氯沙坦与吲达帕胺对老年高血压血尿酸及β2-微球蛋白的影响

目的探讨氯沙坦和吲达帕胺对老年高血压患者的血压、血尿酸及血与尿β2-微球蛋白(β2-MG)的影响.方法老年高血压患者66例,随机分为氯沙坦组和吲达帕胺组,每组33例,分别服用氯沙坦及吲达帕胺,于治疗前、后分别测量坐位血压以及血尿酸与β2-MG水平的变化.结果两组治疗后收缩压及舒张压均较治疗前明显下降(P＜0.001);吲达帕胺组治疗前后比较,血尿酸浓度明显升高(P＜0.01),血及尿β2-MG浓度无明显变化;氯沙坦组治疗前后比较血尿酸及血、尿β2-MG均明显下降(P＜0.01).结论氯沙坦和吲迭帕胺均能有效控制老年高血压患者的血压,而氯沙坦既能改善老年高血压患者的代谢紊乱,又能起到保护肾脏的作用.     

吲达帕胺和波依定治疗老年收缩期高血压临床观察

吲达帕胺是一种新型噻嗪类磺胺利尿剂,是具有轻微利尿作用的血管扩张药,已广泛用于临床。本研究采用随机、对照、开放的方法比较观察吲达帕胺和波依定对老年收缩期高血压的降压效果与安全性。1资料与方法1.1一般资料70例均符合1999年WHO/ISH高血压治疗指南标准SBP>140/DBP<90mmHg。其中男53例,女17例;年龄60-82岁,平均71.2岁。随机分为吲达帕胺组和波依定组。本组病例排除标准:①继发性高血压;②近期(6月)内发生脑卒中、TIA、心肌梗死、心力衰竭;③严重肝肾功能不全;④痛风、高尿酸血症(男>416μmol/L,女性>357μmoL/L);⑤磺胺药过敏者。     

吲达帕胺联合缬沙坦治疗难治性高血压病人的临床疗效观察

目的讨论吲达帕胺与缬沙坦联用治疗难治性高血压病人的临床疗效。方法回顾性分析江苏省苏州市吴江区同里卫生院2012-11—2014-04期间治疗的46例难治性高血压病人的临床资料。根据病人的门诊尾号随机分为对照组(吲达帕胺治疗)与观察组(吲达帕胺与缬沙坦联合治疗),每组各23例。对比两组病人的临床疗效及不良反应。结果通过治疗,观察组病人的治疗总有效率明显优于对照组,P0.05,差异具有统计学意义;两组病人的不良反应发生率对比差异不具有统计学意义(P0.05)。结论针对难治性高血压病人,采用吲达帕胺联合缬沙坦进行治疗具有临床疗效显著、安全的优势,对提升病人的生活质量具有十分重要的意义。     

非洛地平联合吲达帕胺治疗高血压疗效观察

目的：观察非洛地平与吲达帕胺治疗高血压的疗效。方法：将1级、2级高血压患者60例随机分为两组,非洛地平、吲达帕胺组30例（每日10 mg、2.5 mg,晚餐后口服）,卡托普利为对照组30例（75 mg/d,分3次口服）,连续治疗8周。结果：两组之间治疗高血压没有显著性差异,但控制24 h血压非洛地平与吲达帕胺更好,同时副作用发生率更低。结论：非洛地平联合吲达帕胺是治疗高血压有效安全的药物。     

吲达帕胺片联合卡托普利治疗糖尿病合并高血压48例疗效观察

当今联合用药治疗高血压被认为比较合理的配伍占首位的是ACEI与利尿剂[1]。糖尿病往往合并高血压存在,传统认为利尿剂对糖、脂代谢有一定的影响。吲达帕胺片系吲满类利尿降压药,多年临床验证报道对糖、脂代谢影响不大。本文对48例吲达帕胺联合卡托普利治疗糖尿病合并高血压进行     

