厄贝沙坦与苯磺酸氨氯地平治疗轻中度原发性高血压的疗效比较

目的:比较厄贝沙坦(安博维)与苯磺酸氨氯地平(络活喜)治疗轻中度原发性高血压的降压疗效.方法:将2008年1月至2009年12月于明确诊断为轻中度原发性高血压患者100例随机分为安博维组和络活喜组各50例,分别应用安博维和络活喜治疗,比较两组治疗8周时的降压疗效.结果:治疗2周、4周、6周和8周时安博维组和络活喜组的降压有效(率)分别为35例(70%)、38例(76%)、41例(82%)、43例(86%)和36例(72%)、39例(78%)、40例(80%)、42例(84%),两组各疗程均无显著性差异.结论:厄贝沙坦(安博维)与苯磺酸氨氯地平(络活喜)治疗轻中度原发性高血压均可获良好疗效,且无明显不良反应.     

Pharmacokinetics and Pharmacodynamics of Levornidazole in Patients With Intra-abdominal AnaerobicInfection

Purpose

The pharmacokinetic (PK) and pharmacodynamic characteristics of levornidazole were studied in patients with intra-abdominal anaerobic infection to provide the rationale of new clinical dosing regimen of levornidazole.

加倍剂量厄贝沙坦治疗慢性肾脏病轻中度蛋白尿的临床研究

目的 研究加倍剂量厄贝沙坦治疗慢性肾脏病轻中度蛋白尿的疗效及安全性.方法 80例纳入研究的患者按随机数字表法分为试验组(40例)与对照组(40例).试验组厄贝沙坦在尿蛋白未完全缓解时每8周剂量在原剂量基础上增加1倍,分为3个阶段;对照组24周均予以黄葵胶囊常规剂量治疗.治疗过程中监测尿液分析、24 h尿蛋白定量、血液分析、电解质、肾功能、肝功能、血压及观察不良反应.结果 1)试验组24 h尿蛋白定量试验前为(2.35±0.86)g,第1阶段治疗后降至(1.96±0.85)g(P＜0.01),第2阶段治疗后降至(1.35±0.56)g(P＜0.01),第3阶段治疗后降至(0.65±0.35)g(P＜0.01);对照组24 h尿蛋白定量治疗前为(2.30±0.95)g,治疗后降至(1.25±0.52)g(P＜0.01);2组患者治疗24周后24 h尿蛋白定量比较,差异有统计学意义(P＜0.05),24 h尿蛋白基线水平下降百分比比较,差异有统计学意义(P＜0.05).2)试验组完全缓解22例,部分缓解10例,部分有效4例,总有效率为94.74%;对照组完全缓解15例,部分缓解8例,部分有效8例,总有效率为83.78%.3)试验组中5例患者在予以厄贝沙坦300 mg Bid剂量时出现过一过性体位性低血压症状,试验组患者未出现干咳现象.2组患者中均未出现血肌酐值升高大于基线值的30%,均未出现高血钾.2组患者所测血钠、血氯、血钙、血磷、血镁及肝功能在治疗前后差异均无统计学意义(P＞0.05).结论 1)厄贝沙坦组较对照组降尿蛋白更有显著疗效,且成剂量依赖性.2)150 mg Bid剂量厄贝沙坦具有良好的降尿蛋白疗效及安全性.3)300 mg Bid剂量厄贝沙坦治疗时虽有显著降尿蛋白疗效且未见高血钾、干咳及血肌酐明显升高不良反应,但需要高度警惕体位性低血压发生率的上升.     

厄贝沙坦和依那普利治疗轻中度高血压患者临床效果分析

目的分析比较厄贝沙坦和依那普利治疗轻中度高血压患者的临床疗效与安全性。方法以随机数字表法将我院2011年7月～2011年12月收治的172例轻中度高血压患者分为观察组与对照组各86例。对照组患者给予每天10mg依那普利治疗,观察组患者给予每天150mg厄贝沙坦治疗。治疗28d后,根据患者每周的血压检测(ABPM)记录进行对比分析。结果观察组和治疗组两组患者服药后血压均明显降低(P<0.05),厄贝沙坦观察组患者服药后不良反应发生率明显低于依那普利对照组(P>0.01)。结论厄贝沙坦和依那普利治疗轻中度高血压均可达到预期效果,厄贝沙坦治疗轻中度高血压比依那普利更为安全。     

