硝苯地平控释片与普通片治疗老年高血压病比较

目的 比较硝苯地平控释片与普通片对老年高血压患者的降压疗效。方法 采用随机、单盲的方法，对８４例老年高血压患者进行２４ｈ动态血压监测，比较其疗效及副反应。结果 两药均能显著降低老年高血压患者的偶测血压及２４ｈ平均血压（Ｐ〈０．０１）。两药在降低偶测压缩压、２４ｈ平均收缩压及白天平均血压幅度方面差异无显著性（Ｐ〉０．０５），硝苯地平控释片能明显降低患者的偶测舒张压（Ｐ〈０．０５）、２４ｈ平均舒张压（     

Twelve hour (trough) plasma nifedipine concentrations during chronic treatment with nifedipine retard

Summary Variations in plasma nifedipine concentrations have been reported and one study has suggested the existence of a subpopulation of poor metabolisers of this drug. We have studied the variability of 12 h plasma nifedipine concentrations in 64 hypertensive patients on long-term nifedipine Retard 20 mg twice daily. A slightly skewed unimodal distribution with a modal concentration of 15 to 30 ng/ml was obtained. No relationship between 12-h plasma levels and debrisoquine hydroxylation phenotype was found.     

Antihypertensive effect of fractionated sublingual administration of nifedipine in moderate essential hypertension

Summary The magnitude and duration of the antihypertensive effect of nifedipine were studied in 7 cases of moderate essential hypertension. In a double-blind crossover study, nifedipine 10 mg or a placebo were administered sublingually 4 times a day for 2 days, and the results were compared. Each dose of nifedipine reduced systolic and diastolic blood pressure by 14% both in the supine and upright positions. The antihypertensive action lasted for about 3 h and it was not cumulative. The reduction in blood pressure was associated with a temporary increase in heart rate. Administration of nifedipine 10 mg did not significantly raise plasma renin activity or plasma aldosterone. The drug was well tolerated and no side effects were detected.     

高原低氧环境下硝苯地平控释片对高血压患者降压作用的临床研究

目的 考察高原低氧环境下硝苯地平控释片对高血压患者降压疗效及安全性评价。方法 将42例第九四〇医院高血压住院患者（海拔1 500 m）设为平原高血压组,42例八一医院高血压住院患者（海拔3 800 m）设为高原高血压组。两组患者均每日给予硝苯地平控释片30 mg,晨起口服,连续治疗6 d。每日监测3次血压和心率,观察两组患者的临床疗效及药物不良反应的发生情况。结果 经治疗后,高原高血压组和平原高血压组的总有效率分别为47.62%（20例/42例）和76.19%（32例/42例）,差异有统计学意义（P<0.05）。观察到两组患者的药物不良反应均为心动过速及心悸,高原高血压组和平原高血压组的总药物不良反应发生率分别为14.29%和11.90%,差异无统计学意义（P>0.05）。结论 高原低氧环境下硝苯地平控释片的降压疗效下降,未能有效控制高原地区高血压患者短期内的血压。     

Long acting nifedipine in the treatment of severe hypertension

Summary The medication of patients receiving hydralazine, captopril and minoxidil was replaced by a new galenical form, long-acting nifedipine. An additional decrease in blood pressure was observed in most of the patients. Renal function was maintained in all of them. Adverse reactions may be reduced by the use of long-acting nifedipine, which would permit a reduction in the dosage of captopril and minoxidil.     

硝苯地平缓释片与硝苯地平控释片治疗高血压的疗效比较

目的比较硝苯地平缓释片与硝苯地平控释片治疗高血压病的临床疗效。方法 112例高血压患者随机分为控释片组和缓释片组,各61例。缓释片组服用硝苯地平缓释片10mg,每天2次;控释片组服用硝苯地平控释片30mg,每天1次。2组均治疗8周。观察2组血压变化情况、谷/峰（T/P）比值和不良反应发生情况。结果控释片组总有效率为91.8%高于缓释片组的80.3%（P〈0.05）;2组治疗后血压均降低,控释片组HR降低,缓释片组HR升高,与治疗后比较差异有统计学意义（P〈0.05）;控释片组治疗后血压、心率均低于缓释片组（P〈0.05）;控释片组SBP与DBP降压T/P值分别为92.1%与85.9%,缓释片组分别为29.7%与25.6%;控释片组不良反应发生率低于缓释片组（P〈0.05）。结论硝苯地平控释片具有良好的抗高血压作用,不良反应少,效果优于硝苯地平缓释片。     