贝那普利和吲达帕胺合用对高血压患者血糖的影响

目的 研究贝那普利和吲达帕胺合用对高血压患者血糖、血脂代谢的影响。方法 86例轻中度高血压患者随机分为观察组：贝那普利和吲达帕胺联合治疗（A组）和对照组：单用贝那普利（B组），76例完成研究（A组40例，B组36例），服药12个月，观察血压、血糖、血脂、血钾等的变化。结果 A组降压总有效率显著高于B组（97．5％VS77．8％，P〈0．01），治疗后血糖和血脂升高；其中30例患者停服吲达帕胺后，血糖和血脂改善。结论 贝那普利和吲达帕胺联合应用比单用贝那普利能更有效降低血压，但长期应用可恶化血糖和血脂代谢。而单用贝那普利能改善高血压患者血糖和血脂代谢。提示吲达帕胺可诱发糖尿病。     

吲达帕胺对高血压患者糖、脂代谢及肾功能的影响

吲达帕胺（indapamide,寿比山）作为一种利尿扩血管降压药物,每日只需用药1次,疗效确切且价格便宜,已广泛用于临床,其引起血尿酸升高的病例时有报道,影响了临床的广泛应用。为进一步观察此药对血糖、血脂代谢及肾功能的影响,评价其安全性,现对138例高血压患者采用吲达帕胺治疗的有关资料总结如下。     

吲达帕胺降压疗效观察

吲达帕胺降压疗效观察黄改荣，侯淑彦，高恩民随着高血压人群的增多，对高血压的治疗越来越受到重视，尤其对初期高血压的很好控制，防止并发症的产生、提高高血压患者的生活质量越来越显得重要。两年来我们应用吲达帕胺治疗Ⅰ、Ⅱ期高血压病收到良好效果，现总结如下。１...     

吲达帕胺致血尿酸升高两例

吲达帕胺是一种具有钙离子拮抗作用和轻度利尿作用的降压药,是《中国高血压病防治指南》确定的治疗高血压的一线药物,用于轻度及中高度高血压病的治疗。随着临床的广泛应用,其不良反应报道也逐渐增多。现将我院服用吲达帕胺致血尿酸升高的2例病例报告如下。1病例资料2例患者均为男性,年龄分别为66岁、68岁;均有高血     

依那普利联合吲达帕胺治疗原发性高血压逆转左室肥厚152例

目的 观察依那普剂联合吲达帕胺治疗原发性高血压逆转左室肥厚的疗效.方法 对原发性高血压伴有不同程度的左心室肥厚152例,应用依那普剂10～20 mg,1次/d口服;吲达帕胺2.5～5 mg,1次/d口服.结果 治疗前后收缩和舒张压比较有显著性差异(P均＜0.01),治疗前后室间隔厚度、左室后壁厚度比较有显著性差异(P均＜0.05).有7例患者出现干咳.结论 依那普利联合吲达帕胺治疗原发性高血压疗效显著,可改善左室肥厚.     

An overview of the pharmacology and clinical efficacy of indapamide sustained release

The relationship between blood pressure (BP) and cardiovascular risk is clearly established; hypertension increases the rate of cardiovascular. High systolic blood pressure (SBP) may be the main parameter involved in cardiovascular morbidity and mortality. The benefit of lowering BP, particularly with diuretics has been proven in many outcome studies. Indapamide, a thiazide-type diuretic, was available for many years at a dosage of 2.5 mg in an immediate release formulation. A new sustained release (SR) formulation has been developed in order to allow the same antihypertensive efficacy with a better acceptability profile. This paper reviews the pharmacology of indapamide 1.5 mg SR from the bench to the bedside. Indapamide has a dual mechanism of action: diuretic effect at the level of the distal tubule in the kidney and a direct vascular effect, both of which contribute to the antihypertensive efficacy of the drug. The SR formulation contains a hydrophilic matrix, which delivers a smoother pharmacokinetic profile. This avoids unnecessary plasma peak concentrations, which may be associated with side effects. Indapamide SR has now been extensively used in hypertensive patients, including those at increased risk, for example elderly or diabetic patients. It has been shown to decrease BP, particularly SBP, with 24-h efficacy, allowing a once-daily dosage. Studies have demonstrated BP lowering to be at least as effective as all major therapeutic classes including the more recent antihypertensive drugs. Beyond BP decrease, indapamide SR has also been shown to protect against hypertensive target-organ damage in the heart and the kidney and to have a favorable metabolic profile. A broad evidence-base has accumulated to support the benefit of indapamide 1.5 mg SR in hypertensive patients, alone or as part of combination therapy, as recommended by the majority of guidelines.     