Pharmacokinetics and Pharmacodynamics of Avitriptan in Patients With Migraine After Oral Dosing

Avitriptan (BMS-180048) is a 5-HT₁-like receptor agonist for the treatment of migraine. This double-blind, placebo-controlled, randomized, parallel-group study evaluated the pharmacokinetics, safety, and preliminary efficacy of avitriptan in patients with migraine during migrainous and pain-free states. Patients met the IHS criteria for migraine with or without aura and suffered one to six migraines per month for at least 1 year. Patients in a clinic experiencing a migraine headache received avitriptan 75 mg, 150 mg, or 200 mg or matching placebo capsules. Blood samples were obtained before and 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, and 6 hours after dosing. Headache intensity was rated before and up to 6 hours after dosing. Seven to 30 days after the inclinic treatment, patients returned in a pain-free state for the same study medication. All pharmacokinetic and safety measures were repeated. Forty-eight patients (9 men and 39 women) participated. Peak plasma concentrations of avitriptan were achieved 1 to 2 hours following dosing in migraine and pain-free states for all doses. The pharmacokinetics of avitriptan were proportional to dose during a migraine attack over the 75- to 200-mg dose range. The 150- and 200-mg doses of avitriptan demonstrated a greater decrease in headache intensity scores at 2 hours postdose. The most common adverse event was paresthesia. Thus, avitriptan was rapidly absorbed, well tolerated, and demonstrated preliminary efficacy in this population.     

Fluticasone/Formoterol Combination Therapy Compared With Monotherapy in Adolescent and Adult Patients With Mild to Moderate Asthma

Objectives

This study investigated the efficacy and tolerability of a new asthma therapy combining fluticasone propionate and formoterol fumarate (fluticasone/formoterol)*, administered twice daily (BID) via a single aerosol inhaler, compared with fluticasone propionate (fluticasone) or formoterol fumarate (formoterol) administered alone, in patients with mild to moderate asthma.

Methods

Patients aged ≥12 years were evenly randomized to 12 weeks of treatment with fluticasone/formoterol (100/10 µg BID), fluticasone (100 µg BID), or formoterol (10 µg BID), in this multicenter, double-blind, parallel-group, study. The 2 coprimary end points were: (1) change in forced expiratory volume in 1 second (FEV₁) from morning predose at baseline to predose at week 12 for the comparison of the combination product with formoterol alone; and (2) change in FEV₁ from morning predose at baseline to 2 hours postdose at week 12 for the comparison of the combination product with fluticasone alone. The secondary objective was to demonstrate the efficacy of fluticasone/formoterol using other pulmonary function tests and clinical end points. Tolerability was assessed based on adverse events, clinical laboratory tests and vital sign evaluations.

Results

Statistically significant differences were demonstrated for the 2 coprimary end points. Fluticasone/formoterol combination therapy showed significantly greater improvements from baseline to end of study in the change in predose FEV₁ compared with formoterol (least squares [LS] mean treatment difference, 0.118 L [95% CI, 0.034–0.201; P = 0.006]) and the change in predose compared with 2 hours postdose FEV₁ versus fluticasone (LS mean treatment difference, 0.122 L [95% CI, 0.040–0.204; P = 0.004]). Statistical analyses of the secondary efficacy endpoints revealed that evaluations of lung function, asthma exacerbations, asthma symptoms, rescue medication use and asthma control were supportive overall of the superior efficacy of fluticasone/formoterol combination therapy compared with its individual components; were supportive overall of the efficacy of fluticasone/formoterol combination therapy compared with its individual components. Since the secondary endpoints were analyzed using the sequential gatekeeper approach, only the mean change from baseline to final week in morning peak expiratory flow rate between the combination-therapy and formoterol groups returned statistically significant results (least squares mean difference, 20.05 [95% CI, 7.631-32.472; P = 0.002]). The fluticasone/formoterol combination therapy had a good tolerability profile over the 12-week treatment period.

Conclusions

Fluticasone/formoterol had a good tolerability profile and showed statistically superior efficacy for the two co-primary endpoints compared to fluticasone or formoterol, in adolescents and adults with mild to moderate asthma. ClinicalTrials.gov identifier: NCT00394199.     

