氯沙坦与吲哒帕胺或氢氯噻嗪合用的降压疗效观察

目的：研究和评价氯沙坦与吲哒帕胺或氢氯噻嗪合用降压疗效及对代谢的影响。方法：选择４５例轻一中度原发性高血压患者,随机分成３组,氯沙坦与吲达帕胺合用组：氯沙坦５０ｍｇ,每日一次,加吲达帕胺２．５ｍｇ,每日一次;氯沙坦与氢氯噻嗪合用组：氯沙坦５０ｍｇ,每日一次,加氢氯噻嗪１２．５ｍｇ,每日二次。三组疗程均为１２周。观察三组治疗前后的随测血压（ＣＢＰ）和２４小时动态血压（ＡＢＰＭ）及生化指标。结果：氯沙坦加吲达帕胺或加氢氯噻嗪组降压总有效率及随测血压、２４小时动脉血压的变化均明显优于氯沙坦单用组,且治疗前后心率和生化指标无明显改变。结论：氯沙坦与吲达帕胺或氢氯噻嗪联合应用降压效果较单用氯沙坦更有效,且对代谢无影响。     

卡托普利与小剂量氢氯噻嗪合用治疗高血压疗效观察

目的:研究卡托普利与小剂量氢氯噻嗪合用对高血压患者的疗效及对代谢的影响.方法:50例原发性高血压患者随机分为两组,第1组:单用卡托普利12.5 mg～7 5 mg,每日2～3次.第2组:卡托普利12.5 mg,每日2次,加服氢氯噻嗪12.5 mg,每日1次,两组治疗时间均为8周,测定治疗前后的基础血压,空腹血糖、血脂、血钾、血尿酸、尿素氮、肌酐, 以及治疗前后的24小时动态血压.结果:卡托普利加小剂量氢氯噻嗪组的总有效率及24小时动态血压结果均明显优于单用卡托普利组,而且两组治疗前后的代谢指标均无明显改变.结论:卡托普利与小剂量氢氯噻嗪合用治疗高血压较单用卡托普利更有效,而且对代谢无明显影响.     

非洛地平地加小剂量美托洛尔和利尿剂联合治疗对中重度高血压左室肥厚的影响

观察非洛地平加小剂量美托洛尔利尿剂对左室肥厚的影响。方法随机选择８８例原发性中重度高血压左室肥厚（ＬＶＨ）的患者分为２组，治疗组４８例非洛地平５～１０ｍｇ每日１～２次，加倍美托洛尔１２．５ｍｇ～５０ｍｇ／ｄ，分两次口服，加双氢克尿噻１２．５ｍｇ，每日一次或隔日一次。对照组４０例。硝苯地平５ｍｇ～１０ｍｇ每日１～３次。结果治疗组与对照组比较：逆转ＬＶＨ的作用有明显差异。结论非洛地平加小剂量美托洛尔和利尿剂有明显的稳定心率，均衡降血压以及改善左心室舒张功能的作用。     

非洛地平地加小剂量美托洛尔和利尿剂联合治疗中重度高血压左室肥厚的影响

观察非洛地平加小剂量美托洛尔利尿对左室肥厚的影响。方法 随机选择８８例原发性中重度高血压左室肥厚的患者分为２组，治疗组４８例非洛地平５－１０ｍｇ每日１－２次，加倍美托洛尔１２．５ｍｇ－５０ｍｇ／ｄ，分两次口服，加双氢克悄噻１２．５ｍｇ，每日一次或隔日一次。对照组４０例，硝苯地平５ｍｇ－１０ｍｇ每日１－３次。结果 治疗组与对照组比较；逆转ＬＶＨ的作用有明显差异。     

吲达帕胺治疗中枢性尿崩症的临床观察

应用吲达帕胺（ｉｎｄａｐａｍｉｄｅ）２．５～７．５ｍｇ／ｄ或双氢氯噻嗪５０～７５ｍｇ／ｄ治疗１０例中枢性尿崩症，治疗后第３天患者日尿量减少近一半，尿渗透压增高１倍多，治疗后第６天上述指标无进一步改善，两种药物的疗效比较无显著性差异。吲达帕胺治疗期间，血压和血清电解质未见明显变化。双氢氯噻嗪治疗后血钾下降。提示吲达帕胺是治疗中枢性尿崩症的一种新的有效药物。     