硝苯地平控释胶囊在Beagle犬体内的药动学研究

目的评价自制硝苯地平(NF)控释胶囊在Beagle犬体内的药动学,并对其体内外相关性进行研究。方法 6只健康Beagle犬随机分成2组,分别单剂量服用实验制剂(硝苯地平控释胶囊)和参比制剂(拜新同渗透泵片)各30 mg,一周后交叉给药。采用HPLC法,以尼群地平(NT)为内标测定犬给药后不同时间的血药浓度,用以估算药动学参数和相对生物利用度。结果实验制剂与参比制剂的主要药动学参数分别为:Cmax(21.79±8.11)、(21.99±3.97)ng·mL-1;tmax(8.32±1.51)、(9.31±1.02)h;AUC0^t(337.42±84.44)、(348.65±56.25)ng·h·mL-1;t1/2(9.27±1.75)、(8.96±1.73)h;相对生物利用度为(96.8±7.34)%;体内外相关性r=0.944。结论自制硝苯地平控释胶囊具有明显的控释特性,体内外相关性良好。     

国产硝苯地平控释片降压效果动态血压分析

目的:观察国产硝苯地平控释片的降压效果。方法:82例原发性高血压(EH)患者每天服用国产硝苯地平控释片30～60mg,疗程4～8周,均以24 h动态血压作为监测及评价方法。结果:24 h收缩压和舒张压均明显下降(P<0.01),收缩压谷峰比=89%,舒张压谷峰比=82%,对夜间血压不产生过度降压作用,对血糖、血脂、血尿酸无影响,不良反应发生率低。结论:每日服用30～60 mg国产硝苯地平控释片对EH有24 h平稳降压作用。     

硝苯地平缓释片及控释片的体外释放度试验

目的　对不同厂家硝苯地平缓、控释片的释放度进行考察 ,为评定药品的质量提供依据。方法　以pH =3.0 75的磷酸盐缓冲液为溶出介质 ,用紫外分光光度法对 4个厂家的硝苯地平缓、控释片进行体外释放度测定和比较。结果　A、B、C片体外释放符合一级动力学 ,D片符合零级动力学。结论　均能达到缓、控释目的 ,减少用药次数     

Effects of treatment with nifedipine and metoprolol in essential hypertension

Summary In a double-blind trial 26 patients with essential hypertension were treated with nifedipine or placebo for 8 weeks, following a 4-week run-in place-bo period in all patients. The daily dosage of nifedipine during this phase was 10mg 3 times daily. Metoprolol was then added to the therapeutic regimen of both groups for a further 12 weeks. Both nifedipine and metoprolol used as mono-therapy caused statistically significant reductions of arterial pressure. The addition of metoprolol to nifedipine tended to reduce blood pressure further, but blood pressures were not significantly lower than during nifedipine mono-therapy. Side-effects were few and only two patients had to be withdrawn during active therapy, one for headaches during nifedipine therapy, and another for asthma during metoprolol treatment. Combined therapy with a beta-adrenoceptor blocking agent, such as metoprolol, and a calcium antagonist with vasodilating properties, such as nifedipine, offers a theoretically interesting approach in the treatment of hypertension, even though the practical outcome in the present study probably suffered from an inadequate dose of nifedipine during the period of combined therapy.     

氨氯地平与硝苯地平治疗老年原发性高血压的疗效比较

目的　探讨氨氯地平与硝苯地平治疗老年人原发性高血压的疗效比较。方法　老年人原发性高血压患者 80例 ,随机分成两组即A组 (氨氯地平组 )和B组 (硝苯地平组 )。A组 40例应用氨氯地平 5～ 10mg ,每日 1次 ,连服 4周。B组 40例应用硝苯地平 10～ 2 0mg ,每日 3次 ,连服 4周。两组均同时观察血压下降情况及不良反应。结果　氨氯地平降压总有效率 82 .5 % ,硝苯地平降压总有效率 70 %。结论　氨氯地平组的降压总有效率高于硝苯地平组 ,且不良反应少 ,安全性高 ,服用方便 ,是老年人原发性高血压有效的降压药。     

苯磺酸左旋氨氯地平和硝苯地平缓释片治疗原发性高血压的疗效观察

目的比较苯磺酸左旋氨氯地平和硝苯地平缓释片对轻中度原发性高血压的降压疗效及安全性。方法108例原发性高血压患者随机分成两组：苯磺酸左旋氨氯地平组和硝苯地平缓释片组，疗程8周，观察治疗前后血压变化，判断降压疗效并记录不良反应。结果两组均能有效降低血压（P〈0．01），苯磺酸左旋氨氯地平组总有效率为90．74％，硝苯地平缓释片组总有效率为79．63％，二者差异无统计学意义（P〉0．05）。苯磺酸左旋氨氯地平组不良反应（7．41％）显著低于硝苯地平缓释片组（18．52％）（P〈0．05）。结论苯磺酸左旋氨氯地平治疗轻中度高血压具有较好的降压效果和依从性，不良反应轻微。     