Clinical Efficacy and Safety of Lower-Dose Indapamide Therapy in the Treatment of Patients with Mild to Moderate Hypertension

Previous clinical studies with indapamide, an indoline antihypertensive drug with diuretic and vasodilating activities, have shown a dose relationship associated with potassium loss. Two placebo-controlled, randomized, double-blind, parallel clinical studies were, therefore, done to evaluate the safety and efficacy of a low dose (1.25 mg) of indapamide and to determine if an improved safety profile could be produced while maintaining efficacy with a 1.25-mg dose in patients with mild to moderate essential hypertension. Four hundred seventeen (417) adult patients with mild to moderate essential hypertension (sitting diastolic blood pressure greater-than-or-equal 95 mmHg and less-than-or-equal 110 mmHg) were enrolled in two clinical studies; 209 patients were randomized to indapamide 1.25 mg and 208 patients to placebo. Patients received single-blind placebo for a 4-week washout period followed by an 8-week double-blind treatment period during which patients received either indapamide 1.25 mg or placebo. The primary efficacy endpoint was the mean change from baseline to week 8 in sitting diastolic blood pressure. Secondary efficacy variables were the proportion of patients whose sitting diastolic blood pressure had decreased greater-than-or-equal 10 mmHg and/or had a sitting diastolic blood pressure of less-than-or-equal 90 mmHg (treatment success) at all visits and at endpoint, mean changes from baseline in sitting diastolic blood pressure at designated timepoints and at endpoint, and mean changes from baseline in standing diastolic blood pressure and in sitting and standing systolic blood pressure at all visits and at endpoint. Results of these trials were pooled in order to have a larger patient population in an attempt to detect trends not readily apparent with a smaller sample size. In the primary analysis, indapamide produced statistically significantly (p = 0.0001) greater reductions in sitting diastolic blood pressure than placebo after 8 weeks of therapy. In the secondary analysis, the percentage of indapamide-treated patients who achieved treatment success after 8 weeks of therapy was statistically significantly (p < 0.0001) higher compared to placebo-treated patients. In addition, indapamide produced a statistically significantly (p = 0.0001) superior reduction compared to placebo in sitting systolic and standing systolic and diastolic blood pressure after 8 weeks of therapy. The incidence of drug-related adverse events between patients in the indapamide and placebo groups was similar. There were no clinically meaningful differences in laboratory values, including serum potassium, between the patients in the indapamide and placebo groups. Low-dose (1.25 mg) indapamide proved to be safe and effective in the treatment of mild to moderate hypertension.     

Prevalence of Nocturnal Hypoxaemia Amongst Men with Mild to Moderate Hypertension

Thirty men (aged 35—65) with untreated essential hypertension(BP     

Effect of Nifedipine on the Steady-State Pharmacokinetics and Pharmacodynamics of Irbesartan in Healthy Subjects

BACKGROUND: In clinical practice, nifedipine has the potential to alter the pharmacokinetics, and therefore possibly the pharmacodynamics and efficacy or safety, of irbesartan. The objectives of the current study were to determine the effects of concomitant administration of nifedipine on the steady-state pharmacokinetics and pharmacodynamics of irbesartan in 12 healthy subjects. METHODS AND RESULTS: This was an open-label, randomized, crossover study. Each subject received irbesartan 300 mg once daily for 4 days in one period and irbesartan 300 mg once daily plus long-acting nifedipine (Procardia XL, Pratt Pharmaceuticals, New York, NY) 30 mg once daily for 4 days in the other period. The order of treatment periods was randomized, and a minimum 7-day washout phase separated the two periods. Steady state was achieved by day 3. On day 4, no significant differences were observed between the two treatments with respect to maximum concentration of irbesartan at the end of the dosing interval (C(max)) or the area under the plasma concentration versus time curve during a dosing interval (AUC(tau)) of irbesartan. Steady-state C(max) and AUC(tau) met the criteria for bioequivalence when irbesartan was administered alone or with nifedipine. On day 4, mean plasma renin activity was somewhat higher at every point but one when irbesartan was administered with nifedipine; however, no significant difference was observed between the two treatments in mean 24-hour AUC values. On day 4, there was a modest overall decrease from baseline in mean blood pressure for both treatments. No significant differences were observed between the two treatments in mean 24-hour AUC values for seated diastolic or systolic blood pressure. No serious adverse events were reported. CONCLUSIONS: Concomitant administration of nifedipine 30 mg with irbesartan 300 mg for 4 days in healthy subjects (1) does not alter the steady-state pharmacokinetic parameters of irbesartan, (2) results in C(max) and AUC(tau) values for irbesartan that meet the criteria for bioequivalence, and (3) is well tolerated.     

