吲哒帕胺与依那普利联合应用治疗原发性高血压病42例临床观察

近年来 ,我国高血压病的发病率虽逐年增高 ,但其知晓率、治疗率均偏低 ,故合理应用药物治疗高血压已成为当务之急 ,常用的五大类降压药各有利弊。近年来研究认为 ,为了最大程度地取得治疗高血压的疗效 ,就要求最大程度地降低血压 ,即尽可能将血压降至目标值 ,而做到这一点 ,单药治疗常力不能及 ,或一味增大剂量 ,不良反应的发生率也随之增加。国际大规模临床试验证明 :合并用药有其需要和价值 ,合并用药时 ,可以根据患者的病情选择两种或两种以上不同作用机制的降压药 ,药物的治疗作用应有协同或至少相加的作用 ,而其不良作用可以相互抵消或…     

联合用药治疗原发性高血压病80例疗效观察

笔者自1994年以来,采用卡托普利与尼群地平联用口服,对80例原发性高血压患者的疗效及不良反应进行系统的观察,并与单方卡托普利、尼群地平对照组进行了对比分析,现报道如下:1临床资料1·1一般资料:所有病例均符合WHO-ISH诊断标准,选择原发性高血压患者222例随机分为三组,卡托普     

尼群地平与依那普利联合治疗原发性高血压病45例临床分析

我院2003年6月～2006年12月应用尼群地平与依那普利联合治疗原发性高血压病45例,收到了满意的疗效,现报道如下。     

氯沙坦和卡托普利治疗原发性高血压病的疗效观察

我们从2000年1月～2004年12月小剂量联合应用氯沙坦和卡托普利治疗原发性高血压患者80例，取得了较好的疗效。而且不良反应较少，现报道如下。     

依那普利治疗原发性高血压的疗效观察

目的:观察依那普利治疗原发性高血压的疗效。方法:将40例原发性高血压患者随机分为两组。依那普利组23例,巯甲丙脯酸组17例。两组均在2周前停用其它降压药物,2周后,依那普利组服用依那普利5mg,每天2次,最大剂量为每天40mg;巯甲丙脯酸组服用巯甲丙脯酸12.5mg,每天3次,最大剂量为每天150mg。两组疗程均为4周。结果:依那普利的降压有效率为78.2％,巯甲丙脯酸的降压有效率为70.6％,两组间无明显差异(P>0.05)。结论:依那普利和巯甲丙脯酸治疗原发性高血压的疗效相似,但依那普利的用药剂量和次数明显少于巯甲丙脯酸。     

依那普利治疗原发性高血压病43例

目的观察依那普利治疗原发性高血压的降压效果及其对原发性高血压病早期肾损害的疗效。方法选取原发性高血压病(EH)患者43例,在常规治疗(包括低盐饮食、适量运动、戒烟等)基础上给予依那普利治疗,连续8周,观察治疗前、后血压改善情况,检测尿微量白蛋白(u-ALB)和β2微球蛋白(β2-MG)水平,并与30名同期健康体检者进行对照(对照组)。结果依那普利治疗4周时,EH组患者血压明显下降(P<0.05,P<0.01),治疗8周后血压显著下降,甚至已基本接近正常水平(P<0.01);治疗后EH组患者u-ALB和β2-MG水平显著降低(P<0.01),与对照组比较,差异无统计学意义(P>0.05)。结论依那普利治疗轻、中度原发性高血压,降压作用明显、确切,患者耐受性好,且能降低尿微量白蛋白、β2微球蛋白含量,对肾脏具有一定的保护作用。     

氯沙坦治疗原发性高血压的疗效观察

目的:观察氯沙坦治疗原发性高血压的疗效。方法:原发性高血压病人80例,随机分成氯沙坦组和依那普利组,每组各40例,分别给予氯沙坦50~100mgd和依那普利10~20mgd口服,并对两组治疗4周前后的血压改变及有效率进行对比。结果:氯沙坦及依那普利均能安全、有效地控制血压,氯沙坦组较依那普利组副反应轻微。     

