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1.
曾道亮 《实用中西医结合临床》2023,23(11)
目的 分析氢氯噻嗪结合缬沙坦在中、重度高血压病人治疗中的效果及安全性。方法 选取我院于2019年2月~2022年2月内收治的164例中、重度高血压病人,依据其治疗手段差异分成2组。观察组89例病人实施氢氯噻嗪结合缬沙坦口服治疗,对照组75例病人实施非洛地平结合缬沙坦口服治疗,持续治疗12周。对比两组患者治疗前后的动态血压监测结果,对比两组患者血液中一氧化氮、内皮素、血清钾离子水平,对比两组患者治疗前后的心脏彩超结果,以及对比两组患者的不良反应发生率情况。结果 经过治疗,两组患者平均24h的收缩压(24hSBP)、平均24h的舒张压(24hDBP)、白天平均收缩压(dMSBP)、白天平均舒张压(dMDBP)、夜间平均收缩压(nMSBP)、夜间平均舒张压(nMDBP)均下降,且观察组患者的各项血压水平均低于对照组(P<0.05)。治疗后,两组病人的血清一氧化氮升高、内皮素降低,且观察组病人血清内的一氧化氮浓度水平较对照组高(P<0.05),观察组病人的内皮素浓度水平较对照组病人低(P<0.05)。两组患者的左心房容积指数、左心室后壁厚度(PWT)及左心室舒张期内径(LVEDD)均较治疗前下降(P<0.05),观察组患者的左心房容积指数、PWT及LVEDD低于对照组(P<0.05)。观察组患者治疗前后的血清钾离子浓度变化无统计学意义(P>0.05),对照组患者血清钾离子浓度提高,且浓度高于观察组患者(P<0.05)。对照组患者高钾血症发生率高于观察组(P<0.05),但总不良反应出现概率方面,两组病人对比并无差异(P>0.05)。结论 缬沙坦联合氢氯噻嗪能有效降低中、重度高血压患者的血压水平,有效缓解患者的左心室肥大、改善患者的血管内皮功能,稳定患者的血钾水平且不增加不良反应发生率。 相似文献
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目的:分析氢氯噻嗪联合缬沙坦在中、重度高血压患者治疗中的效果及安全性。方法:选取医院于2019年2月至2022年2月收治的164例中、重度高血压患者,依据治疗方法不同分成两组。观察组89例患者实施氢氯噻嗪结合缬沙坦口服治疗,对照组75例患者实施非洛地平联合缬沙坦口服治疗,持续治疗12周。对比两组治疗前后动态血压监测结果,对比两组血清一氧化氮、内皮素、钾离子水平,对比两组治疗前后心脏彩超指标以及不良反应发生情况。结果:治疗后,两组患者平均24 h收缩压(24 h SBP)、平均24 h舒张压(24 h DBP)、白天平均收缩压(dMSBP)、白天平均舒张压(dMDBP)、夜间平均收缩压(nMSBP)、夜间平均舒张压(nMDBP)均下降,且观察组各项血压水平均低于对照组(P<0.05)。治疗后,两组血清一氧化氮水平升高、内皮素水平降低,且观察组血清一氧化氮水平较对照组高,内皮素水平较对照组低(P<0.05)。两组左房容积指数、左室后壁厚度(PWT)及左室舒张末期内径(LVEDd)均较治疗前下降,且观察组低于对照组(P<0.05)。观察组治疗前后血清钾离子水平比较,差异无统计学意义(P>0.05),观察组血清钾离子水平降低,且低于对照组(P<0.05)。观察组高钾血症发生率低于对照组(P<0.05),但不良反应发生率方面,两组对比并无明显差异(P>0.05)。结论:缬沙坦联合氢氯噻嗪能有效降低中、重度高血压患者的血压水平,有效缓解左心室肥大,改善血管内皮功能,稳定血钾水平且不增加不良反应发生率。 相似文献
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C. A. Cooke D. G. Frazer A. J. Jackson 《Journal of Applied Research in Intellectual Disabilities》2006,19(4):383-390
Background Intraocular surgery in patients with intellectual disability can be hazardous. Our aim was to determine the outcomes of surgery on all such patients seen in a consultant‐led service, and to assess the overall risks and benefits. Materials and Methods A retrospective chart review of patients with moderate to severe intellectual disability, operated upon over a 9‐year period was undertaken. Thirty‐four eyes of 21 patients were operated upon and procedures included four penetrating keratoplasties, five combined penetrating keratoplasties with cataract extractions, and 25 cataract extractions alone. Results Most patients achieved a beneficial outcome, noted by their carers, such as better mobility and social interaction. Three patients had major post‐operative complications, all associated with corneal grafts. Only seven patients were, within the context of conventional busy outpatient clinics, deemed capable of co‐operating with a formal visual acuity assessment either pre‐ or post‐operatively. Conclusions Cataract and corneal graft surgery in individuals with intellectual disability is beneficial, and referral to an ophthalmologist should be considered as intellectual disability need not necessarily be a contraindication for surgery. The authors recommend that these patients should be assessed in a dedicated ophthalmology clinic setting for the intellectually disabled, where there should be better facilities for appropriate visual assessment tailored to the patients’ abilities. 相似文献