尼群地平伍用倍他乐克对高血压病的治疗及随访

目的：探讨尼群地平伍用倍他乐克治疗高血压病的医疗效果。方法：１３４例高血压病患分为两组：观察组与对照组。观察组８６例,服用尼群地平,１０～２０ｍｇ／次,２～３次／日,伍用倍他乐克１２．５～５０ｍｇ／次,２次／日;对照组４８例,用开搏通片,１２．５～２５ｍｇ／次,２～３次／日,疗程４周。测血压,１次／日。根据血压、心率变化调整用药方案,直到血压正常或接近正常。之后,每月监测血压１～２次,坚持长期随     

比索洛尔加小剂量氢氯噻嗪治疗原发性高血压

目的 观察比索洛尔加小剂量氢氯噻嗪治疗原发性高血压的疗效和安全性.方法 原发性高血压86例,随机分为对照组和观察组各43例,对照组单用比索洛尔2.5mg,晨服,每日1次;观察组在对照组治疗基础上再加用氢氯噻嗪12.5mg,晨服,每日1次.两组疗程均为1个月,测量治疗前、后的血压、心率、血脂、血糖、肝功能、肾功能、血电解质.结果 经治1个月后观察血压下降,对照组总有效率72%,观察组总有效率93%,差异有统计学意义(P＜0.05),两组均无不良事件发生.结论 治疗高血压,比索洛尔加小剂量氢氯噻嗪比单用比索洛尔疗效更好.     

依那普利和小剂量双氢克尿塞治疗高血压病61例

我院应用依那普利和小剂量双氢克尿塞治疗高血压病６１例,收到满意效果。现报告如下。 一般资料;选择符合１９９９年ＷＨＯ／ＩＳＨ高血压诊断标准、血肌酐（Ｃｒ）＜３５４．７μｍｏｌ／Ｌ的高血压病患者６１例。男３７例,女２４例;年龄３２～７６岁,平均（５２．２±１１．３）岁。其中高血压１级７例,２级３１例,３级２３例。合并心功能不全２３例,按ＮＹＨＡ心功能分级法：级４例,Ⅲ级１６例,Ⅳ级３例。 方法：治疗前均停一切降压药１周,晨起顿服依那普利１０ｍｇ,双氢克尿塞 １２．５ ｍｇ,每天 ２次;若 １周后降压不满…     

拉西地平对高血压大鼠的降压作用

目的：观察新的钙拮抗剂拉西地平的降压作用。方法：急性降压实验：将５个月龄雄性卒中型自发性高血压大鼠（ＳＨＲｓｐ）随机分为Ａ、Ｂ、Ｃ（分别经管饲给药１次，拉西地平剂量１ｍｇ／ｋｇ，０．５ｍｇ／ｋｇ，０．２５ｍｇ／ｋｇ）、Ｄ（尼群地平１０ｍｇ／ｋｇ）、Ｅ（溶媒对照）组，每组１１只，于用药后１、３、５、９、１２、２４小时各测１次收缩压及心率（尾套法）。慢性降压实验：将３个月龄ＳＨＲｓｐ分为Ａ、Ｂ、Ｄ、Ｅ组（剂量同急性降压实验），每组１０只，治疗１４天，于治疗后第２、４、６、８、１０、１２、１４天各测１次收缩压及心率。结果：拉西地平１ｍｇ／ｋｇ和０．５ｍｇ／ｋｇ均可显著降低ＳＨＲｓｐ血压，降压作用分别持续１２～２４小时和９～１２小时，降压作用均强于尼群地平１０ｍｇ／ｋｇ，仅轻度增加了心率。结论：拉西地平对ＳＨＲｓｐ降压作用明确，持续时间长。     

倍他索洛尔治疗轻中度原发性高血压的疗效评价

目的：观察倍他索洛尔降压疗效、谷峰比值及不良反应。方法：采用随机双盲法、与另一β１受体阻滞剂比索洛尔作平行对照。１２８名３０～６５岁不拘性别的轻、中度原发性高血压患者，服安慰剂２周后，舒张压１２．６～１５．３ｋＰａ（９５～１１５ｍｍＨｇ）、收缩压≤２４．６ｋＰａ（１８５ｍｍＨｇ）者，进入研究。治疗组（ｎ＝６２）每日服倍他索洛尔１０～２０ｍｇ；对照组（ｎ＝６６）每日服比索洛尔５～１０ｍｇ，共４周。服用倍他索洛尔的２２例完成了２４小时动态血压监测。结果：治疗组收缩压及舒张压分别下降２．４及２．０ｋＰａ（１８及１５ｍｍＨｇ）；对照组相应值为２．７及２．０ｋＰａ（２０及１５ｍｍＨｇ）。动态血压监测结果显示：服倍他索洛尔４周后总血压负荷，昼夜平均收缩压与舒张压明显下降，收缩压及舒张压谷峰比值均大于５０％。两组不良反应少，各项生化指标无明显变化。结论：倍他索洛尔系第２代长效β１受体阻滞剂，可以做为治疗轻中度原发性高血压的药物。     