依那普利与卡托普利对原发性高血压患者降压的临床疗效比较

目的:比较依那普利与卡托普利对原发性高血压患者降压的临床疗效。方法:选取2013年3月—2015年3月间收治的原发性高血压患者126例的临床资料,将其按照随机数字表法分为治疗组与对照组,每组63例;对照组患者给予卡托普利片降压治疗,治疗组患者给予依那普利降压治疗,比较两组患者用药后降压的临床效果。结果:治疗组患者治疗后的总有效率为95.24%高于对照组为79.36%(P<0.05);治疗前两组患者血压各指标测得值经比较其差异无统计学意义(P>0.05);治疗后两组患者血压各指标测得值均优于对照组(P<0.05);治疗组患者用药后不良反应的发生率为4.76%低于对照组为25.40%(P<0.05)。结论:依那普利用于治疗原发性高血压患者,降压效果较为显著,能改善患者血压水平,不良反应的发生率低,安全性高,其降压作用优于卡托普利。     

硝苯地平缓释片联合依那普利治疗126例原发性高血压病疗效分析

目的：探究硝苯地平缓释片与依那普利联合用药治疗原发性高血压临床疗效,为硝苯地平缓释片联合依那普利治疗原发性高血压提供科学理论依据。方法选择本院2011年4月~2013年8月收治的126例原发性高血压患者为研究对象,采用随机数字表法分为对照组与观察组（每组63例）,对照组给予常规口服依那普利治疗,观察组在对照组治疗基础上加用硝苯地平缓释片治疗,对比两组患者临床治疗效果及治疗前后血压变化情况。结果两组患者经为期2个月治疗后,血压均有下降,观察组患者血压下降水平显效36例,对照组10例;观察组患者血压下降水平有效24例,对照组35例;观察组患者血压未曾变化甚至恶化3例,对照组18例,组间数据对比,观察组降压效果明显优于对照组（P〈0.05）;两组患者治疗前后舒张压、收缩压均有明显变化（P〈0.05）。结论硝苯地平缓释片联合依那普利治疗原发性高血压有显著降压治疗效果,可在临床上进行大力推广并应用。     

依那普利联合吲哒帕胺治疗原发性高血压疗效观察

目的研究和评价依那普利与吲哒帕胺合用降压疗效及对代谢的影响。方法选择120例Ⅰ、Ⅱ级原发性高血压患者，随机分成两组，对照组：吲达帕胺2．5mg，每日1次口服；治疗组：在对照组治疗基础上加用依那普利10mg，每日1次口服。疗程均为12周。观察两组治疗前后的血压和生化指标。结果治疗组血压的变化均明显优于对照组，且治疗前后生化指标无明显改变。结论依那普利联合吲达帕胺降压效果较单用吲哒帕胺更有效，且对代谢无影响。     

氨氯地平治疗老年高血压病48例临床疗效

考察氨氯地平对４８例老年高血压病的疗效及不良反应。采用自身对照的方法观察服药后１，２，３，４ｗｋ的疗效，与治疗前相比有统计学显著差异，显效率为６２．５％，总有效率为９３．８％，不良反应少，未见严重的不良反应，可见氨氯地平是一有效的耐肥性好的老年抗高血压药。     

EFFECT OF GRADED LOW-DOSE NORADRENALINE INFUSIONS ON NORADRENALINE CLEARANCE IN NORMALS AND ESSENTIAL HYPERTENSIVES

1. In normal subjects and essential hypertensives, plasma noradrenaline (NA) levels, and NA clearance (3H-NA constant infusion), were measured during graded infusion of NA. 2. Plasma levels of NA were similar in both groups, with parallel increases to levels approximately three times basal, but still in the upper normal range. 3. Clearance did not increase in either group with increasing plasma NA levels. There was no correlation between plasma NA achieved and NA clearance, which was similar in hypertensives and normotensives. 5. Insofar as plasma clearance reflects tissue clearance, these studies provide no support for the contention that altered NA metabolism might predispose to elevated NA levels in essential hypertension.     

CIRCADIAN VARIATIONS OF BLOOD PRESSURE AND PULSE RATE IN ESSENTIAL HYPERTENSIVES WITH DIABETES MELLITUS

1. The circadian variations of blood pressure and pulse rate in essential hypertensives either with or without diabetes mellitus were studied. 2. Diabetic patients with orthostatic hypotension showed an increase in variability of blood pressure and a decrease in that of pulse rate when assessed by coefficient of variation. Cosinor analysis showed no significant circadian rhythm in both blood pressure and pulse rate in these patients. 3. There were no differences in the circadian variations of blood pressure and pulse rate between essential hypertensives with and without diabetes mellitus unless orthostatic hypotension was present. 4. These results suggest that diabetes mellitus per se does not have any effects on the circadian variations of blood pressure and pulse rate in essential hypertensives unless autonomic neuropathy is present.     

