卡维地洛对高血压的降压作用及对胰岛素抵抗的影响

目的探讨卡维地洛的降压作用及对胰岛素抵抗的影响。方法对58例高血压病Ⅰ期或Ⅱ期患者服用卡维地洛10 mg,bid,疗程为6 wk;治疗前后观察血压、空腹血糖(FBS)、血脂和胰岛素敏感性(ISI)的变化。结果服药前收缩压(158．3±13．5)mm Hg,舒张压(92．3±5．7)mm Hg;服药后收缩压(141．5±12．7)mm Hg,舒张压(81．8±6．4)mm Hg,服药前后比较(P< 0．05),治疗前后血糖、血脂无显著性改变(P>0．05),胰岛素敏感性增加(P<0．05)。结论卡维地洛能有效地降低收缩压和舒张压,能显著改善胰岛抵抗。     

Influence of carvedilol and propranolol on coronary blood flow

A total of 17 patients with angiographically proven coronary artery disease and at least one stenosis blocking 70% of the left anterior descending or circumflex artery were included in a double-blind, randomized study. They received either 5 mg carvedilol or 6 mg propranolol intravenously. Heart rate, aortic pressure, mean coronary sinus pressure and coronary flow (thermodilution) were measured and coronary resistance and the rate-pressure product were calculated before and 25 min after injection. Carvedilol significantly (P < 0.05)=" lowered=" the=" heart=" rate=" (mean,=" 76=" to=" 69=" beats/min),=" aortic=" pressure=" (mean,=" 153/80–135/72=" mmhg),=" rate-pressure=" product=" (mean,=" 117–93=" mmhg/min),=" and=" coronary=" flow=" (mean,=" 114–94=" ml/min).=" coronary=" resistance=" (mean,=" 0.97–1.07=" mmhg=" ×=" min/ml)=" and=" coronary=" flow=" related=" to=" the=" rate-pressure=" product=" (mean,=" 1.0–1.02=" ml/mm=" hg)=" showed=" no=" significant=" change=" after=" carvedilol=" treatment.=" propranolol=" lowered=" the=" heart=" rate=" (mean,=">P < 0.05)=" and=" rate-pressure=" product=" (mean,=" 109–96=" mm.=" hg/min;=" not=" significant).=" aortic=" pressure=" (mean,=" 145/72–147/74=" mmhg),=" coronary=" flow=" (mean=" 109–101=" ml/min),=" coronary=" resistance=" (mean,=" 1.1–1.2=" mmhg=" ×=" min/ml),=" and=" coronary=" flow=" related=" to=" the=" rate-pressure=" product=" (mean,1.12–1.19=" ml/mmhg)=" showed=" no=" significant=" change=" after=" propranolol=" administration.=" following=" single=" application,=" carvedilol=" lowered=" the=" rate-pressure=" product=" more=" markedly=" than=" did=" propranolol=" on=" account=" of=" its=" acute=" blood-pressure-lowering=" effect.=" no=" differences=" in=" the=" hemodynamic=" effects=" of=" carvedilol=" and=" propranolol=" were=" found.=" neither=" drug=" seems=" to=" influence=" the=" adaption=" of=" coronary=" flow=" to=" myocardial=" oxygen=">     

3,4,5-三甲氧基苯甲酸-8-(二乙胺基)-辛酯对大鼠脑血流及其自动调节功能的影响

用激光多谱勒血流仪连续测量脑血流量（CBF），观察3,4,5-三甲氧基苯甲酸-8-(二乙胺基)-辛酯(TMB-8)对麻醉大鼠CBF及脑血流自动调节功能的影响. 结果表明, TMB-8 0.5, 1.0和2.0 mg·kg^-1呈剂量依赖性地增加CBF 5%, 20% 和34%. 其中仅2.0 mg·kg^-1组使平均动脉压（MABP）降低6%. 而尼莫地平(Nim)0.01 mg·kg^-1在使CBF增加21%的同时，使MABP降低了27%. 麻醉大鼠脑血流自动调节的MABP低限是5.3 kPa. 在MABP 4.0 kPa时TMB- 8 2.0 mg·kg^-1能增加脑血流自动调节能力，而Nim 0.01 mg·kg^-1则无明显作用. 提示TMB-8增加CBF和增强脑血流自动调节能力是其抗脑缺血作用的机理之一.     