厄贝沙坦及倍他乐克对高血压患者动态血压的影响

目的观察厄贝沙坦及倍他乐克对高血压患者动态血压的影响。方法选择80例原发性高血压患者,分成厄贝沙坦组及倍他乐克组,每组40例。治疗前及治疗后3个月行24h动态血压检测,观察血压控制情况。结果治疗前两组患者血压无显著差异,经治疗后两组患者血压都有显著性下降,两组在治疗后24h夜均舒张压没有显著差异性,其余24h收缩压、24h舒张压、日间收缩压和舒张压、夜间收缩压均有显著差异性,厄贝沙坦组血压下降更明显。结论厄贝沙坦和倍他乐克对原发性高血压降压疗效均明显,厄贝沙坦组血压下降效果更佳。     

Effect of indapamide on urinary calcium excretion in patients with and without urinary stone disease

BACKGROUND: Indapamide is an antihypertensive agent similar to thiazides, but with some different effects. Thiazide and thiazide-like diuretics are useful in preventing recurrent urinary stone formation due to their hypocalciuric effects. OBJECTIVE: To determine the hypocalciuric and other effects on certain laboratory parameters of indapamide 1.5 mg in different patient groups. METHODS: Four groups of patients recruited from urology and nephrology outpatient departments were experiencing non-hypercalciuric urinary stone disease (group 1), idiopathic hypercalciuria (group 2), urinary stone disease with hypercalciuria (group 3), and essential hypertension (group 4). In all patients, fasting serum uric acid, calcium, sodium, potassium, cholesterol, triglyceride, parathyroid hormone (PTH) values, and morning second-spot urine calcium and creatinine levels were assessed before and 8 weeks after treatment with indapamide. RESULTS: Urinary calcium excretion was reduced significantly in all groups: group 1 from 0.10 +/- 0.02 to 0.07 +/- 0.03 (mean +/-SD; 30% reduction; p < 0.001), group 2 from 0.30 +/- 0.15 to 0.15 +/- 0.10 (50% reduction; p < 0.001), group 3 from 0.35 +/- 0.15 to 0.20 +/- 0.10 (43% reduction; p < 0.001), and group 4 from 0.10 +/- 0.03 to 0.08 +/- 0.02 (20% reduction; p < 0.0010). These results should be interpreted with caution since no control group was included in this study. Mean serum uric acid and triglyceride levels were significantly increased, and mean PTH and potassium levels and diastolic and systolic blood pressure were significantly decreased in all groups. Few temporary adverse effects, such as dizziness and fatigue, were noticed and none of them caused discontinuation of treatment. CONCLUSIONS: Indapamide 1.5 mg/day is effective in decreasing calciuria in patients with non-hypercalciuric urinary stone disease, idiopathic hypercalciuria, urinary stone disease with hypercalciuria, and essential hypertension. This could be achieved with few adverse effects similar to those of thiazides and indapamide 2.5 mg. Indapamide decreased the PTH levels in all groups. Long-term clinical benefits of these effects should be evaluated prospectively with further randomized studies.     

