地尔硫卓注射液治疗老年人非心脏手术后高血压的临床应用

目的 观察地尔硫卓注射液治疗老年人非心脏手术后高血压的疗效和安全性.方法 采用随机、对照方法将58例老年非心脏手术后高血压患者分为地尔硫卓组(n=30)与硝酸甘油组(n=28),分别用地尔硫卓注射液与硝酸甘油注射液治疗,剂量分别为每分钟5～15 μg/kg 和每分钟5～15 μg.观察两组用药前后30、60、120分钟血压和心率变化.结果 地尔硫卓组与硝酸甘油组血压均显著下降,总有效率分别为80%和82.1%,组间比较差异无显著性(P＞0.05),不良反应轻.结论 地尔硫卓治疗老年人非心脏手术后高血压安全、有效,与硝酸甘油相似,而在降低心率作用方面更优于硝酸甘油.     

地尔硫卓注射液治疗老年人非心脏手术后高血压的临床应用

该文观察地尔硫卓注射液治疗老年人非心脏手术后高血压的疗效及安全性。方法：采用随机、对照方法将58例均有高血压病史的老年非心脏手术患者当天或术后第1天并发血压升高。入选标准收缩压≥160mmHg和（或）舒张压≥95mmHg，时间超过1h或血压持续高于基础水平50mmHg，出现心脑缺血有关症状，如心悸、气急、头晕、头痛等，排除合并心、肝、肾功能不全患者。     

地尔硫卓注射液治疗老年人非心脏手术后高血压的临床应用

该文观察地尔硫卓注射液治疗老年人非心脏手术后高血压的疗效及安全性。方法:采用随机、对照方法将58例均有高血压病史的老年非心脏手术患者当天或术后第1天并发血压升高。入选标准收缩压≥160     

地尔硫(艹卓)治疗不稳定型心绞痛疗效观察

目的观察口服地尔硫[艹卓]（合心爽）治疗不稳定型心绞痛的临床疗效。方法45例不稳定型心绞痛患者予合心爽30mg．每日3次口服,观察心绞痛发作情况,心电图及血压心率变化。结果45例患者用药前后,平均心绞痛发作次数减少,每次持续时间缩短;其中38例用药后的48h内未再发作心绞痛,患者异常ST恢复。5例心电图缺血性表现明显改善,2例无改善;口服地尔硫[艹卓]血压下降,心率减慢,出现1例窦性心动过缓,1例皮疹,经停服药物后给予对症处理均好转。结论口服合心爽维持治疗不稳定型心绞痛是安全的、有效的。     

地尔硫[艹卓]联合阿托伐他丁对原发性高血压患者血管内皮依赖性舒张功能的影响

目的探讨地尔硫[艹卓]联合阿托伐他丁对原发性高血压患者血管内皮依赖性舒张功能的影响。方法将100例原发性高血压病患者随机分为治疗组和对照组,治疗组用地尔硫[艹卓]联合阿托伐他丁治疗,对照组单用阿托伐他丁治疗,治疗6个月后评价疗效。结果治疗组总有效率94.0%,显著高于对照组的76.0%（P〈0.05）。治疗组肱动脉和胫前动脉△Dia-P明显改善,与治疗前及对照组治疗后比较均有统计学差异（P均〈0.05）。结论地尔硫[艹卓]联合阿托伐他丁对原发性高血压患者的血管内皮依赖性舒张功能有明显改善作用。     

地尔硫卓注射液治疗高血压急症的疗效观察

目的观察地尔硫卓注射液治疗高血压急症的疗效和安全性。方法采用随机对照方法将72例高血压急症患者分为地尔硫卓组(38例)与硝普钠组(34例),分别用地尔硫卓注射液和硝普钠注射液治疗,剂量分别为5～15μg.kg-1.min-1和10～30μg/min。观察两组用药前与用药后60min血压和心率变化。结果地尔硫卓组与硝普钠组血压均显著下降,总有效率均为100%,两组间比较差异无统计学意义(P0.05)。结论地尔硫卓治疗高血压急症安全、有效,与硝普钠相似,而在降低心率作用方面更优于硝普钠。     