The functional role of the alpha-1 adrenergic receptors in cerebral blood flow regulation

Cerebral vasculature is richly innervated by the α-1 adrenergic receptors similar to that of the peripheral vasculature. However, the functional role of the α-1adrenergic receptors in cerebral blood flow (CBF) regulation is yet to be established. The traditional thinking being that during normotension and normocapnia sympathetic neural activity does not play a significant role in CBF regulation. Reports in the past have stated that catecholamines do not penetrate the blood brain barrier (BBB) and therefore only influence cerebral vessels from outside the BBB and hence, have a limited role in CBF regulation. However, with the advent of dynamic measurement techniques, beat-to-beat CBF assessment can be done during dynamic changes in arterial blood pressure. Several studies in the recent years have reported a functional role of the α-1adrenergic receptors in CBF regulation. This review focuses on the recent developments on the role of the sympathetic nervous system, specifically that of the α-1 adrenergic receptors in CBF regulation.     

老年高血压病患者卡托普利与阿替洛尔干预前后脑血流量的变化特征及其意义

目的 对比研究卡托普利(CPT)与阿替洛尔(ATL)对老年高血压病患者脑血流量的影响.方法选择年龄均在60岁以上的轻中度高血压病患者62例,随机给予CPT75～150mg/d或ATL50～100mg/d,分别于服药前后4周应用三维经颅超声多普勒测定患者颅内血管射血速度.结果服药前患者颅内血管平均流速均异常增高,服药4周后均明显降低,其中CPT组患者降至正常水平,ATL组患者却降至显著低于正常水平.结论 CPT可明显改善高血压病老年患者的脑血流量,而ATL则可使其异常减少.     

Effects of arotinolol on regional cerebral blood flow in hypertensive patients with a history of stroke

Although optimal blood pressure control is important for managing stroke patients, the use of antihypertensives in stroke patients often causes cerebral blood flow reduction leading sometimes to deterioration of symptoms. Effects of arotinolol, a β-blocker with a moderate α-blocking action, on the regional cerebral blood flow (rCBF) were investigated in 10 hypertensive patients with a history of stroke by using a noninvasive ¹³³Xe inhalation method. The rCBF was measured before and after administration of 15 mg/day arotinolol (three times a day) for 2–3 weeks. After the administration, the blood pressure was reduced in all the patients showing a change in average values of from 176/105 mmHg to 152/90 mmHg. The rCBF in the infarcted and healthy hemispheres was 44.3 ± 4.4 and 44.6 ± 5.0 ml/100 g/min before arotinolol and 44.9 ± 6.4 and 45.3 ± 6.5 ml/100 g/min after arotinolol, respectively. No significant rCBF change was observed after arotinolol in both hemispheres. During the administration, none of the patients suffered from dizziness or other ischemic symptoms. The above results suggest that arotinolol exerts little influence on the cerebral circulation and may be useful for the management of hypertension in stroke patients.     

牛磺酸对急性局部脑缺血大鼠脑血流和脑梗死体积的影响

目的 :研究牛磺酸对脑缺血再灌注模型大鼠的局部脑血流和脑梗死体积的影响。方法 :用大脑中动脉栓塞 (MCAO)法制作大鼠急性局部脑缺血再灌注模型 ,分别用 10 ,4 0和 80mg·kg- 1牛磺酸经腹腔注射给药 ,检测缺血 1h和灌注 30min内脑血流 ,再灌注 2 4h后进行神经功能缺损评分并计算脑梗死体积的大小。结果 :MCAO引起大脑中动脉供血区脑血流显著下降 ,牛磺酸可减少脑血流量下降的幅度 ;缺血 1h再灌注 2 4h后 ,模型组脑梗死体积为 (33±s 9) % ,而牛磺酸治疗组脑梗死体积明显缩小 ,各组分别为 (17± 5 ) % ,(12± 5 ) %和 (11± 3) % ;牛磺酸治疗组神经缺损评分比模型组小。结论 :牛磺酸可以增加缺血局部的脑血流量 ,缩小脑梗死体积 ,对急性脑缺血具有脑保护作用。     