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Mila Etropolski Brigitte Kuperwasser Maren Flügel Thomas Häufel Bernd Lange Christine Rauschkolb Frank Laschewski 《Advances in therapy》2014,31(6):604-620
Introduction
This analysis of pooled data from four randomized, controlled-dose adjustment, phase 3 studies (three 15-week, double-blind, placebo- and active-controlled studies and a 1-year, open-label, active-controlled safety study) in patients with chronic osteoarthritis hip or knee pain or low back pain evaluated the safety and tolerability of tapentadol extended release (ER) for the management of moderate to severe, chronic pain.Methods
In the three 15-week studies, patients were randomized (1:1:1) to twice-daily (bid) doses of placebo, tapentadol ER (100–250 mg), or oxycodone hydrochloride (HCl) controlled release (CR; 20–50 mg). In the 1-year safety study, patients were randomized (4:1) to tapentadol ER (100–250 mg bid) or oxycodone HCl CR (20–50 mg bid). Adverse events (AEs) and discontinuations were recorded in each study; pooled results were analyzed by treatment group.Results
In the placebo (n = 993), tapentadol ER (n = 1,874), and oxycodone CR (n = 1,224) groups, respectively, 40.7%, 48.4%, and 62.3% of patients discontinued treatment prematurely and 58.7%, 79.0%, and 86.6% of patients experienced ≥1 treatment-emergent AE (TEAE). Incidences of gastrointestinal TEAEs in the placebo, tapentadol ER, and oxycodone CR groups, respectively, were 26.6%, 47.3%, and 65.4%; incidences of nervous system TEAEs were 22.5%, 42.6%, and 45.1%, respectively. Moderate or severe gastrointestinal TEAEs were reported for 10.9% of patients who received placebo, 25.3% of patients who received tapentadol ER, and 42.3% of patients who received oxycodone CR, and moderate or severe nervous system TEAEs were reported for 10.6%, 22.1%, and 25.2% of patients, respectively. In the placebo, tapentadol ER, and oxycodone CR groups, respectively, incidences of gastrointestinal TEAEs leading to study discontinuation were 2.1%, 8.3%, and 24.1%; incidences of nervous system TEAEs leading to discontinuation were 1.4%, 7.9%, and 16.3%, respectively.Conclusion
Results from this large patient population showed that tapentadol ER (100–250 mg bid) had improved gastrointestinal tolerability compared with oxycodone CR, based on the overall incidence of gastrointestinal TEAEs, the incidence of moderate or severe gastrointestinal TEAEs, and the incidence of gastrointestinal TEAEs leading to discontinuation. 相似文献6.