Long-term efficacy of combination therapy with losartan and low-dose hydrochlorothiazide in patients with uncontrolled hypertension

We evaluated the long-term efficacy of losartan and low-dose hydrochlorothiazide combination therapy in the treatment of hypertension. We enrolled 15 Japanese hypertensive outpatients whose 24-hour ambulatory blood pressure was >or= 135/80 mmHg after candesartan 8 mg (CND group; n = 10) monotherapy or amlodipine 5 mg (AML group; n = 5) monotherapy for 2 months or more. The monotherapy was then switched to losartan 50 mg and hydrochlorothiazide 12.5 mg combination therapy. Ambulatory blood pressure and indices of glucose and lipid metabolism were measured at the end of the monotherapy and after 3 and 12 months of the combination therapy. In the CND group, 24-hour blood pressure decreased significantly from 137 +/- 9/89 +/- 4 to 126 +/- 8/81 +/- 7 mmHg after 3 months (P < 0.05/ P < 0.001) and to 123 +/- 7/81 +/- 4 mmHg after 12 months (P < 0.01/P < 0.001). In the AML group, 24-hour blood pressure decreased significantly from 137 +/- 11/81 +/- 7 to 125 +/- 12/75 +/- 6 mmHg after 3 months (P < 0.05/P < 0.05) and to 124 +/- 9/77 +/- 7 mmHg after 12 months (P < 0.05/NS). There were significant decreases in systolic blood pressure during the daytime (6:00-21:30), nighttime (22:00-5:30) and early morning (6:00-8:00) after 12 months in both groups. No adverse changes in the indices of glucose or lipid metabolism were observed in either group. In conclusion, long-term combination therapy with losartan and low-dose hydrochlorothiazide was effective in the treatment of hypertensive patients whose blood pressure was not controlled by candesartan or amlodipine monotherapy alone.     

拜新同与科素亚或海捷亚合用的降压疗效观察

目的研究和评价拜新同与科素亚或海捷亚合用降压疗效及对代谢的影响。方法选择45例中、重度原发性高血压患者,随机分成3组,每组各15例。拜新同组:单用拜新同30mg,每日1次;拜新同与科素亚合用组:拜新同30mg,每日1次,加科素亚50mg,每日1次;拜新同与海捷亚合用组:拜新同30mg,每日1次,加海捷亚50mg,每日1次。3组疗程均为12周。观察3组治疗前后的随测血压(CBP)和24h动态血压(ABPM)及生化指标。结果拜新同加海捷亚组降压总有效率及CBP、ABPM的变化均明显优于拜新同单用组和拜新同与科素亚合用组。治疗前后心率和生化指标则无明显改变。结论拜新同与海捷亚联合应用降低中、重度高血压效果较单用拜新同组以及拜新同和科素亚合用组更有效,且对代谢无影响。     

Comparative double-blind study of ramipril and captopril in mild to moderate essential hypertension

The angiotensin converting enzyme inhibitors ramipril and captopril were administered in doses of 10 mg once daily and 50 mg twice daily, respectively, to patients with mild to moderate essential hypertension. After a 4-week single-blind placebo washout period, patients were treated for 12 weeks with 1 of the drugs under double-blind conditions. Patients who did not respond after 6 weeks of treatment were given 50 mg hydrochlorothiazide concomitantly. The ramipril group showed greater decreases in blood pressure compared with baseline values: 20.1/14.9 mm Hg (ramipril) compared with 16.5/13.5 mm Hg (captopril). A further 6 weeks of treatment lowered the blood pressure even more: 22.5/20.0 mm Hg (ramipril) compared with 20.5/18.6 mm Hg (captopril). Concomitant hydrochlorothiazide given to nonresponders reduced the blood pressure levels in 24 of 40 patients in the ramipril group and in 20 of 36 patients in the captopril group. At the end of the study the overall response to treatment with ramipril alone and ramipril plus hydrochlorothiazide was 77.1%. The overall response rate in the captopril group was 82.7%. No clinically relevant adverse reaction occurred in any patient. Ramipril given once daily was as effective as captopril given twice daily in lowering blood pressure. Both drugs proved to be safe during treatment for 12 weeks.     

