Withdrawal of antihypertensive therapy. Hypertensive crisis in renovascular hypertension

Hypertensive crises were reported in three patients with hypertension associated with underlying renovascular occlusive disease during reduction of antihypertensive therapy. In each case, rebound hypertension was observed during clonidine hydrochloride withdrawal. Therapy with propranolol hydrochloride and diuretics had also been discontinued in two of the three patients. This and other reports of rebound hypertension during clonidine withdrawal are contrasted with the absence of reports of this syndrome in the setting of cessation of beta-adrenergic blockade therapy. This suggests that the discontinuation of clonidine therapy was primarily responsible for the hypertensive crises herein described. It is further concluded that rebound hypertension may follow gradual as well as abrupt reduction of clonidine dosage, and that patients with renovascular hypertension may be at greatest risk.     

新型抗高血压治疗可减少心血管事件

Lancet在线杂志（www.lancet．com）刊载的盎格鲁-斯堪地那维亚心脏预后试验-降压分支试验（ASCOT—BPLA试验）的最终结果表明，与以β受体阻滞剂阿替洛尔（atenolol）为基础的抗高血压治疗方案比较，以钙通道拮抗剂氨氯地平（amlodipine）加上血管紧张素转换酶抑制剂培哚普利（perindopril）为基础的抗高血压治疗方案可以有效地降低心血管事件的发生。     

呼吸道异物特殊情况的处理

[目的]探讨呼吸道异物救治当中一些特殊情况的发生原因和处理方法。[方法]总结分析西安交通大学第二医院1965至2000年收治的呼吸道异物病人3 306例。年龄最小4个月,最大68岁,其中3岁以下2 208例。[结果]上述病例中气管切开97例,咳出41例,开胸12例,经口支气管镜检取出3156例。死亡24例。[结论]对在呼吸道异物救治当中出现的特殊情况要对症处理:注意气管切开的时机;选择适当的麻醉,掌握好麻醉深度;特别注意变位性异物和喘息型气管异物的处理;特殊异物要选择适当的器械和正确的方法,必要时请胸科开胸取异物;正确使用心肺复苏,妥善处理并发症和后遗症。     

Improved survival from stroke. An effect of antihypertensive therapy?

A major improvement in the case/fatality ratio of patients who were admitted to the Royal Melbourne Hospital with a first stroke was observed between 1974, and 1978. Reference to a current population-based stroke-incidence study enabled the most likely cause, changing selection criteria, to be discounted and there have been no improvements in acute hospital care to which this improvement may be attributed. The hypothesis is advanced that the marked improvement in survival after a first stroke, particularly in older patients, observed between the hospital series may be related to the high and increasing prevalence of treatment for hypertension in the community.     

舌咽神经痛的病因及治疗现状

舌咽神经痛最先由Weisenburg(1910年)所描述,特点为沿该神经分布区的短暂发作性剧痛.其发病率并不高,约为三叉神经痛的1%.据Rushton(1981年)[1]的217例统计,43%发病在18～50岁,以男性居多.国内报道,患者多为50岁左右,男女比例无差异.现就舌咽神经痛病因及治疗现状综述如下.     

Focal cerebral ischaemia and infarction due to antihypertensive therapy

Eight cases of postural focal cerebral ischaemia due to antihypertensive medications presented to one neurologist over an eight-month period. Most patients were elderly and suffered from chronic hypertension; their symptoms resolved after the reduction or cessation of these medications. These findings re-emphasize that considerable caution is required when antihypertensive medications are used in elderly persons and in patients with chronic hypertension whose cerebral blood-flow autoregulatory curves are shifted to the right. We also draw attention to the fact that drug-induced hypotension may induce focal cerebral ischaemia rather than generalized cerebral ischaemia more frequently than is generally appreciated.     

高血压伴肾功能不全降压治疗效果及影响因素分析

高血压合并肾功能不全在治疗上比单纯高血压病明显复杂。本实验对高血压合并肾功能不全的患者进行了降血压治疗效果及影响因素研究。     

综述：小剂量联合用药降压优于单药标准剂量

数据来源：Medline(1966～2000年，包括2001年的血管紧张素Ⅱ受体拮抗剂的研究)、Cochrane图书馆、科学数据库网、相关研究的参考书目、制药公司。