螺内酯在中重度高血压联合降压治疗中的疗效观察

目的研究螺内酯在肾功能正常的中重度高血压患者联合降压方案中的疗效和安全性。方法 98例中、重度高血压患者随机分为治疗组和对照组。对照组中分别使用福辛普利10~20 mg/d(或厄贝沙坦150~300 mg/d)、非洛地平缓释片5~10 mg/d及吲哒帕胺缓释片1.5 mg/d治疗,治疗组在对照组基础上联合螺内酯(20 mg/d),两组均治疗12周,分别在用药治疗后4周、8周、12周监测血压、血钾、血尿酸、血肌酐和不良反应等指标。结果治疗组较对照组血压可更快达标;两组之间尿酸、血肌酐及血清钾比较无明显变化(P>0.05),两组治疗后患者的血肌酐(Cr)较治疗前无明显变化(P>0.05)。结论螺内酯用于肾功能正常的中重度高血压患者的联合降压疗效显著,副作用少,安全性高。     

吲哒帕胺对高血压病患者心功能康复的影响

目的 探讨吲哒帕胺对高血压病患者的疗效及对心功能的影响。方法 56例高血压病患者随机分为氢氯噻嗪组和吲哒帕胺组，分别应用氢氯噻嗪和吲哒帕胺治疗，并辅以合理膳食、控制体重等常规非药物治疗；治疗前与治疗2个月后采用超声心动图评定两组患者的心功能。结果 治疗后，两组患者的射血分数提高，左心室相对厚度下降（P〈0．05），但吲哒帕胺组的效果优于氢氯噻嗪组（P〈0．05）。结论 吲达帕胺改善心脏功能与结构的效果优于氢氯噻嗪。     

Use of spironolactone and indapamide in the treatment of low-renin arterial hypertension

AIM: To compare efficacy of use of the blocker of aldosteron receptors spironolactone and diuretic indapamide in low-renin arterial hypertension (AH), their action on blood pressure, serum concentrations of sodium, potassium, creatinine, plasmic renin activity (PRA), plasmic aldosteron concentration (PAC). MATERIAL AND METHODS: The study included 31 females aged 40-60 years with hardly correctable AH and high PAC to (PRA) ratio. Biochemical parameters were measured before 2-week treatment with indapamide (1.5 mg/day) and spironolactone (25 mg/day) and after the treatment. Between the courses there was a 2-week interval. RESULTS: In AH patients with high PAC/PRA spironolacton reduced AP more significantly (-15.5 / -8.2 mmHg) than indapamide (-10.9 / -5.9 mmHg). Indapamide lowered potassium serum levels by 0.28 mmol/l (p < 0.05), spironolacton raised it by 0.26 mmol/l (p = 0.05). Sodium concentration in the serum reduced only after treatment with spironolactone. Both drugs increased blood concentrations of creatinine, aldosteron, PRA, but spironolactone was more active. CONCLUSION: In treatment-resistant AH it is necessary to perform screening for detection of patients with low-renin hypertension. Such patients are effectively treated with spironolacton in low doses.     

Possibilities of using indices of vascular wall function as markers of negative metabolic effects of treatment with thiazide diuretics in patients with essential hypertension

AIM: To evaluate the influence of antihypertensive and metabolic effects of thiazide diuretics on vascular endothelial function and coronary risk (CR) in patients with essential hypertension (EH). Materials and methods. The study included 50 EH patients treated with indapamide retard (n = 25) or hydrochlorothiazide (n=25) during 12 weeks. Changes in blood pressure, blood lipid and glucose levels, Framingham algorithm-calculated coronary risk (CR), the brachial response to endothelium-dependent and endothelium-independent stimuli, studied by high-resolution ultrasound, were evaluated. Results. Indapamide retard (1.5 mg/day) and hydrochlorothiazide (25 mg/day) showed the similar antihypertensive effect. Indapamide retard was metabolically neutral whereas hydrochlorothiazide increased the blood levels of triglycerides and glucose by 15.3% (p < 0.05) and 12.2% (p < 0.05), respectively. The calculated CR decreased by 21.3% (p < 0.01) on indapamide retard treatment and practically unchanged on hydrochlorothiazide. There were significant group differences in the effects of the drugs on endothelium-dependent vasodilatation. The latter tended to improve by indapamide retard (+8.9%; p = 0.10) and to significantly worse by hydrochlorothiazide (-17.0%; p < 0.05). Hydrochlorothiazide-induced changes in total cholesterol, triglycerides, and low-density lipoprotein cholesterol were directly related to calculated CR changes (r = 0.69, r = 0.58, and r = 0.57, respectively; p < 0.01) and the changes in blood glucose levels were inversely related to those in vascular endothelial function (r = -0.52; p < 0.01). Such relations were not observed on indapamide retard. Conclusion. The negative metabolic effects of hydrochlorothiazide induce negative changes in vascular endothelial function just at early stages of therapy. These changes may be used as a predictor of a coronary risk during thiazide diuretic treatment in patients with EH.     