卡维地洛改善高血压患者的血管内皮功能

目的：探讨卡维地洛对原发性高血压患血管内皮功能的影响。方法：用高分辨率超声检测经美托洛尔或卡维地洛治疗12wk前后的高血压患肱动脉流量介导的舒张活性（FMD）和硝酸甘油介导的舒张活性（NTGMD）的变化。并以18例健康作为对照；同时采用酶联免疫检测法（ELISA）测定卡维地洛治疗前后高血压患血浆氧化低密度脂蛋白（ox-LDL)的变化。结果：健康对照组的FMD显高于高血压患美托洛尔或卡维地洛治疗前的FMD，而3组间NTGMD的差异无显统计学意义。卡维地洛组治疗后FMD显性升高，NTGMD无显性改变，卡维地洛组治疗后血浆ox-LDL显降低。结论：卡维地洛可能通过其抗氧化活性改善高血压患的血管内皮依赖性舒张功能。     

Effects of piracetam on regional cerebral blood flow and mental functions in patients with organic dementia

The effects of piracetam (Nootropil^®, UCB 6215) on mental functions and on regional cerebral blood flow (rCBF) were investigated in eight patients in the presenile age who displayed symptoms of moderate dementia. The double-blind crossover design included nine measurement occasions, each involving rCBF measurement by the 133-Xe inhalation method, ratings of symptoms of dementia, personality changes, and side effects, and a psychometric investigation. Three investigations were included in each of three treatment periods. The first investigation in a period was made without medication. Then either placebo or piracetam 4.8 g/day or 9.6 g/day was given during four weeks with measurements after 2 weeks and 4 weeks. There were intervals of 4 weeks without medication between the treatment periods. Piracetam had no significant effect on either mental functions or rCBF.     

卡维地洛、比索洛尔和多沙唑嗪降压疗效比较

目的：观察并比较卡维地洛（Car）、比索洛尔（Bis）和多沙唑嗪（Dox）治疗轻、中度原发性高血压的降压疗效和安全性。方法：选择48例原发性高血压患者,随机分成3组。Car组15例（Car25-50mg,po,qd）;Bis组16例（Bis5-10mg,po,qd）;Dox组17例（Dox4mg,po,qd）。3组疗程均为4wk。检测各组服药后的血压、心率、肝肾功能、血糖和血电解质等。结果：Car组的降压总有效率为80.0％,Bis组为81.25％,Dox组为70.59％,3组疗效无显著差别（P＞0.05）,Car与Dox对心率无影响,而Bis具有减慢心率作用。3种药物对肝肾功能、血糖和血电解质无明显影响。结论：Car、Bis和Dox疗效相似,均能有效降低轻、中度原发性高血压,且无明显不良反应。     

Effects of nitrendipine on the autoregulation of regional cerebral blood flow in the pithed rabbit

Summary Effects of the calcium-channel antagonist, nitrendipine, on the autoregulation of regional cerebral blood flow were studied by analysing the pressure-flow relationship in the cortex, subcortex and thalamus in pithed anesthetized rabbits. Arterial pressure was altered from 50 to 125 mm Hg by electrical stimulation of the spinal nerve roots. Regional blood flow was measured with the hydrogen clearance technique. Under control conditions, regional blood flow in the cortex, subcortex and thalamus did not change significantly within the range of mean arterial pressures of 50 to 100 mm Hg. Vascular resistance in each region rose significantly (P < 0.05) in a pressure-dependent manner. During the intravenous infusion of nitrendipine (0.3 and 1 g · kg^–1 · min^–1), blood flow to the three regions of the brain increased in a pressure-dependent manner when mean arterial pressure was increased from 50 to 125 mm Hg. The autoregulatory increase in regional vascular resistance was abolished. In addition, nitrendipine produced a blood pressure-dependent decrease of the vascular resistance in the subcortex and thalamus but not in the cortex. These results indicate that nitrendipine increases regional cerebral blood flows and suppresses regional autoregulations simultaneously. The autoregulatory adjustment in the cortex is more resistant to nitrendipine than that in the subcortex and thalamus. The observation that the action of nitrendipine was not the same in the three brain regions may be due to the vascular beds of these regions differing in their calciumchannel equipment.     

