高血压疗效肯定、安全、有效,可临床推广使用。     

Comparison of sublingual captopril and sublingual nifedipine in hypertensive emergencies

Hypertensive crises require immediate therapy, usually by parenteral drug administration. Sublingual nifedipine has been shown to be highly effective. However, the blood pressure fall following nifedipine is frequently associated with side-effects. The use of sublingual captopril has recently been indicated in hypertensive crisis, assuming that by this route, there would be a faster absorption and thus a more rapid effect on blood pressure than with the oral route. To verify this hypothesis, we have compared the hypotensive effects of sublingual nifedipine and sublingual captopril in 52 patients with hypertensive emergencies: 25-mg captopril and 10-mg nifedipine were administered sublingually to 28 and 24 patients, respectively. Blood pressures and heart rates were continuously measured up to 240 min postdose. A significant (P less than 0.001) hypotensive effect of both sublingual captopril and nifedipine therapy occurred at 5 min and persisted for 240 min. Heart rates increased with nifedipine, but decreased with captopril. We observed no side-effects in the captopril group, but flushing, tachycardia and headache were observed in 6 patients in the nifedipine group. We conclude that sublingual captopril is effective in patients with hypertensive emergencies and that captopril may be an excellent alternative to sublingual nifedipine in the urgent treatment of hypertensive crisis.     

高血压大鼠学习记忆障碍及降压药物疗效

目的：观察高血压大鼠学习记忆功能的损害并评价比较降压药物的治疗效果。方法：自发性高血压大鼠（ＳＨＲ，１６ｗｋ）分３组（ｎ＝６），其中两组分别使用尼群地平、卡托普利，另一组为对照组；肾血管性高血压Ｗｉｓｔａｒ－Ｋｙｏｔｏ（ＷＫＹ）大鼠（ＲＨＲ，１６ｗｋ）共６组（ｎ＝６），其中５组分别使用卡托普利、美多洛尔、普萘洛尔、硝苯地平、哌唑嗪，另一组不用药。再设一正常对照ＷＫＹ（１６ｗｋ，ｎ＝６）组。治疗８ｗｋ后，连续５ｄ进行跳台试验，每天１０次。结果：两种未经治疗的高血压大鼠ｄ５的主动回避反应计分均有不同程度的下降（ＳＨＲ：０．９±１．１，ＲＨＲ：４．２±１．２ｖｓ，ＷＫＹ：８．７±１．８，Ｐ均＜０．０１）；用药ＳＨＲ两组与对照ＳＨＲ组相比（３．６±１６，４．３±１．８ｖｓ０．９±１．１，Ｐ＜０．０５），记分明显改善；ＲＨＲ美多洛尔７．７±１．６，ＲＨＲ普萘洛尔８．３±１．９，ＲＨＲ卡托普利８．０±２．０，ＲＨＲ硝苯地平７．２±１．７，ＲＨＲ哌唑嗪７．３±１．７，与ＲＨＲ对照（４．２±１．２）比较，Ｐ均＜０．０１；主动回避反应计分有显著提高。进一步比较不同药物治疗组，当降压程度相似时，各组主动回避反应计分无明显差别。?     

Blood pressure, baroreflex sensitivity, and end organ damage in hybrid offspring of spontaneously hypertensive rats and Sprague-Dawley rats

AIM: To investigate the blood pressure (BP), baroreflex sensitivity (BRS), and organ damage in hybrids of spontaneously hypertensive rats and Sprague-Dawley rats. METHODS: Spontaneously hypertensive rats and Sprague-Dawley rats were crossbred, and the F1 hybrids were inbred randomly to produce an F2 generation. At the age of 52 weeks, the F1 and F2 hybrids were tested to determine BP and BRS in a conscious state. Histopathological examinations were carried out after BP recording and BRS studies. RESULTS: BP and BRS were not different in F1 and F2 hybrids. BRS was inversely related to systolic BP (SBP) in male, female, or whole populations of hybrids. Quantitatively, BRS values were one-third determined by SBP level (the determinant coefficient was 0.326). The indexes for left ventricular hypertrophy, aortic hypertrophy, and renal damage were all positively related to BP, and negatively related to BRS. In multiple-regression analysis, left ventricular and aortic hypertrophy and glomerulosclerosis score were all most significantly associated with lower BRS and higher systolic BP. The contribution of BRS to left ventricular and aortic hypertrophy and glomerulosclerosis was greater than that of SBP. CONCLUSION: The present work with hybrid rats demonstrated quantitatively that the BRS value was one-third determined by SBP level. Both BP level and BRS value contributed greatly to the hypertensive organ damage. However, the contribution of BRS to the hypertensive organ damage was greater than that of BP level in these rats.     