Arterial hypertension: problems of maintenance therapy

AIM: To study hypotensive reactions in patients taking hypotensive drugs and to specify peculiarities of blood pressure elevation in patients with a long history of taking hypotensive drugs, especially atenolol. MATERIAL AND METHODS: ECG, ultrasound investigation, chest x-ray, cholesterol, lipoprotein, urea, creatinine assays, tests for serum transaminase and transpeptidase activity were made in 200 patients with essential hypertension of the 1-3 degree (110 males, 90 females, age 30-80 years) to elucidate effects of 24-h and prolonged administration of peripheral vasodilators, diuretics, beta-adrenoblockers. The following drugs were given: nitroglycerin (sublingually, 0.0005 g--3 tablets or intraveous drops), lasix (40 mg), anaprilin (0.04-0.12 g per os), verapamil (0.04 g) or nifedipine (0.01 g 3 times a day), enap or diroton (per os, once a day). Blood pressure was measured each 3-4 hours in the first 24 hours. CONCLUSIONS: Hypotensive drugs can normalize blood pressure and control it for a long time but their effect has some specific features. In hypertension of the 2-3 degree, beta-blockers are more effective than blockers of Ca channels, ACE, diuretics and nitroglycerin. Hypertensive patients on beta-adrenergic drugs maintenance have sometimes hypertensive crises which should be managed with nitroglycerin, ACE drugs (enap, as a rule) and diuretics (less frequently).     

比索洛尔联合吲达帕胺治疗扩张型心肌病效果观察

目的:探讨比索洛尔联合吲达帕胺对改善扩张型心肌病左心室功能的作用.方法:选择确诊的86例扩张性心肌病,随机分为比索洛尔、吲达帕胺治疗组与对照组.对照组予强心、扩张血管等常规治疗,治疗组在常规治疗的基础上,加用比索洛尔及吲达帕胺,观察1年,比较两组治疗前后心率、血压、左心室内径的变化,评估其临床治疗的有效性.结果:治疗组、对照组心率、血压均下降,左心室内径缩小、心功能改善程度不同,两组比较差异具有非常显著的统计学意义(P<0.001). 结论:比索洛尔联合吲达帕胺在常规抗心力衰竭药物治疗的基础上,可明显改善患者的心功能,缩小左心室内径,提高患者的生存率,是值得临床推广的治疗方法.     

波依定合用卡托普利治疗老年高血压病64例

目的　观察波依定合用卡托普利治疗老年高血压病的临床疗效。方法　随机分为两组比较疗效。波依定、卡托普利合用组 (1组 ) 6 4例 ,单用卡托普利组 (2组 ) 6 4例 ,观察疗效 ,并观察对心率、血脂、血糖、肾功能的影响。结果　 1组显效 5 0例 ,有效 10例 ,无效 4例 ,总有效率 93% ;2组显效 2 8例 ,有效 2 4例 ,无效12例 ,总有效率 70 % ;两组间比较有显著差异。两组治疗前后心率、血脂、血糖、肾功能无明显变化。结论　波依定、卡托普利合用在取得较理想降压效果的同时 ,对心率、血脂、血糖、肾功能均无明显影响 ,是治疗老年高血压病的适宜药物