吲哒帕胺联合比索洛尔治疗原发性高血压患者的疗效观察

目的：探讨小剂量吲哒帕胺联合比索洛尔治疗原发性高血压患者的安全性和疗效。方法：60例初诊的高血压Ⅰ级、Ⅱ级患者,随机分为治疗组及对照组。治疗组予以吲哒帕胺2.5mg/次,及比索洛尔2.5mg/次,每天早晨7时服药1次;对照组单用吲哒帕胺2.5mg/次,每天早晨7时口服1次,疗程8周。结果：两组患者血压（收缩压及舒张压）均有下降,但以治疗组血压下降明显。治疗组显效13例,有效14例;对照组显效8例,有效15例;治疗组总有效率为90%,治疗组无效率为10%;对照组有效率76.7%,无效率23.3%,2组疗效差异有统计学意义（P〈0.05）。两组不良反应相似,治疗前后生化指标变化差别无统计学意义。结论：比索洛尔联合吲哒帕胺治疗原发性高血压安全有效,对糖、脂代谢无明显影响。     

Early Use of Remdesivir and Risk of Disease Progression in Hospitalized Patients With Mild to Moderate COVID-19

PurposePreliminary data suggest that remdesivir may influence the course of COVID-19 according to the duration of pre-admission symptoms. We aim to evaluate whether early use of remdesivir is associated with a reduced COVID-19 progression in a homogeneous cohort of patients with mild to moderate COVID-19.MethodsThis prospective, observational study included patients with COVID-19 pneumonia treated with remdesivir at the University Hospital of Pisa (Italy) from September 2020 to January 2021. According to national recommendations, remdesivir was prescribed in patients with pneumonia who required oxygen supplementation by nasal cannula or mask but without the need for high-flow nasal cannula, non-invasive or invasive mechanical ventilation and had symptoms from no more than 10 days. Patients who received early (≤5 days from onset of symptoms) versus late (>5 days from onset of symptoms) remdesivir were compared. The primary outcome was a composite of high-flow nasal cannula, non-invasive or invasive mechanical ventilation, or death. A multivariate logistic regression analysis was performed to identify factors independently associated with the composite endpoint.FindingsAmong 312 consecutive patients with COVID-19 pneumonia who received remdesivir, 90 (28.8%) received early remdesivir, whereas 222 (71.2%) received late remdesivir. Twenty-nine patients (32.2%) in the early-remdesivir group versus 104 patients (46.8%) in the late-remdesivir group met the primary end point (P = 0.018). On multivariate analysis, a history of dyspnea at home (odds ratio = 2.53; 95% CI, 1.55–4.12; P < 0.001) was the strongest factor independently associated with the progression to severe COVID-19, whereas early-remdesivir use was a protective factor (odds ratio = 0.49; 95% CI, 0.27–0.87; P = 0.015). The delayed admission to the hospital was associated with a delayed administration of remdesivir.ImplicationsThe early use of remdesivir (<5 days from symptoms onset) may reduce COVID-19 progression. The identification of patients who need early hospitalization and early remdesivir may provide clinical benefit in patients with COVID-19.     