Diminished responses to nifedipine imply severe end-organ damage in spontaneously hypertensive rats

This study was designed to investigate the effect of end-organ damage (EOD), the initial blood pressure levels, and baroreflex sensitivity (BRS) on the blood pressure-lowering effect of nifedipine in spontaneously hypertensive rats (SHRs). Nifedipine was intravenously administered at a dose of 1 mg/kg. BP was continuously recorded in the conscious state before and after nifedipine administration. BRS was determined before drug administration. Two days after the blood pressure (BP) recording, rats were killed for organ-damage evaluation. Univariate correlation analysis showed that BP changes induced by nifedipine injection were negatively correlated with EOD score and aortic weight/length but positively correlated with left kidney weight/body weight and basal BP levels. Stepwise multiple linear regression analysis demonstrated that increase in overall end-organ damage was most significantly related to the decrease in hypotensive effect of nifedipine; increase in aortic hypertrophy was also related to a decreased fall in systolic and diastolic BP induced by nifedipine, whereas increase in initial BP levels was associated with increased hypotensive effect of nifedipine. In conclusion, the severity of overall EOD contributed more than basal BP levels to the diminished responses to nifedipine, and aortic hypertrophy was also involved in diminished drug responses.     

Blood pressure variability, cardiac baroreflex sensitivity and organ damage in experimentally hypertensive rats

1. The present study was designed to investigate the haemodynamic features and morphological changes in experimentally hypertensive rat models. 2. Sprague-Dawley rats were used to prepare the experimentally hypertensive models, including two-kidney, one-clip renovascular hypertensive (2K1C) rats, deoxycorticosterone acetate salt hypertensive (DOCA) rats and N(G)-nitro-l-arginine methyl ester-induced hypertensive (l-NAME) rats. Six weeks after the induction of hypertension, 24 h blood pressure was recorded and blood pressure variability (BPV) expressed by 24 h (or 12 h in the daytime and night-time study) standard deviation of the variables was calculated. Then, cardiac baroreflex sensitivity (BRS) was determined and four endogenous factors (tumour necrosis factor-alpha, interleukin-1beta, angiotensin II and endothelin-1) were measured. Finally, morphological changes were examined. 3. It was found that an increase in BPV and a decrease in BRS were accompanied by an elevation of blood pressure in all three hypertensive models. The DOCA rats had the highest BPV, whereas the l-NAME rats had the lowest BRS. 4. Morphological changes were similar in DOCA and l-NAME rats and the cardiac changes were relatively slight in 2K1C rats. Tumour necrosis factor-alpha was increased in all the three models, especially in DOCA rats. Endothelin-1 was higher in DOCA rats and angiotensin II was increased in 2K1C rats and decreased in DOCA rats. 5. In conclusion, increased BPV and decreased BRS accompanied the elevation of blood pressure in all three hypertensive models. The DOCA rats had the highest BPV and the l-NAME rats had the lowest BRS. Obvious organ damage was seen in all three hypertensive models 6 weeks after the induction of hypertension.     

高血压3种治疗方案的成本效果分析

应用药物经济学的成本效果分析方法 ,对临床常用的 3种治疗高血压的方案 ,进行了回顾性分析评价 ,为临床合理用药 ,提供参考依据。 3种治疗方案病人的平均每天治疗费用没有显著性差异 (P >0 0 5 )。成本效果比 :硝苯地平与硝苯地平加卡托普利基本一致 ,约为 0 0 32 ,硝苯地平加阿替洛尔约为 0 0 2 4,说明前两种方案疗效好 ,花费少 ,而后一种方案临床疗效差 ,且治疗费用高     

Effect of Captopril and Propranolol,Alone and in Combination,on the Responses to Isometric and Dynamic Exercise in Normotensive and Hypertensive Men