Fenglei Huang Viktoria Moschetti Benjamin Lang Atef Halabi Marc Petersen-Sylla Chan-Loi Yong Mabrouk Elgadi 《Antimicrobial agents and chemotherapy》2015,59(1):251-257
Faldaprevir is a potent hepatitis C virus (HCV) NS3/4A protease inhibitor with negligible urinary excretion. We assessed the pharmacokinetics and safety of a single oral dose of faldaprevir (480 mg) in 32 HCV-negative subjects with renal impairment or normal renal function. Compared with subjects with normal renal function, the adjusted geometric mean ratios (90% confidence intervals in parentheses) for overall exposure area under the concentration-time curve from zero to infinity (AUC0–∞) were 113.6% (41.6 to 310.2%), 178.3% (85.2 to 373.0%), and 169.2% (73.2 to 391.2%) for subjects with mild, moderate, and severe renal impairment, respectively. Overall, 5/8 (63%) subjects with normal renal function and 20/24 (83%) subjects with renal impairment reported adverse events, with gastrointestinal events being the most common. No severe or serious adverse events or deaths were reported. These results suggest that moderate or severe renal impairment can result in a modest increase in faldaprevir exposure. The increase in exposure may be related to decrease in the activity of the liver uptake transporter OATP1B1 as a result of renal impairment. Given this relatively slight increase in exposure, a dose adjustment in HCV patients with renal impairment is not warranted. (This study has been registered at ClinicalTrials.gov under registration number .) NCT01957657相似文献
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Masaya Sasaki Tomoko Johtatsu Mika Kurihara Hiromi Iwakawa Toshihiro Tanaka Shigeki Bamba Tomoyuki Tsujikawa Yoshihide Fujiyama Akira Andoh 《Journal of Clinical Biochemistry and Nutrition》2010,47(1):32-36
We investigated the energy expenditure in hospitalized patients with severe or moderate ulcerative colitis (UC), and compared them to healthy controls. Thirteen patients (5 women and 8 men; mean age 31.8 years; mean BMI 19.0 kg/m2) and 10 healthy volunteers were enrolled in this study. The resting energy expenditure (mREE) levels were determined by indirect calorimetry. The mREEs of the UC patients were significantly higher than those of healthy controls (26.4 ± 3.6 vs 21.8 ± 1.7 kcal/kg/day), although the mREEs of the UC patients were almost the same as the predicted REEs (pREEs) calculated by the Harris-Benedict equation (26.4 ± 2.4 kcal/kg/day vs 26.5 ± 2.6 kcal/kg/day). The mREE/pREE ratio, which reflects stress, was 1.0 ± 0.15. In the UC patients, a significant correlation was observed between the mREEs and the clinical activity index. In conclusion, UC patients showed a hyper-metabolic status as evaluated by their mREE/body weight. Energy expenditure was significantly correlated with disease activity. From our observations, we recommend that nutritional management with more than 30–35 kcal/ideal body weight/day (calculated by the mREE × activity factor) may be optimal for active severe or moderate ulcerative colitis. 相似文献
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目的分析中重度慢性阻塞性肺疾病(COPD)稳定期患者应用糖皮质激素吸入治疗的临床疗效及安全性。方法将80例中重度COPD稳定期患者随机分为对照组及观察组两组,每组患者40例,分别给予沙丁胺醇吸入联合口服甲强龙片治疗及联合沙丁胺醇及布地奈德雾化吸入治疗。结果两组治疗前临床症状评分、体征评分及第一秒用力呼气量(FEV1)及FEV1占预计值百分比(FEV1%预计值)比较未见统计学差异,经治疗2周后两组以上指标均较治疗前明显改善,且观察组较对照组改善更为明显。同时两组治疗后肝肾功均较治疗前无明显变化(P0.05),且治疗期间两组药物副作用总发生率比较无统计学差异(P0.05)。结论中重度COPD患者应用糖皮质激素吸入治疗可显著提高临床治疗效果,且安全可靠。 相似文献
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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。 相似文献
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《The journal of pain》2008,9(12):1144-1154