赛庚啶对心、脑、肾血流量的影响及对实验性脑血栓的影响

目的观察赛庚啶对大鼠脑血流量、心肌血流量及肾血流量的影响及其对以ADP、凝血酶、肾上腺素复合物为诱导剂的实验性脑血栓的影响。方法：放射性微球法。结果：赛庚啶iv2mg·kg(－1)可以使正常SD大鼠脑血流量增加28．6％，心肌血流量增加43．0％，肾皮质血流量增加45．6％，与对照组相比差异有显著性。ivlmg·kg(－1)可以抑制实验性脑血栓的形成。结论：赛庚啶可以改善心、脑、肾的血液循环。     

注射用辛芍对大鼠脑缺血再灌注损伤的保护作用和对脑微循环血流量的影响

目的:观察注射用辛芍对大鼠中动脉阻断(MCAO)局灶性脑缺血再灌注损伤及脑缺血局部微循环血流量的影响。方法:采用栓线法建立局灶性脑缺血再灌注模型,观察注射用辛芍(0.31,0.62,1.25g.kg-1)分别对MCAO再灌注大鼠神经行为学、脑梗死率和脑组织超氧化物歧化酶(SOD)、一氧化氮合酶(NOS)活性,丙二醛(MDA)含量及脑组织病理变化的影响;使用相同动物模型,以激光多普勒血流仪监测各药物干预组对大鼠脑微循环血流的影响。结果:注射用辛芍可明显降低或改善MCAO大鼠行为障碍、脑梗死率及缺血所致组织病理改变,提高SOD活力,降低NOS活性及MDA含量,改善缺血大鼠脑微循环。结论:注射用辛芍对实验性脑缺血具有显著的保护作用,其作用机制可能与增强病灶组织抗氧化和改善局部脑微循环血流有关。     

卡维地洛与美托洛尔对照治疗原发性高血压60例

目的:评价卡维地洛对原发性高血压的临床疗效及安全性.方法:60例原发性高血压患者经过2周安慰剂洗脱期后随机分为:对照组30例给予美托洛尔25mg,bid,服药2周末血压下降未达有效标准增至50mg,bid,疗程共8周.治疗组给予卡维地洛10mg,bid,服药2周末血压下降未达有效标准者增至20mg,bid,疗程共8周.结果:治疗组降压总有效率80.0%,显效率56.7%,对照组总有效率73.3%,显效率53.3%;两组疗效比较差异无显著性(P>0.05),不良反应发生率差异无显著性(P>0.05).不良反应程度轻微,可耐受.结论:卡维地洛是治疗原发性高血压的安全有效的药物.     

Effects of carvedilol on renal function

A randomized, double-blind, placebo-controlled study was conducted to study the effects of acute and chronic administration of carvedilol in essential hypertension, with special emphasis on renal haemodynamics and function. Acute administration of a single dose of 50 mg carvedilol reduced systolic and diastolic blood pressure without inducing reflex tachycardia. Renal blood flow was preserved; accordingly, renal vascular resistance was significantly reduced. A significant reduction in the glomerular filtration rate and filtration fraction was observed. Plasma renin activity (PRA) and plasma aldosterone values were not changed. Chronic carvedilol treatment produced a significant fall in systolic and diastolic blood pressure, heart rate, PRA and plasma aldosterone. Renal blood flow, glomerular filtration rate and filtration fraction also remained unchanged; renal vascular resistance decreased significantly. It is concluded that carvedilol possesses definite antihypertensive and renal vasodilating properties, both acutely and after chronic treatment.     

高血压病患者血压水平与脑血管并发症发生率的关系

目的:探讨不同血压水平与高血压病脑血管并发症发生率的关系。方法:回顾性调查近5年住我院未治疗高血压病患者696例(男387例,女309例),按不同收缩压、舒张压和脉压水平进行分组,分析不同收缩压、舒张压及脉压水平与脑血管并发症发生率的关系。结果:脑血管并发症的发生率与收缩压、舒张压和脉压有关(P<0.05),其影响顺序依次为:脉压>收缩压>舒张压。结论:高血压病患者脑血管并发症发生率与收缩压、舒张压和脉压有关,但脉压起着更重要的作用。     