地尔硫[艹卓]联合麝香保心丸治疗冠状动脉慢血流的疗效观察

目的观察地尔硫[艹卓]联合麝香保心丸治疗冠状动脉慢血流(CSF)的临床疗效。方法选取2017年1月-2019年6月在皖西卫生职业学院附属医院确诊为CSF的病人80例,随机分为对照组、观察组,各40例,对照组采用麝香保心丸治疗,观察组采用地尔硫[艹卓]联合麝香保心丸治疗,观察5个月。比较两组临床疗效,观察两组炎性因子超敏C反应蛋白(hs-CRP)、胱抑素-C(Cys-C)水平变化。结果观察组临床疗效总有效率为92.31%,高于对照组的60.53%,差异有统计学意义(P<0.05)。观察组治疗后hs-CRP、Cys-C较治疗前明显降低(P<0.05);观察组治疗后hs-CRP、Cys-C较对照组明显降低(P<0.05)。结论地尔硫[艹卓]联合麝香保心丸治疗CSF,可降低hs-CRP、Cys-C水平,提高临床疗效。     

地尔硫(艹卓)联合美托洛尔治疗不稳定型心绞痛临床观察

目的:观察地尔硫(艹卓)联合美托洛尔治疗不稳定型心绞痛(UA)的疗效.方法:32例UA患者(初发劳力性心绞痛18例,恶化劳力性心绞痛14例,均合并静息性心绞痛)在基础治疗的同时,联合应用地尔硫(艹卓)口服,30～45mg/次,每日3次,美托洛尔口服,12.5～50mg,每日2次,疗程2周.观察并记录治疗前后心绞痛发作频率、程度、持续时间,硝酸甘油用量,心率,血压及12导联心电图;以ST下移导联数(NST)和ST下移总和(∑ST)表示心肌缺血范围及程度.结果:治疗前后心绞痛发作频率(次)为3.0±1.2∶0.9±0.6,持续时间(分钟)为10.6±3.2∶2.3±1.8,硝酸甘油消耗量(片/日)为2.8±1.3∶0.8±0.5,收缩压(mmHg)为140±12.6∶120±10.4,心率(次/分)为88±9.12∶70±8.6,NST为3.58±1.56∶2.12±1.10,∑ST为2.72±1.48∶1.10±0.92,差异显著(P<0.01).临床显效16例(50%),有效12例(37.50%),总有效率87.50%.结论:地尔硫(艹卓)联合美托洛尔为UA的有效治疗方法.     

静脉应用地尔硫(艹卓)治疗不稳定型冠状动脉疾病的临床观察

目的观察静脉应用地尔硫(艹卓)治疗不稳定型冠状动脉疾病,评价其疗效及其对心脏功能的影响.方法58例冠心病病人,包括不稳定型顽固性心绞痛45例及急性非Q波心肌梗死13例,静脉注射地尔硫(艹卓)0.3mg/kg(5mg/mm),继而静脉点滴10ug·kg-1·min-1(90min内),随后口服地尔硫(艹卓)30mg,每日4次,共计10d为一个疗程,分别在用药前、用药过程中及用药后1、3、5、10、15、20、30、60、90min及第10d监测心率、血压,用药前及用药后90min、10d各做同一切面超声心动图,监测心脏功能指数(每搏心输出量SV、每搏心指数SI、每分心输出量CO、每分心指数CI、射血分数EF、心率HR).结果用药后5min心率开始下降,15min时达高峰,下降幅度为(15±5)bpm(P＜0.05),收缩压(SBP)10min下降(12±4)mmHg(P＜0.05)、舒张压(DBP)下降不明显(6±2)mmHg(P≥0.05);超声心动图显示心脏功能指数变化:SV、CI、EF无明显改变(P≥0.05),而SI、CO、HR明显改善(P＜0.05).结论静脉应用地尔硫(艹卓)治疗不稳定型冠状动脉疾病疗效确切,安全可靠.     

地尔硫（艹/卓）联合依那普利治疗肥厚型心肌病临床观察

目的:探讨地尔硫（艹/卓）联合依那普利治疗肥厚型心肌病(HCM)的疗效.方法:19例HCM病人口服地尔硫及依那普利,从小剂量开始,逐渐加量致地尔硫60mg,3次/日,依那普利10mg,2次/日,观察治疗前、后临床症状、心电图、心率、心脏彩超检查的变化.结果:治疗后临床症状减轻,心电图倒置T波深度减少或变为直立,心率下降,总有效率分别为89.47%、73.68%、100%.心脏彩超改变总有效率为36.84%.结论:在无临床禁忌的情况下,地尔硫联合依那普利治疗肥厚型心肌病有一定疗效.     