A Study of the Efficacy and Safety of Moexipril in Mild to Moderate Hypertension

This placebo-controlled, double-blind, multicenter study examined the efficacy, safety, and tolerability of the angiotensin-converting enzyme inhibitor, moexipril, in lowering blood pressure in mildly to moderately hypertensive patients. Patients were initially randomized into four groups, two of which received moexipril 7.5 mg per day and two received moexipril 15 mg per day, for first 12 weeks of treatment. Patients then entered a withdrawal phase with one of the groups in each dose category continuing that dose of moexipril and one receiving placebo for 12 more weeks. From 223 patients randomized initially, 190 completed the 12-week withdrawal phase. In the two dosage groups from baseline to 12 weeks, sitting diastolic blood pressure decreased from 101.1 to 92.8 mm Hg for the 7.5-mg group and from 100.7 to 91.3 mm Hg for the 15-mg group (p < 0.05 baseline to week 12 in both groups) with a significant difference between those groups attained at week 12 only (p = 0.03). By the end of the withdrawal phase (24-week evaluation), the group that continued to receive 7.5 mg moexipril decreased diastolic blood pressure by 8.2 mm Hg, whereas the corresponding placebo group decreased diastolic blood pressure by 3.7 mm Hg. Although the difference between these two groups was not significant at the 24-week end point, all other time points differed significantly between groups at p less-than-or-equal 0.017. Similarly, whereas the corresponding placebo group had a mean reduction in diastolic blood pressure of 4.6 mm Hg, the group that continued 15 mg of moexipril showed a mean diastolic blood pressure reduction of 10.6 mm Hg (p < 0.001 between groups). No comparison between the two moexipril dosage groups was significant, however, during the withdrawal phase. These results during medication withdrawal indicate that moexipril is effective in significantly lowering diastolic blood pressure.     

Population Pharmacokinetics Study of Nemonoxacin Among Chinese Patients With Moderate Hepatic Impairment

Purpose

Nemonoxacin is a novel C-8-methoxy nonfluorinated quinolone that has been approved for the treatment of community-acquired pneumonia (CAP) in adults. The goals of this study were to evaluate the pharmacokinetic (PK) and population PK parameters of nemonoxacin and to provide the appropriate dose adjustment recommendations for patients with hepatic impairment.

Efficacy and Safety of Nifedipine Coat-Core versus Amlodipine in Patients With Mild to Moderate Essential Hypertension: Comparison of 24-Hour Mean Ambulatory Diastolic Blood Pressure

BACKGROUND: Calcium channel blockers have been successfully used for the treatment of hypertension. In this study, the antihypertensive efficacy and safety of the dihydropyridine calcium channel blockers nifedipine coat-core 30 mg and amlodipine 5 mg were evaluated. METHODS: This multicenter, double-blind, prospective, randomized, parallel-arm study compared once daily administration of nifedipine coat-core 30 mg with once daily amlodipine 5 mg in subjects with mild-to-moderate essential hypertension. A 4-week placebo run-in period was followed by an 8-week active treatment period. Blood pressure reduction was measured by ambulatory blood pressure monitoring and casual office blood pressure measured by mercury sphygmomanometer. RESULTS: Nifedipine coat-core and amlodipine produced equivalent reductions in mean diastolic blood pressure, as determined by 24-hour ambulatory blood pressure monitoring. Mean reduction in diastolic blood pressure was 5.4 mmHg and 5.8 mmHg for nifedipine coat-core and amlodipine, respectively. Both drugs were well tolerated and neither treatment resulted in a significant change in heart rate. CONCLUSIONS: Nifedipine coat-core 30 mg once-daily is comparable to amlodipine 5 mg once-daily for blood pressure reduction.     

依普利酮片治疗轻中度高血压的疗效和安全性

【目的】评估依普利酮片治疗轻、中度原发性高血压的临床疗效和安全性。[方法]本研究为随机、双盲、平行对照的多中心II期临床试验,235例轻、中度高血压患者,随机分为两组：（1）氯沙坦组（n=118）,（2）依普利酮组（n=117）。分别接受氯沙坦和依普利酮治疗,治疗4周后,若血压未达标,药物剂量加倍后继续治疗4周;若血压达标,维持原剂量继续治疗4周。观察两组疗效及不良反应。【结果】治疗8周后：①依普利酮组平均坐位舒张压下降（14．09±7．84）mmHg,收缩压下降（19．77±10．89）mmHg,氯沙坦组分别下降（12．87±8．04）mmHg,（18．63±9．66）mmHg,两组间差异无统计学意义（P均〉0．05）;依普利酮组及氯沙坦组平均坐位血压达标率分别为77．6％和73．50％,降压显效率分别为65．5％和56．6％,总有效率分别为87．9％和82．3％,两组间均无统计学意义（P〉0．05）。②两组的不良事件及不良反应发生率均无显著性差异（P〉0．05）。【结论】依普利酮能有效降压,疗效与氯沙坦相当,且其安全性良好。     

Renal Effects of Aliskiren Compared With and in Combination With Irbesartan in Patients With Type 2 Diabetes, Hypertension, and Albuminuria

OBJECTIVE

We investigated whether the antiproteinuric effect of the direct renin inhibitor aliskiren is comparable to that of irbesartan and the effect of the combination.