工作场所干预条件下不同药物组合的降压效果

目的比较分析工作场所干预条件下,不同药物组合对高血压患者的降压效应。方法 2009-04-2010-05对开滦集团有限责任公司井下及井下辅助单位在岗患高血压的职工进行综合干预[共5367例,其中男性4023例,女性67例,年龄(45.5±6.5)岁]。干预措施包括免费发放降压药物,宣传教育和行政干预。免费发放的降压药为下列组合之一:①尼群地平5mg2次/d+卡托普利12.5mg2次/d(A组,1115例);②尼群地平5mg2次/d+螺内酯20mg1次/d(B组,704例);③氢氯噻嗪12.5mg1次/d+卡托普利12.5mg2次/d(C组,794例);④氢氯噻嗪12.5mg1次/d+螺内酯20mg1次/d(D组,1477例)。干预期间每2周随访1次并测量血压,观察干预前后的血压变化情况。结果干预后收缩压[(134.1±13.1)比(147.6±17.5)mmHg]、舒张压[(86.6±8.9)比(96.9±10.9)mmHg]下降(均P<0.01)。A、B、C、D组收缩压分别下降(14.1±23.3)、(11.4±23.0)、(12.1±21.7)和(14.8±20.9)mmHg,舒张压分别下降(9.5±15.5)、(7.4±14.8)、(10.2±14.4)和(12.1±13.6)mmHg,组间比较差异有统计学意义(均P<0.01),D组血压下降值大于其他组。A、B、C、D组的总有效率分别为67.0%、62.9%、68.5%和77.3%,D组的总有效率高于其他组(P<0.01)。结论工作场所不同抗高血压药物组合能有效降低高血压患者的血压水平。     

优化联合治疗老年单纯性收缩期高血压

目的比较卡托普利单药、左旋氨氯地平（施慧达）单药、卡托普利＋左旋氨氯地平、卡托普利＋左旋氨氯地平＋阿托伐他汀四种治疗方案治疗老年单纯性收缩期高血压（ISH）的临床疗效。方法纳入60岁以上ISH患者264例，平均分为4组。卡托普利组：口服卡托普利（12．5～50）mg（bid）。左旋氨氯地平组：晨起顿服左旋氨氯地平2．5mg（qd）。联合治疗组（联合组）：卡托普利（12．5～50）mg（bid）＋左旋氨氯地平2．5mg（qd）。优化联合组（优化组）：在联合治疗组的基础上加用阿托伐他汀10mg（qd）；共治疗12周。并分别比较治疗前、治疗后1周、3周、6周、12周4组血压、血脂水平及心电图变化。结果四组治疗后收缩压均有不同程度的降低，优化组和联合组与卡托普利组、左旋氨氯地平组比较差异具有统计学意义（P≤0．05）。优化组降压、降脂及心肌供血改善尤其显著，且4组治疗前后肝肾功能变化无明显差异。结论左旋氨氯地平联合卡托普利治疗老年ISH安全有效，可改善心肌缺血、降低血脂，联合阿托伐他汀治疗效果更佳。     

缬沙坦与卡托普利改善高血压胰岛素抵抗的比较研究

目的：观察缬沙坦（代文）及卡托普利（开博通）对高血压胰岛素抵抗（ISR）的影响。方法：将54例伴有空腹胰岛素增高的轻中度高血压病患者随机分为两组。缬沙坦治疗组（V组）：26例，每日服缬沙坦1次，80－160mg；卡托普利治疗组（C组）：28例，每日服卡托普利2次，每欠25－50mg。疗程为3个月。测定治疗前后血压、空腹及餐后2h血糖和胰岛素，计算胰岛素敏感指数（ISI），治疗前后比较，并设正常对照组，进行组间比较。结果：两组降压作用相似，治疗前各组空腹血糖无显著差异，两组餐后2h血糖、空腹及餐后2h胰岛素显著升高（P＜0.01)，ISI显著降低（P＜0.01)，治疗后以上指标显著改善（P＜0.05)，但均未达正常（P＜0.05)。结论：缬沙坦和卡托普利都能改善高血压胰岛 素抵抗，但短期治疗不能使胰岛素敏感性恢复正常。     