阿托伐他汀联合阿司匹林对急性脑梗死患者脑血流及颈动脉粥样斑块的影响

目的 研究不同剂量阿托伐他汀联合阿司匹林对急性脑梗死患者脑血流指标以及颈动脉粥样斑块的影响。方法 选取2013年4月至2014年4月榆林市星元医院收治的急性脑梗死患者99例为研究对象,随机数表法将患者分为治疗组1、治疗组2及对照组,每组各33例。3组均常规行活血化淤等基础治疗,使用不同剂量的阿托伐他汀联合阿司匹林治疗,分别观察3组的颈动脉内膜中层厚度（IMT）及粥样硬化斑块积分、血清血小板膜表面P选择素（CD62p）、血小板糖蛋白复合物（PAC-1）及超敏C反应蛋白（hs-CRP）变化、血脂变化。结果 治疗后,治疗组1及治疗组2患者IMT及颈动脉斑块积分显著改善（P<0.05）。与治疗前及对照组相比,治疗6个月后,治疗组1及治疗组2患者CD62p、PAC-1及hs-CRP水平显著降低（P<0.05）。治疗后,治疗组1及治疗组2患者血清三酰甘油（TG）,总胆固醇（TC）和低密度脂蛋白（LDL）均显著降低（P<0.05）。结论 使用10 mg/d阿托伐他汀联合阿司匹林治疗急性脑梗死患者可抑制血小板活化,减少炎性反应,同时具有稳定颈动脉粥样硬化斑块的作用。     

激光散斑成像法测定灯盏花素对大鼠脑血流量的影响

目的:考察灯盏花素对大鼠脑血流量的影响。方法:通过激光散斑成像方法测定灯盏花素对正常大鼠脑血流量的影响,并对大鼠脑血流的不同区域进行了计算分析。结果:正常大鼠腹腔注射灯盏花素100mg.kg-1后,大鼠的脑血管(包括大小动脉和静脉)的形态无明显变化;大鼠脑动脉的血流量迅速增加,最高可增加一倍左右,并维持在一个相对较高的水平;给药10min后,微循环区的血流量显著增加,最高可增加原血流量的50%～60%左右。结论:灯盏花素能显著改善正常大鼠大脑动脉及微循环区的血流量,其机制可能与其松弛毛细血管前后括约肌,减少血流阻力及改善血液的流变性等作用有关。     

Effects of carvedilol on common carotid arterial flow, peripheral hemodynamics, and hemorheologic variables in hypertension

The effects of a beta-blocker, carvedilol, on peripheral hemodynamics and hemorheologic parameters were evaluated in 11 geriatric patients with essential hypertension [3 men and 8 women aged 62–79 years (mean, 68.6 years)]. Carvedilol was given orally after breakfast at a dose of 10 or 20 mg daily for 8 weeks. Peripheral hemodynamics, the common carotid arterial flow, and hemorheologic parameters were determined twice prior to administration and after 4 and 8 weeks of carvedilol treatment. The common carotid arterial flow was determined using the pulsed Doppler method. Peripheral hemodynamics were assessed by venous occlusion plethysmography. The hemorheologic parameters assessed include erythrocyte aggregation, erythrocyte deformability, plasma viscosity, whole-blood hematocrit, and platelet function tests. Erythrocyte aggregation was measured using an Erythrocyte Aggregometer MA-1 (Myrenne, USA), taking a high shear rate of 600 s^\t-1 and a low shear rate of 3 s^\t-1 as the indices. Statistical comparisons of values before and after carvedilol administration were made using the paired Student'st-test. Systolic and diastolic blood pressure were decreased by carvedilol. The common carotid arterial flow was increased, and peripheral hemodynamics were improved by carvedilol. Erythrocyte aggregation (measured at both a high and a low shear rate) and plasma viscosity were decreased, erythrocyte deformability was increased, and levels of circulating platelet aggregates were also improved by carvedilol. This improvement of hemorheologic variables may contribute to prevention of the initiation and progression of thrombosis and atherosclerosis in geriatric patients with essential hypertension.     

三七总皂甙对实验性脑缺血脑血流及血脑屏障的影响作用

目的 观察三七总皂甙对脑缺血后再灌流期间血脑屏障及脑血流的影响。方法 利用大鼠局灶性脑缺血再灌流和全脑缺血再灌流损伤两种实验模型。结果 与相应对照组比较，不论是全脑缺血还是局灶性脑缺血1h后再灌注3d，应用三七总皂甙的各组动物及水肿明显减轻，血脑屏障通透性改善，大脑局部血流量显著增加。结论 三七总皂甙对脑缺血后脑水肿、血脑屏障、大脑局部血流量具有保护作用。