缬沙坦分散片+硝苯地平控释片联合用药方案治疗原发性高血压病的临床研究

目的探究缬沙坦分散片+硝苯地平控释片联合用药方案治疗原发性高血压病的临床效果和安全性。方法 80例原发性高血压病患者,按照随机数字表法分为对照组(39例)和试验组(41例)。对照组采用硝苯地平控释片治疗,试验组采用缬沙坦分散片+硝苯地平控释片联合用药方案治疗。比较两组的临床疗效、治疗前后血清免疫球蛋白G(IgG)、补体C3水平及不良反应发生情况。结果试验组的总有效率为95.12%,显著高于对照组的79.49%,差异具有统计学意义(P<0.05)。治疗前,两组血清IgG、补体C3比较差异无统计学意义(P>0.05)。治疗后,两组血清IgG、补体C3均较治疗前降低,差异有统计学意义(P<0.05)。试验组治疗后血清IgG、补体C3分别为(10.65±2.86)g/L、(872.11±43.64)mg/L,均低于对照组的(15.11±2.32)g/L、(912.27±43.51)mg/L,差异均有统计学意义(P<0.05)。试验组不良反应发生率为4.88%,与对照组的2.56%比较差异无统计学意义(P>0.05)。结论针对原发性高血压病患者,采用缬沙坦分散片联合硝苯地平控释片治疗可降低血压,改善血清IgG、补体C3水平,更利于疾病恢复,且未增加不良反应发生率,值得临床借鉴。     

Effects of cilnidipine, a novel dihydropyridine calcium antagonist, on autonomic function, ambulatory blood pressure and heart rate in patients with essential hypertension

AIMS: The aim of the present study was to evaluate the effects of cilnidipine, a novel dihydropyridine calcium antagonist, on autonomic function, ambulatory blood pressure and heart rate in patients with essential hypertension. METHODS: Ten inpatients with mild to moderate essential hypertension (four men and six women; age: 44-64 years) underwent a drug-free period for 7 days and a treatment period with cilnidipine 10 mg orally for another 7 days, in a randomized crossover study. On the sixth day of each period, they underwent autonomic function tests including a mental arithmetic test, a cold pressor test and a Valsalva manoeuvre. After these tests, 24 h ambulatory blood pressure, heart rate, and the electrocardiogram R-R intervals were monitored every 30 min. A power spectral analysis of R-R intervals was performed to obtain the low-and high-frequency components. RESULTS: Cilnidipine significantly decreased the 24 h blood pressure by 6.5 +/- 1.7 mm Hg systolic (mean +/- s.e.mean; P < 0.01) and 5.0 +/- 1.1 mmHg diastolic (P < 0.01), whereas cilnidipine did not change heart rate or any indices of power spectral components. During the cold pressor test, the maximum change in systolic blood pressure and percentage changes in both systolic and diastolic blood pressures were significantly lower during the treatment period with cilnidipine than during the drug-free period. The baroreflex sensitivity measured from the overshoot phase of the Valsalva manoeuvre did not differ significantly between the two periods. CONCLUSIONS: Cilnidipine is effective as a once-daily antihypertensive agent and causes little influence on heart rate and the autonomic nervous system in patients with mild to moderate essential hypertension. Moreover, it is suggested that cilnidipine has an additional clinical benefit in the inhibition of the pressor response induced by acute cold stress.     

尼索地平缓释胶囊与硝苯地平控释片治疗高血压及稳定性心绞痛比较

目的 :观察尼索地平缓释胶囊对高血压及稳定性心绞痛的疗效。方法 :76例 1级和 2级高血压并稳定性心绞痛病人随机分为尼索地平组 (40例 )和硝苯地平组 (36例 ) ,分别给予尼索地平缓释胶囊 10～ 2 0mg ,与硝苯地平控释片 30～ 6 0mg ,均po ,qd× 6wk。结果 :尼索地平组降压总有效率92 % ,硝苯地平组为 94 %。 2组间疗效无显著差异(P >0 .0 5 )。 2组治疗后 2 4h、日间及夜间平均SBP和DBP均较治疗前显著下降 (P <0 .0 1)。尼索地平组治疗后SBP ,DBP的谷/峰比值 (T/P)分别为6 0 .5 %及 5 1.2 % ,硝苯地平组为 6 3.8%及 5 4.8%(P >0 .0 5 )。 2组治疗后心绞痛发作次数、持续时间、硝酸甘油耗量及心电图蹬车运动负荷试验各指标均较治疗前明显改善 ,组间无显著差异。结论 :尼索地平缓释胶囊能有效降压 ,改善稳定性心绞痛病人的症状和运动能力 ,且耐受性良好。     