ENALAPRIL DECREASES PLASMA NORADRENALINE LEVELS DURING THE COLD PRESSOR TEST IN HUMAN HYPERTENSIVES

1. The effects of the angiotensin-converting enzyme (ACE) inhibitor enalapril on the responses of blood pressure and plasma catecholamine levels to the cold pressor test in human hypertensives were examined. 2. Systolic and diastolic blood pressure decreased significantly after treatment with enalapril (5 mg/day for 4 weeks) as did the resting level of plasma noradrenaline. 3. The cold pressor test induced a rise in blood pressure and plasma noradrenaline levels. After 2 and 4 weeks enalapril treatment, the rises in the plasma noradrenaline level and systolic and diastolic pressure due to cold pressor test were reduced significantly. 4. These results suggest that ACE inhibition has a sympatho-inhibitory effect. One possible explanation is that enalapril reduces angiotensin II formation thus decreasing the activation of release-enhancing angiotensin II receptors on postganglionic sympathetic nerve endings.     

尼索地平和尼群地平降血压效果和安全性的比较

采用随机双盲对照试验比较国产尼索地平和尼群地平片对60例轻、中度原发性高血压的疗效和安全性.经过10d的安慰剂清洗期后,入选患者随机接受尼索地平或尼群地平10mg,bid治疗共6wk.结果;尼索地平治疗组收缩压和舒张压分别(157.00±13.66)和(103.04±4.60)mmHg[(20.93±1.82)和(13.74±0.61)kPa]降至(139.00±13.34)和(87.71士6.81)mmHg[(18.53±1.78)和(11.69±0.91)kPa],收缩压和舒张压降压幅度分别达11.46%和14.88%;尼群地平组收缩压和舒张压分别从(157.31±12.80)和(101.86±4.52)mmHg[(20,97±1.71)和(13.58±0 60)kPa]降至(141.52±10.25)和(91.66±7.05)mmHg[(18.87±1.37)和(12.22±0.94)kPa],收缩压和舒张压降压幅度分别为10.04%和10.01%.两组中不良反应均多为轻度且呈一过性.提示国产尼索地平片和尼群地平片10～20mg bid po能有效治疗轻、中度原发性高血压,并具有较好的安全性.     

马来酸依那普利片治疗原发性高血压的疗效及安全性分析

目的探讨马来酸依那普利片治疗原发性高血压的疗效及安全性。方法 90例原发性高血压患者,按随机数字表法分成观察组和对照组。对照组给予卡托普利片治疗;观察组给予马来酸依那普利片治疗。结果观察组总有效率为95.56%,高于对照组的80.00%,差异有统计学意义(P<0.01)。观察组副反应总发生率为8.89%,少于对照组的24.44%,差异有统计学意义(P<0.05)。结论马来酸依那普利片治疗原发性高血压疗效可靠,具有良好的安全性。     

固相萃取高效液相色谱法测定人血浆中依那普利浓度

建立了用固相萃取高效液相色谱法测定依那普利血药浓度的方法。色谱柱为200mm×4.6mm不锈钢柱,内填 Spherisorb C₈(5μm),流动相为乙醇—水—10% H₃PO₄—三乙胺(30∶70∶1.5∶0.1);流速1.0ml·min^-1,紫外检测波长215nm。血样用固相小柱预处理。此法线性范围25～150ng·mL^-1。最小检测浓度1.5ng·mL^-1,日内及日间误差<8.8%,平均回收率>91.6%。用此法测定了8例健康志愿者po国产依那普利片后的血药浓度并计算了药代动力学参数。     

HAEMODYNAMIC AND HORMONAL EFFECTS OF PRAZOSIN ON HEAD-UP TILT IN ESSENTIAL HYPERTENSIVE PATIENTS: COMPARISON WITH THOSE OF PROPRANOLOL