RESEARCH DESIGN AND METHODS

This was a double-blind, randomized, crossover trial. After a 1-month washout period, 26 patients with type 2 diabetes, hypertension, and albuminuria (>100 mg/day) were randomly assigned to four 2-month treatment periods in random order with placebo, 300 mg aliskiren once daily, 300 mg irbesartan once daily, or the combination using identical doses. Patients received furosemide in a stable dose throughout the study. The primary end point was a change in albuminuria. Secondary measures included change in 24-h blood pressure and glomerular filtration rate (GFR).

RESULTS

Placebo geometric mean albuminuria was 258 mg/day (range 84–2,361), mean ± SD 24-h blood pressure was 140/73 ± 15/8 mmHg, and GFR was 89 ± 27 ml/min per 1.73 m². Aliskiren treatment reduced albuminuria by 48% (95% CI 27–62) compared with placebo (P < 0.001), not significantly different from the 58% (42–79) reduction with irbesartan treatment (P < 0.001 vs. placebo). Combination treatment reduced albuminuria by 71% (59–79), more than either monotherapy (P < 0.001 and P = 0.028). Fractional clearances of albumin were significantly reduced (46, 56, and 67% reduction vs. placebo). Twenty-four-hour blood pressure was reduced 3/4 mmHg by aliskiren (NS/P = 0.009), 12/5 mmHg by irbesartan (P < 0.001/P = 0.002), and 10/6 mmHg by the combination (P = 0.001/P < 0.001). GFR was significantly reduced 4.6 (95% CI 0.3–8.8) ml/min per 1.73 m² by aliskiren, 8.0 (3.6–12.3) ml/min per 1.73 m² by irbesartan, and 11.7 (7.4–15.9) ml/min per 1.73 m² by the combination.

CONCLUSIONS

The combination of aliskiren and irbesartan is more antiproteinuric in type 2 diabetic patients with albuminuria than monotherapy.Albuminuria is the best available surrogate parameter in the treatment of diabetic nephropathy. Degree of proteinuria is associated with risk of renal and cardiovascular events (1). Proteinuria reduction is associated with a slowing of the decline in renal function (2). Blockade of the renin-angiotensin-aldosterone system (RAAS) is the cornerstone treatment of incipient and overt diabetic nephropathy, and in type 2 diabetes angiotensin II receptor blockers (ARBs) such as irbesartan are considered standard treatment after the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria (IRMA) 2 Study (3) and Irbesartan Diabetic Nephropathy Trial (IDNT) (1).Aliskiren represents a new principle of blocking the RAAS, inhibiting renin directly and acting at the rate-limiting step. The drug is approved for treatment of hypertension but has also shown renoprotective potential in patients with type 2 diabetes and albuminuria (4,5).Combining an ARB and a direct renin inhibitor could offer improved RAAS blockade by acting both at the receptor level and at the first step of the cascade. We compared the antiproteinuric effect of maximal recommended doses of aliskiren, irbesartan, and the combination in patients with type 2 diabetes and albuminuria. We also assessed the impact of the treatments on RAAS components and biomarkers of inflammation, endothelial dysfunction, and cardiovascular risk.     

动态血压比较洛汀新与络活喜降压疗效

目的比较洛汀新与络活喜对轻中度原发性高血压的疗效.方法分别选取38例与31例原发性高血压(essentialhypertension,以下简称EH)患者,以洛汀新10mg或络活喜5mg每天晨服一次,治疗4周,比较两药治疗前后的动态血压检测(ambulatory blood Pressure monitoring,以下简称ABPM)结果.结果两药治疗后24小时平均血压分别由SBP 143.75±13.66,147.63±14.37(mmHg)降至125.13±14.85,126.63±11.92(mmHg),DBP 98.87±9.14,94.13±8.53(mmHg)降至76.75±9.94,80.25±11.45(mmHg);白昼平均血压分别由SBP 147.38±10.86,151.63±15.30(mmHg)降至127.25±12.10,130.63±12.84(mmHg),DBP 90.25±9.29,97.5±8 37降至76.25±13.63,83.13±9.45(mmHg);夜间平均血压分别由SBP131.25±11.93,133.25±12.37(mmHg)降至115.88±7.30,117.13±8.82(mmHg),DBP 88.75±8.07,91.75±8.07(mmHg)降至73.25±8.07,74.75±10.55(mmHg);两药降压幅度无显著差异(P＞0.05);两药降压谷峰比值分别为SPB 68.51%,DBP 74.10%和 SBP 70.36%,DBP 76.29%;洛汀新治疗前后心率无明显变化(P＞0.05),络活喜治疗后心率有所增加(P＜0.05);两药不良反应均较少(分别为21.05%和19.35%),耐受性良好.结论洛汀新与络活喜均能持续稳定地控制轻中度EH,值得在临床广泛应用.     