单硝酸异山梨酯对老年人单纯收缩期高血压治疗的影响

目的比较卡托普利和氢氯噻嗪加用或不加用单硝酸异山梨酯两种降压方案治疗老年单纯收缩期高血压(ISH)的降压疗效及安全性。方法 142例轻、中度老年ISH患者,随机分为A组(加用单硝酸异山梨酯组)72例,给予单硝酸异山梨酯缓释片(40 mg)、卡托普利(25 mg)、氢氯噻嗪(12.5 mg),晨顿服;B组(不加用单硝酸异山梨酯组)70例,给予卡托普利(25 mg,2次/d),氢氯噻嗪(25mg/d),均治疗8周。治疗前后测定动态血压、诊室血压、心率及生化指标。结果 A组总有效率在诊室血压为91.67%,在动态血压为86.12%;B组分别为80.01%和74.29%。24 h、白昼和夜间平均收缩压下降A组大于B组;收缩压谷/峰比及平滑指数A组高于B组(谷/峰比:0.73、0.58;平滑指数:0.87、0.62)。两组结果相比差异均有统计学意义(均为P<0.05)。心率及生化指标改变无统计学意义。结论硝酸酯三药联用晨服1次,能24 h平稳降低轻中度老年ISH患者的血压,降压效果大于常规二药联用,且安全性良好。     

抗高血压药对单纯舒张期高血压短期降压疗效的对比研究

目的比较不同类高血压药物在未治疗的单纯舒张期高血压患者中的短期疗效。方法纳入初发单纯舒张期高血压患者104例,年龄40岁～75岁,随机分为四个药物治疗组：①双氢克尿噻组（n=37）：予双氢克尿噻（12.5～25）mg/d;②阿替洛尔组（n=19）：予阿替洛尔（12.5～25）mg/d;③硝苯地平缓释片组（n=27）：予硝苯地平缓释片（20～40）mg/d;④卡托普利组（n=21）：予卡托普利（25～50）mg/d。比较干预4周后的治疗效果差异。结果治疗4周后所有患者舒张压均有明显下降（P＜0.001）,校正年龄、性别、体质指数、腰围、腰臀比、治疗前相应的血压值、血脂、血糖、吸烟、饮酒等传统危险因素后,四组间无统计学差异,但双氢克尿噻和硝苯地平较阿替洛尔和卡托普利降低收缩压的作用更明显（P＜0.05）。结论阿替洛尔和卡托普利对收缩压影响较小,更适合单纯舒张期高血压患者的降压治疗。     

Effectiveness and safety of captopril in Sudanese hypertensive patients

This study reports on the effectiveness, safety and acceptability of captopril in 36 Sudanese patients, who were classified as resistant, moderate to severe and mild according to initial diastolic blood pressure and history of treatment. The patients were titrated against a six-step captopril treatment regime with or without hydrochlorothiazide and reserpine. The median follow up period was 11.6 month. The initial median pre-treatment blood pressure was 159/101, 182/120 and 217/130 and at the end of study 125/77, 120/74 and 165/95 for the mild, severe and resistant groups respectively. Tolerance was good and side effects were mild and similar to others reported in literature. The effective daily treatment was 25-50 mg captopril for mild hypertension, 50 to 100 mg captopril with 50 mg hydrochlorothiazide for severe hypertension while it was 225 mg captopril with 50 to 100 mg hydrochlorothiazide and a need for a third drug in 30% of patients in the resistant group. These results reveal normal responsiveness to captopril among black Sudanese patients with good tolerance and safety.     

Low-dose captopril titration in patients with moderate-to-severe hypertension treated with diuretics

To study the value of low-dose captopril (6.25 and 12.5 mg) and a diuretic combination, the blood pressure and heart rate of 17 patients with moderate-to-severe hypertension were monitored for 6 hours (hospital) or 3 hours (office) after the single low-dose or larger (25, 50, 100 and 150 mg) captopril dosage. All patients had preserved renal function and were taking an oral diuretic (hydrochlorothiazide or furosemide) for at least 4 weeks. The supine and upright acute blood pressure lowering with 6.25 mg was not different from the larger captopril doses; none produced persistent or profound hypotension. There was no deterioration of renal function, new or persistent increase in proteinuria, neutropenia or agranulocytosis acutely or during 17 +/- 2 weeks of follow-up. Low-dose captopril (6.25 or 12.5 mg three times daily) normalized the supine blood pressure of 35% of these patients acutely. We suggest that in hypertensive patients already taking a diuretic, a lower starting dose of captopril than the recommended 25 mg three times daily may be desirable.