地尔硫卓在围手术期重症高血压中的疗效观察

目的:评价盐酸地尔硫卓(合贝爽)注射剂在治疗围手术期高血压中的有效性和安全性。方法:开放性病例收集研究。共收集23例非心脏外科手术合并有高血压的患者。先以(5～10)μg/(kg·min)静脉滴注或泵入,每5min递增5～10μg/(kg·min),平均点滴速率在30min内渐增至10～20μg/(kg·min)。观察血压和心率的变化。结果:治疗前与治疗后不同时间段对收缩压(SBP)、舒张压(DBP)以及心率(HR)的作用效果分别为:从治疗前的SBP/DBP210.8±19.6/128.4±10.3(mmHg)至治疗后10min的SBP/DBP186.4±15.3/93.1±11.2(mmHg),和用药前相比P<0.05;治疗后60min:SBP/DBP158.3±14.7/84.3±8.3mmHg,和用药前相比P<0.001。给药前与给药后各时间段的心率无显著性改变(用药前HR:88.6±18.6次/min,用药后60min81.4±14.9次/min),P>0.05。结论:地尔硫卓注射剂治疗围手术期重症高血压安全有效。     

Long-term treatment of hypertension with the calcium channel blocker diltiazem

A group of 48 patients with essential mild to moderate hypertension were treated with the calcium-channel blocker diltiazem (90-270 mg/day) for one year. Adequate blood pressure control was achieved in all patients. No tolerance developed during the one-year treatment period. The drug is almost free from side effects. Very few patients develop fluid retention, which can be controlled by adding a diuretic.     

24-hour efficacy of once-daily diltiazem in essential hypertension.

The safety and effectiveness of a once daily formulation of diltiazem hydrochloride (diltiazem CD) in the treatment of essential hypertension was assessed in a total of 127 patients with supine diastolic blood pressures (DBP) of 95 to 110 mmHg randomized to diltiazem CD (n = 61) or placebo (n = 66). Patients were titrated to doses of 120, 240, or 360 mg to achieve DBP reduction to less than 90 mmHg. At end study diltiazem CD changed trough supine SBP and DBP by -8.4 +/- 1.7 (p = 0.0009) and -8.6 +/- 1.1 mmHg (p = 0.0075), respectively. Heart rate was not significantly changed (-1.3 +/- 1.1 beats/min, p = 0.4362). The average dose of diltiazem CD was 268 mg with 69% achieving a clinical response. A subset of 47 patients underwent ambulatory blood pressure monitoring to assess the consistency of the effect over the full 24-h dosing interval. Diltiazem CD lowered DBP and SBP throughout the dosing interval. The overall side effect profile was similar to placebo. This study provides evidence of 24-h efficacy of this new, once daily formulation of diltiazem.     

Comparison of the efficacy and safety of once-daily versus twice-daily formulations of diltiazem in the treatment of systemic hypertension

Summary The efficacy and safety of optimally titrated once-daily (CD) and twice-daily (SR) diltiazem were compared in 111 patients with mild to moderate systemic hypertension [seated diastolic blood pressure (DBP) 95 mmHg and 114 mmHg] in a multicenter, randomized, double-blind, placebo run-in, parallel-group trial. Following a 4 week washout and placebo-controlled run-in period, patients were randomized to receive diltiazem CD 180 mg and matching placebo (n=54), or diltiazem SR 90 mg bid (n=57). Total daily doses were titrated from 180 mg to 360 mg to achieve a goal of seated DBP <90 mmHg during a 6 week titration period. The patients continued to receive their optimal dose for a 6 week follow-up period. Ninety-six (96) patients (diltiazem CD: 47, diltiazem SR: 49) completed the study protocol, with 60% of the diltiazem CD and 55% of the diltiazem SR patients achieving the goal of seated DBP of <90 mmHg (p=0.685). Although significant decreases occurred in seated and standing measurements of diastolic and systolic BP and heart rate with treatment in both groups, there were no significant differences between treatment groups. Both medications were well tolerated, with a similar frequency of adverse effects [diltiazem CD: 24/54 (37%) patients; diltiazem SR: 24/57 (42.1%) patients] with the most frequently reported adverse effects being headache and edema.See appendix for list of participants.     

高龄高血压患者双下肢动脉闭塞症的危险因素分析

目的 探讨高龄高血压患者双下肢动脉闭塞症（PAOD）的危险因素。方法 入选2012年8月至2013年8月首都医科大学附属北京友谊医院老年病科高龄高血压患者121例,收集临床资料,进行下肢动脉超声以及动态血压监测。根据下肢动脉超声结果将其分为PAOD组（n＝49）和非PAOD组（n＝72）。用SPSS 16.0软件包进行独立样本t检验、相关性分析和logistic回归分析。结果 高龄高血压患者PAOD发病率为40.5%。PAOD组年龄、冠心病发生率、血肌酐以及糖化血红蛋白（HbA1c）水平较非PAOD组患者明显升高（P＜0.05）。logistic回归表明年龄、冠心病、白昼平均收缩压（dDBP）、HbA1c是PAOD的独立危险因素。回归方程：PAOD＝－12.169＋0.131×年龄＋1.341×冠心病-0.069×dDBP＋HbA1c×0.692。 结论 高龄高血压患者PAOD的发生率显著高于普通人群。年龄、冠心病、dDBP、HbA1c是PAOD的独立危险因素。     