This study evaluated the effects of single doses of the angiotensin converting enzyme inhibitor captopril and the beta-adrenergic blocking agent propranolol, alone or in combination, on the blood pressure, heart rate and humoral responses to both isometric (handgrip) and dynamic (ergometric) exercise in normotensive and hypertensive men. Single oral doses of either placebo, captopril 50 mg, propranolol 80 mg, or the latter two in combination were administered to age-matched groups (n = 5) of normotensive and hypertensive men in a random, double-blind manner. Captopril alone was indistinguishable from placebo after both isometric and ergometric exercise. Propranolol suppressed heart rate after both types of exercise and tended to decrease systolic blood pressure only in the hypertensive group; combination with captopril did not alter these responses. These data suggest that in sodium-replete subjects undergoing short-term vigorous exercise, the renin-angiotensin system, as measured by captopril inhibition, is less important than the sympathoadrenal system, as measured by propranolol inhibition, in the reflex cardiovascular adjustments accompanying acute isometric and dynamic exercise in both normotensive and hypertensive men.     

不同降压药对高血压伴糖尿病治疗效果的对比观察

目的分析不同降压药对高血压伴糖尿病的疗效。方法选取2010年1月～2012年12月在本院接受治疗的高血压患者96例,随机分为呋塞米组、卡托普利组和硝苯地平组各32例,分别采用呋塞米、卡托普利和硝苯地平治疗,观察3组的血压、脂联素和胰岛素抵抗水平。结果卡托普利组的降压效果较明显,好于呋塞米组和硝苯地平组的患者（P〈0.05）;卡托普利组的脂联素和胰岛素抵抗改善均优于其他两组（P〈0.05）。结论卡托普利能明显改善高血压伴糖尿病患者的血压和预后。     

Blood pressure variability and baroreflex sensitivity are not different in spontaneously hypertensive rats and stroke-prone spontaneously hypertensive rats

AIM: To demonstrate and compare hemodynamic phenotypes of blood pressure (BP), blood pressure variability (BPV) and baroreflex sensitivity (BRS) in genetic hypertensive rats. METHODS: BP was recorded continuously in conscious, freely moving rats using a computerized technique. BPV was expressed as the standard deviation of beat-to-beat BP values during a 1-h period. BRS was determined by measuring the heart period prolongation in response to the elevation in BP produced by an intravenous injection of phenylephrine. RESULTS: Body weight and heart period were not different between spontaneously hypertensive rats (SHR) and stroke-prone spontaneously hypertensive rats (SHR-SP) at the age of 15 weeks. The BP level was markedly higher in SHR-SP than SHR, whereas there were no significant differences in BPV and BRS. Quantitatively, systolic, diastolic and mean BP were significantly elevated by 36.9%, 42.9% and 39.5%, respectively, in SHR-SP compared with SHR (P < 0.01). However, their variabilities were elevated only by 14.0%, 0.4% and 10.1%, respectively, without statistical significance (P > 0.05). CONCLUSION: BPV and BRS were not changed in parallel with the BP alterations in SHR and SHR-SP.     

Effect of calcium antagonists and other drugs on the hypoxia-induced increase in rat right ventricular pressure

The effect of four calcium antagonists (nifedipine, nitrendipine, nisoldipine, and verapamil) on hypoxia-induced changes in right ventricular parameters were examined in anesthetized closed-chest rats using an ultraminiature catheterization technique. The effect of the calcium antagonists was compared to the alpha-adrenoceptor blocker prazosin, the beta-adrenoceptor blocker propranolol, the angiotensin-converting enzyme (ACE) inhibitor captopril, and the vasodilator nitroglycerin. The animals were exposed to two successive 5-min hypoxic periods separated by a normoxic interval of 60 min, during which the animals received an intravenous (i.v.) infusion of the substances tested. Hypoxia caused a marked rise in right ventricular systolic pressure (RVSP) and a moderate increase in RVdP/dtmax. Heart rate (HR) was only slightly enhanced. The functional response to the second hypoxic period did not differ from the first one in NaCl-infused animals. All calcium antagonists reduced the hypoxic pressure increase in a dose-dependent manner and ultimately abolished it. Nisoldipine was the most effective substance, followed by nifedipine, nitrendipine, and verapamil. In contrast, prazosin and propranolol did not influence the hypoxic pressure response. Administration of captopril and nitroglycerin attenuated the increase in RVSP. Thus, as compared with the other substances tested, calcium antagonists were the most effective drugs that antagonized the hypoxia-induced increase in RVSP.