综合干预对轻中度高血压患者血压和心率的影响

目的寻找轻中度高血压患者新的有效护理干预方法。方法469例轻中度高血压患者随机分为3组,观察组171例、对照组Ⅰ149例和对照组Ⅱ149例;观察组采用磁珠耳穴贴压加有氧运动和饮食疗法;对照组Ⅰ采用有氧运动加饮食疗法;对照组Ⅱ采用药物治疗;观察3组患者的血压、心率变化及不良反应。结果观察组护理干预前后血压和心率比较有极显著性差异（P〈0．01）;对照组Ⅰ护理干预前后血压比较差异有显著性（P〈0．05）,心率比较差异无显著性（P〉0．05）;对照组Ⅱ护理干预前后收缩压和心率比较差异无显著性（P〉0．05）;观察组无不良反应。结论磁珠耳穴贴压加有氧运动和饮食疗法是轻、中度高血压患者的有效护理干预方法,且成本低,无不良反应。     

降压降脂联合治疗对老年高血压患者动脉僵硬度的影响

目的 探讨降压降脂联合治疗对老年高血压患者动脉僵硬度的影响.方法 纳入轻、中度老年高血压患者216例,给予双氢克尿噻( 25 mg/d)作为基础治疗,2周后随机分为4组,每组54例,分别为强化降压降脂组(双氢克尿噻25 mg/d,坎地沙坦8 mg/d,瑞舒伐他汀10 mg/d)、强化降压组(双氢克尿噻25 mg/d,坎地沙坦8 mg/d)、降压降脂组(双氢克尿噻25 mg/d,瑞舒伐他汀10 mg/d)和对照组(双氢克尿噻25 mg/d).治疗12个月后比较4组测量血压(BP)、血生化、颈桡动脉脉搏波传导速度(crPWV)的变化.结果 治疗12个月后,4组SBP、DBP、PP、crPWV均较治疗前明显降低(P＜0.05),其中降压降脂联合治疗对降低老年高血压患者SBP、DBP、PP、CrPWV存在交互作用,F值分别为40.765、4.869、24.829和53.149,P值均＜0.05.结论 降压联合降脂治疗能显著降低老年高血压患者的颈桡脉搏波传导速度,改善动脉僵硬度,优于单一降压或降脂治疗.     

Safety and Efficacy of Once-Daily Captopril Plus Hydrochlorothiazide versus Nifedipine Gastrointestinal Therapeutic System in Black Patients with Mild to Moderate Hypertension

The safety and efficacy of captopril plus hydrochlorothiazide (HCTZ) were compared to nifedipine gastrointestinal therapeutic system (GITS) in 145 randomly assigned black patients with mild to moderate hypertension. Following a 4-week placebo lead-in, patients received captopril plus HCTZ 25/15 mg or nifedipine GITS 30 mg for up to 12 weeks. Upward dose titration was permitted at weeks 3 and 6. Mean seated systolic and diastolic blood pressures decreased 16.1 ± 13.5 mm Hg and 11.5 ± 7.4 mm Hg, respectively, with captopril plus HCTZ. Statistically similar decreases were observed with nifedipine GITS: systolic, 19.3 ± 12.2 mm Hg; diastolic, 13.8 ± 7.2 mm Hg. There were no clinically significant between-group differences in serum chemistries. Edema was reported in 20.3% of nifedipine GITS patients versus 1.4% of captopril plus HCTZ patients (p = 0.001). The two regimens were equally effective in controlling blood pressure in black patients; however, a higher incidence of edema occurred with nifedipine GITS compared to captopril plus HCTZ.