This randomized, double-blind, placebo- and active-controlled, parallel-group study was designed to demonstrate the superiority of oxycodone in combination with naloxone in a prolonged release (PR) formulation over placebo with respect to analgesic efficacy. The active control group was included for sensitivity and safety analyses, and furthermore to compare the analgesic efficacy and bowel function of oxycodone PR/naloxone PR with oxycodone PR alone. The analgesic efficacy was measured as the time from the initial dose of study medication to multiple pain events (ie, inadequate analgesia) in patients with moderate to severe chronic low back pain. The full analysis population consisted of 463 patients. The times to recurrent pain events were significantly longer in the oxycodone PR/naloxone PR group compared with placebo (P < .0001–.0003); oxycodone PR/naloxone PR reduced the risk of pain events by 42% (P < .0001; full analysis population). The appearance of pain events was comparable for oxycodone PR/naloxone PR versus oxycodone PR, confirming that the addition of naloxone PR to oxycodone PR in a combination tablet did not negatively affect analgesic efficacy of the opioid. Furthermore, oxycodone PR/naloxone PR offers benefits in terms of an improvement in bowel function. In a therapeutic area of great unmet need, therefore, the combination tablet of oxycodone PR/naloxone PR offers patients effective analgesia while improving opioid-induced bowel dysfunction. Taken together with the observation that the safety profile of oxycodone PR/naloxone PR is consistent with that expected from other opioid analgesics except opioid-induced constipation, these findings indicate that the addition of naloxone to oxycodone in a PR combination tablet offers improved tolerability. Oxycodone PR/naloxone PR is therefore a promising new treatment approach for the management of chronic pain.PerspectiveThis study evaluated the analgesic efficacy and safety of the combination of oxycodone PR/naloxone PR in chronic nonmalignant pain. Opioids are often reduced in dosage or even discontinued as a result of impaired bowel function, leading to insufficient pain treatment. Not only does oxycodone PR/naloxone PR demonstrate analgesic efficacy comparable with oxycodone PR, but it also improves opioid-induced bowel dysfunction, and may therefore improve the acceptability of long-term opioid treatment for chronic pain. 相似文献
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目的探讨噻托溴铵联合福莫特罗在中重度慢性阻塞性肺疾病患者中的临床治疗效果。方法选取2014年10月~2015年10月我院诊治的80例重度慢性阻塞性肺疾病患者。随机分为对照组和试验组各40例。对照组采用福莫特罗吸入治疗,试验组在对照组基础上联合噻托溴铵治疗,比较两组临床治疗效果。结果试验组平均住院次数为0.13±0.02次、急性发作次数为0.79±0.38次,显著少于对照组的0.27±0.06次和1.20±0.64次;试验组急性发作间隔时间为190.01±35.79d,显著长于对照组的170.46±27.01d;两组患者治疗前咳嗽、咳痰、气促以及肺部音症状评分差异无统计学意义(P〉0.05);试验组治疗后咳嗽、咳痰、气促以及肺部音症状评分,显著低于对照组。结论中重度慢性阻塞性肺疾病患者在福莫特罗吸入治疗基础上联合噻托溴铵治疗效果理想,能够提高临床疗效,促进患者早期恢复,值得推广应用。 相似文献
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中重度睡眠呼吸暂停综合征合并高血压的临床特点探讨 总被引:1,自引:0,他引:1
目的:探讨睡眠呼吸暂停综合征(SAS)合并高血压的临床特点。方法:将70例高血压病人分为两组(A组32例,为中重度SAS合并高血压病患者;B组38例,为普通高血压患者)。比较A、B两组高血压的特点,包括两组患者平均舒张压、平均收缩压的比较,两组高血压的发病年龄、对降压药物反应的比较;比较A、B两组病人不同时段(晨起、睡前)的血压。结果:与B组相比A组的舒张压高更为突出[(111.4±11.3)mm Hg vs(98.1±8.1)mm Hg,P<0.01)],A组患者中高血压发病年龄较普通高血压更为年轻[(44.3±6.9)岁vs(49.3±7.8)岁,P<0.01)]。A组难治性明显多于B组(18.75%vs 5.26%,P<0.01)。A组晨起收缩压和舒张压均较睡前增高[(178.8±13.2)mm Hg vs(165.1±10.3)mm Hg,(115.2±8.7)mm Hg vs(108.1±7.8)mm Hg;P均<0.01)],而B组两时间段收缩压和舒张压均无显著差异[(169.1±10.1)mm Hg vs(167.9±9.7)mm Hg,(97.1±9.5)mm Hg vs(98.9±8.6)mm Hg;P均>0.05)]。结论:SAS并高血压患者多以舒张压增高为主,晨起血压较入睡血压高更为明显,高血压发病年龄有年轻化趋势,且多为难治性高血压。 相似文献
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目的探讨精氨酸对重度创伤患者安全性的影响。方法选择简化损伤分级(AIS)-90创伤评分为16~25分的重度创伤患者37例,根据是否服用精氨酸随机分为对照组和精氨酸组(30 g/d),观察14d。采用等氮等热卡营养支持,术后1d、14d测定两组肝、肾功能,记录感染并发症和胃肠道症状,采用卡方检验、球形检验和独立样本t检验。结果精氨酸组、对照组术后14d丙氨酸转氨酶均显著高于术后1d,差异均有统计学意义(P=0.022,0.007),两组间比较差异亦有统计学意义(P=0.017)。精氨酸组术后14d尿素较术后1d升高,但差异无统计学意义(P>0.05);对照组术后14d较术后1d降低,但差异无统计学意义(P>0.05)。精氨酸组、对照组感染率分别为5.9%、25.0%,差异有统计学意义(P=0.009);两组各种胃肠道症状发生率差异无统计学意义(P>0.05)。结论 AIS-90创伤评分16~25分的重度创伤患者应用30 g/d精氨酸安全可靠。 相似文献