高龄高血压患者反杓型血压与白蛋白尿的相关性

目的探讨高龄高血压患者白蛋白尿与血压节律异常的关系。方法选取2012年6月至2013年6月在北京友谊医院住院的70例高龄高血压患者,收集临床资料、尿白蛋白排泄率以及动态血压监测结果。根据尿检结果将其分为白蛋白尿组（n=32）和非白蛋白尿组（n=38）。比较两组之间的白昼平均收缩压（dSBP）和舒张压（dDBP）、夜间平均收缩压（nSBP）和舒张压（nDBP）,以及夜间收缩压和舒张压下降率、血压变异曲线。结果白蛋白尿组与非白蛋白尿组问比较,年龄、性别、糖尿病发生率、超敏C反应蛋白、左室射血分数等方面均无明显差异（P〉0．05）。与非白蛋白尿组比较,白蛋白尿组患者估测肾小球滤过率（eGFR）明显下降（P〈0．05）。动态血压监测结果显示两组患者dSBP和dDBP均在正常范围,且无明显差异（P〉0．05）,但白蛋白尿组nSBP明显升高（P〈0．01）。两组患者非杓型血压节律的发生率无显著差异,白蛋白尿组患者的反杓型曲线比例更高（P〈0．01）。结论夜间收缩压升高,即反杓型血压节律,与高龄高血压患者白蛋白尿和eGFR下降高度相关。     

老年难治性高血压综合康复治疗后的疗效观察

目的：探讨应用综合康复疗法对老年难治性高血压的疗效。方法：在降压药的基础上,增加运动、音乐治疗、健康教育、饮食调控等综合康复治疗,３个月后观察降压效果。结果：显效８例,好转１５例,总有效率为８８％。治疗前、后血压对比有显差异（Ｐ＜０．０５）。结论：结合康复治疗能有效降低血压,对严重高血压病人可增强降压药的疗效,减少降压药的用量。     

The effect of oral diltiazem on left ventricular performance in postinfarction patients

The purpose of the present study was to evaluate the effect of diltiazem on the left ventricular function in postinfarction patients. Twelve patients without cardiac decompensation at rest began diltiazem therapy beginning 3 months after an acute myocardial Q-wave infarction. Oral diltiazem was administered on the first day in a single dose (120 mg) and the following 2 weeks in a 60 mg three times a day (tid) regimen. The therapeutic effect was studied by isotope angiocardiography at rest using equilibrium measurements with technetium-99m. Acute as well as continuous treatment improved left ventricular function in terms of increased synergy of the contraction (decreased phase deviation from a median of 20.0 degrees to median of 12.4 degrees and 13.0 degrees, respectively, p less than 0.01) and increased ejection fraction from a median of 46% to a median of 50% and 51%, respectively, p less than 0.05. It is suggested that the improvement of left ventricular function may be due in part to decreased pressure rate product. This improved left ventricular function during diltiazem treatment may explain the improved prognosis induced by diltiazem in postinfarction patients.     

Efficacy and safety of clentiazem in patients with essential hypertension: results of an early pilot test

The purpose of this study was to evaluate the antihypertensive effect of a new calcium antagonist, clentiazem, on inpatients or outpatients with essential hypertension. After blood pressure was stable and greater than 160/95 mmHg with placebo for at least a 2-week observation period, oral clentiazem was administered once daily and dosage was increased stepwise from 10 to 40 mg over 10 weeks. Blood pressure significantly decreased by the second week of the study, and this hypotensive effect was maintained until the eighth week. Cumulative effective rate (percent of patients whose blood pressure decreased in 20/10 mmHg) in 62 outpatients were as follows; 10.3% at 10 mg, 39.6% at 20 mg, 70.2% at 30 mg, 76.6% at 40 mg. There was no significant postural change observed in the blood pressure from supine to standing position. Side effects such as dizziness, general malaise and gait disturbances were observed in 3 (3.9%) of 76 patients. No abnormal changes in clinical laboratory examinations or electrocardiograms were caused by clentiazem. Thus these data demonstrated that clentiazem produces certain antihypertensive effects with sufficient safety.