1. To evaluate the haemodynamic and hormonal effects of prazosin, head-up tilt was performed in 10 essential hypertensive patients, and these effects of prazosin on the tilt were compared with those of propranolol. The tilts were performed in control phase and the last days of treatment for two weeks with propranolol (90 mg/day) or prazosin (3–6 mg/day). 2. Each drug significantly lowered the mean blood pressure at rest, and also suppressed its rise on the tilt. Heart rates were significantly increased by the tilt in the control phase, in the propranolol phase and in the prazosin phase. Cardiac index was significantly reduced by the tilt from 2.66 (s.e.m. =0.22) 1/min per m² to 2.08 (s.e.m. =0.20) in the propranolol phase. However, there were not significant changes in other phases. Total peripheral resistance indices were significantly increased by the tilt in all three phases. Plasma renin activity and plasma aldosterone were significantly increased by the tilt from 2.14 (s.e.m. =0.47) ng/ml per h to 2.46 (s.e.m. =0.54) and from 50.6 (s.e.m. =12.9) pg/ml to 74.9 (s.e.m. =14.9) respectively, in the control phase. And they were also significantly increased from 1.06 (s.e.m. =0.29) to 1.65 (s.e.m. =0.45) and from 41.4 (s.e.m. =16.3) to 54.0 (s.e.m. =17.4) in the prazosin phase. There were no significant increases during the administration of propranolol. 3. We observed that prazosin did not alter heart rate and cardiac index, but suppressed the renin-angiotensin system at rest. It is suggested that prazosin did not influence haemodynamic and hormonal responses to the tilt.     

THE EFFECT OF PRAZOSIN THERAPY ON PLATELET ACTIVATION IN ESSENTIAL HYPERTENSION

1. Plasma levels of beta-thromboglobulin, initial and total platelet aggregation (induced by adrenaline or adenosine diphosphate [ADP]) were determined in 26 normotensive subjects and 26 patients with untreated essential hypertension. Groups of 18 essential hypertensive patients and 18 age- and sex-matched normotensives were compared. 2. After 7 days of treatment with prazosin in a dose of 2-8 mg daily the above measures were repeated in 18 essential hypertensive patients. A significant increase in plasma levels of beta-thromboglobulin, initial and total adrenaline-induced as well as ADP-induced platelet aggregation was found in hypertensives. Prazosin restored the mean arterial blood pressure in hypertensives to normal, but it had no significant influence either on increased beta-thromboglobulin levels or on initial and total aggregability. 3. The results confirm increased platelet aggregation and in vivo platelet activation in patients with essential hypertension; however there is a discrepancy with previous reports about those results obtained after prazosin therapy. The results suggest that increased platelet aggregation and in vivo activation need not be restored to normal after effective antihypertensive therapy alone. They give reason for the combination of antihypertensive together with anti-aggregatory therapy in essential hypertension.     

GENOTYPIC INFLUENCE ON PLASMA DIPEPTIDYL CARBOXYPEPTIDASE-1 ACTIVITY IN HYPERTENSIVES

1. Plasma dipeptidyl carboxypeptidase-1 (DCP1; angiotensin I-converting enzyme, kininase II; EC 3.4.15.1) tracks with the deletion allele in genotypes of a 287 bp insertion/deletion (I/D) polymorphism of its gene, DCP1, in healthy Caucasian populations. The aim of the present study was to see whether genotype has a similar influence on plasma DCP1 in hypertensives. 2. The study involved 35 Caucasian patients with severe, familial essential hypertension, who were not being treated with DCP1 inhibitors, and 94 normotensives. Genotyping for the I/D polymorphism was performed by polymerase chain reaction and plasma DCP1 activity was measured by rate of hydrolysis of both [³H]-Hip-Gly-Gly and Hip-His-Leu. 3. Plasma DCP1 activity (nmol Gly-Gly/min per mL; mean ± s.e.m.) was 67 ± 2, 82 ± 4 and 91 ± 6 in II, ID and DD hypertensives, respectively, which was similar to values of 68 ± 4, 82 ± 3 and 94 ± 3 in normotensives (P= 0.0001 by one-way analysis of variance). Results for the His-Leu assay indicated similar tracking with genotype. 4. The Michaelis constant (μmol Hip-Gly-Gly/mL; mean ± s.e.m., n= 10) for DD subjects was the same as for II subjects (10.6 ± 1.6 vs 11.1 ± 2.3; P = 0.86). 5. In conclusion, in severely hypertensive Caucasian subjects, plasma DCP1 activity is subject to a similar genotypic influence in hypertensives as has been reported previously in normotensives. Furthermore, the plasma DCP1 enzyme itself appears to be functionally similar for each genotype.