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Weiss R Toth P Miller EE Zellner SR Shook M Codispoti J Stokes A McNally C 《American journal of therapeutics》1994,1(1):58-64
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. 相似文献
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The safety profile of fluconazole was assessed for 562 children (ages, 0 to 17 years) comprising 323 males and 239 females. The data are derived from 12 clinical studies of fluconazole as prophylaxis or treatment for a variety of fungal infections in predominantly immunocompromised patients. Most children received multiple doses of fluconazole in the range of 1 to 12 mg/kg of body weight; a few received single doses. Administration was mainly by oral suspension or intravenous injection. Overall, 58 (10.3%) children reported 80 treatment-related side effects. The most common side effects were associated with the gastrointestinal tract (7.7%) or skin (1.2%). Self-limiting, treatment-related side effects affecting the liver and biliary system were reported in three patients (0.5%). Overall, 18 patients (3.2%) discontinued treatment due to side effects, mainly gastrointestinal symptoms. Dose and age did not appear to influence the incidence and pattern of side effects. Treatment-related laboratory abnormalities were uncommon, the most frequent being transient elevated alanine aminotransferase (4.9%), aspartate aminotransferase (2.7%), and alkaline phosphatase (2.3%) levels. Although 98.6% of patients were taking concomitant medications, no clinical or laboratory interactions were observed. The safety profile of fluconazole was compared with those of other antifungal agents, mostly oral polyenes, by using a subset of data from five controlled studies. Side effects were reported by more patients treated with fluconazole (45 of 382; 11.8%) than by those patients treated with comparable agents (25 of 381; 6.6%); vomiting and diarrhea were the most common events in both groups. The incidence and type of treatment-related laboratory abnormalities were similar for the two groups. In conclusion, fluconazole was well tolerated by the pediatric population, many of whom were suffering from severe underlying disease and were taking a variety of concurrent medications. The safety profile of fluconazole in children mirrors the excellent safety profile seen in adults. 相似文献
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目的探讨有氧运动联合肺康复训练在中重度慢性阻塞性肺疾病(COPD)患者中的应用效果。方法选择2017年2月~2018年3月进入我院治疗的中重度COPD患者90例,随机数字表法分为对照组和观察组各45例。对照组采用进行肺康复训练,观察组在此基础上进行有氧运动,比较两组肺功能变化情况及运动功能变化情况。结果干预3个月后,观察组第1s用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC均较对照组高,差异均有统计学意义(P<0.05);观察组运动耐量时间、最大耗氧量均高于对照组,差异均有统计学意义(P<0.05)。结论有氧运动联合肺康复训练能有效改善中重度COPD患者肺功能,提升运动功能。 相似文献
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目的:探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)对中重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者的症状和生活质量的影响。方法:采用Epworth嗜睡量表(Epworth sleepiness scale,ESS)和魁北克睡眠问卷(Quebec sleep questionnaire,QSQ)对36例中重度OSAHS患者在行UPPP治疗前及治疗后3年进行症状、生活质量评估。结果:OSAHS患者治疗前后ESS评分变化有统计学意义(P=0.0146):QSQ评分亦有明显提高(P=0.0312),表明OSAHS患者经UPPP治疗后远期症状和生活质量均较治疗前明显改善(P0.05)。结论:OSAHS严重影响患者的生活质量,UPPP能改善患者的远期症状,提高生活质量。 相似文献
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目的探讨超促排卵治疗过程中并发中、重度卵巢过度刺激综合征(ovarian hyper-stimulation syndrome,OHSS)的护理对策。方法回顾性总结2010年6月至2011年6月在接受体外受精-胚胎移植治疗的患者中,80例因超促排卵并发中、重度卵巢过度刺激综合征患者的临床资料及护理体会。结果 80例患者经积极治疗及护理后,均全部康复,其中32例获得妊娠、48例终止妊娠。结论中、重度卵巢过度刺激综合征患者的护理重点应包括预防性监测及护理、心理护理、饮食及用药护理、腹胀及腹痛的护理、腹水引流的护理及出院后指导等。 相似文献