Effect of nifedipine on plasma catecholamines in man at rest and during exercise

Summary Blood pressure, heart rate, and plasma catecholamine concentrations were measured in 9 normotensive volunteers during a randomized cross-over study of oral nifedipine (10 mg×5) and placebo; measurements were made at rest and during maximal anaerobic exercise. At rest nifedipine reduced blood pressure and increased heart rate and plasma noradrenaline, whereas plasma adrenaline did not change. During exercise, the blood pressure response was similar in nifedipine and placebo treated subjects; however, heart rate was significantly higher with nifedipine. Plasma noradrenaline increased more during exercise in nifedipine-treated subjects. By contrast, nifedipine inhibited the increase in plasma adrenaline induced by exercise.The results suggest that peripheral vasodilatation induced by nifedipine is responsible for increased sympathetic nerve activity, both at rest and during exercise, and that nifedipine inhibits adrenaline secretion in man.The data were presented in part at the Symposium: Calcium entry blockers and tissue protection, Rome, 1984     

长效硝苯地平与长效美托洛尔的动态降压作用比较

12例原发性高血压患者(男性5例,女性7例;年龄40±4a)自身交叉服用长效硝苯地平(下称Nif)20mg, qm×2wk;长效美托洛尔(下称Met)0.1g, qm×2wk。结果:踏车运动试验时服Njf者血压及心率明显升高;但服Met者能平稳地控制血压及心率。24h动态血压中平均动脉压在服上述2药后均显著下降(P<0.05),服Met者舒张压、心率下降较明显(P<0.05),且不良反应小,故Met优于Nif。     

地尔硫缓释片与硝苯地平控释片治疗心率增快的高血压病人的疗效

目的 :观察比较地尔硫与硝苯地平对伴有心率增快的高血压病人在降低血压和心率上的疗效。方法 :地尔硫组 37例 (男性 2 1例 ,女性 16例 ;年龄 5 0a±s11a)接受地尔硫缓释片 180mg ,po ,qd× 4wk。硝苯地平组 38例 (男性 2 3例 ,女性15例 ;年龄 5 1a± 10a)接受硝苯地平控释片 2 0mg ,po ,bid× 4wk。结果 :2组治疗后BP均有明显下降 (P <0 .0 1)。SBP :地尔硫组从 (2 2 .7± 1.6)kPa下降至 (18.0± 1.3)kPa ;硝苯地平组从 (2 3.8± 1.5 )kPa下降至 (17.6± 1.3)kPa ,组间比较 (P>0 .0 5 )。DBP :地尔硫组从 (12 .7± 1.3)kPa下降至 (10 .4± 1.5 )kPa ,硝苯地平组的从 (12 .8±1.6)kPa下降至 (10 .8± 2 .3)kPa ,2组间差异无显著意义 (P >0 .0 5 )。地尔硫组治疗后HR从 (90± 10 )次·min- 1下降至 (71± 8)次·min- 1(P <0 .0 1) ;而硝苯地平组由治疗前 (90± 9)次·min- 1至治疗后的 (93± 8)次·min- 1;组间差异明显。结论 :地尔硫对伴有心率增快的高血压病人兼有降低血压和心率的作用 ,优于硝苯地平。     

Effects of autonomic blockade on non-linear cardiovascular variability indices in rats

1. The present study assesses the effects of autonomic blockade (alpha- and beta-adrenoceptor and cholinergic) on cardiovascular function studied by heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity in rats using non-linear dynamics. Little is known about the influence of pharmacological autonomic nervous system interventions on non-linear cardiovascular regulatory indices. 2. In 13 conscious rats, heart rate and aortic blood pressure were measured continuously before, during and after autonomic blockade with atropine, phentolamine and propranolol. Non-linear scaling properties were studied using 1/f slope, fractal dimension and long- and short-term correlation. Non-linear complexity was described with correlation dimension, Lyapunov exponent and approximate entropy. Non-linear indices were compared with linear time and frequency domain indices. 3. Beta-adrenoceptor blockade did not alter the non-linear characteristics of HRV and BPV, although low-frequency power of HRV was depressed. Alpha-adrenoceptor blockade decreased the scaling behaviour of HRV, whereas cholinergic blockade decreased the complexity of the non-linear system of HRV. For BPV, the scaling behaviour was increased during alpha-adrenoceptor blockade and the complexity was increased during cholinergic blockade. The linear indices of HRV and BPV were decreased. 4. The present results indicate that the beta-adrenoceptor system has little involvement in the generation of non-linear HRV and BPV in rats. 5. Alpha-adrenoceptor blockade mostly influenced the scaling properties of the time series, whereas cholinergic blockade induced changes in the complexity measures. 6. The absence of the baroreflex mechanism can trigger a compensatory feed-forward system increasing the complexity of BPV.