依那普利联合辛伐他汀对高血压左室肥厚及舒张功能的影响

目的探讨依那普利联合辛伐他汀对高血压左室肥厚以及舒张功能的影响。方法选择我院收治的80例原发性高血压患者,将其随机分为对照组与治疗组,每组40例,对照组给予依那普利治疗,治疗组在对照组基础上加用辛伐他汀治疗。观察两组治疗前后的血压、血浆总胆固醇（TC）以及低密度脂蛋白胆固醇（LDL-C）变化;测定两组治疗前后的左室舒张末期内径（LVDD）,舒张末期室间隔厚度（LVST）,舒张末期左室后壁厚度（LVPWT）,计算左室质量指数（LVMI）。结果两组治疗后的血压变化比较差异无统计学意义（P〉0.05）;治疗组治疗后的TC以及LDL-C明显低于对照组（P〈0.05）;治疗后,治疗组的LVST、LVPWT以及LVMI均明显低于对照组（P〈0.05）。结论依那普利联合辛伐他汀能够显著降低高血压患者的左室肥厚程度,提高左室舒张功能,值得在临床中推广应用。     

依那普利单用与合用氢氯噻嗪治疗原发性高血压的比较

原发性高血压患者56例(男34,女22;年龄50±7a)采用依那普利2.5-20mg,bid,po,治疗4wk与6mo的疗效比较,两者治疗后均有显著降压疗效(P<0.01),但4wk与6mo治疗组间比较无差异(P>0.05)。副作用亦相仿。另对30例同样患者采用单用依那普利(剂量方法同前)及与氢氯噻嗪2.5-15mg,bid,po,联合治疗4wk作比较,联合用药优于单用组。     

依那普利对高血压病患者左室结构及功能影响

为了探讨依那普利对高血压病患者左室结构及功能的影响 ,观察了 2 8例 期高血压病患者口服依那普利平均 2 2个月后左室结构及功能改变。结果显示 ,依那普利长期治疗可有效降压 ,并同时逆转左室肥厚 ,改善左室舒张功能     

依那普利逆转高血压左室肥厚的疗效观察

目的 探讨依那普利对高血压患者左室肥厚和左室舒张功能的影响.方法 共入选63例新近诊断、未经治疗的高血压患者,口服依那普利5～10 mg,每日2次, 使所有患者的血压在8周内达到标准(＜140/90 mm Hg).治疗前后检测肝功、肾功、血脂、血糖、血尿酸、血常规,进行24 h动态血压(ABPM)检测及超声心动图检查.结果 服用依那普利12周后,ABPM均较治疗前明显下降;左心室舒张末内径(LVDd)、左心室后壁厚度(LVPWT)及左心室重量指数(LVMI)较治疗前明显下降.结论 依那普利不仅可降低血压,对高血压左心室肥厚也有逆转作用,可减少因高血压并发左室肥厚引起的危险.     

依那普利治疗原发性高血压37例

原发性高血压患者37例(男24,女13;年龄50±7yr,)用依那普利5mg,bid,po×1wk,逐周递增10mg,最大剂量20mg,bid;卡托普利治疗相同患者17例作对照,剂量为12.5mg,tid,po×1wk,逐周递增12.5mg,最大剂量50mg,tid;2组疗程均为4wk。结果:2药治疗前、后血压下降均有非常显著差异;但2药组间比较无差异。依那普利可降低总外周阻力。     

地奥心血康对高血压患者左室舒张功能不全的影响

老年高血压患者,早期心脏收缩功能多属正常,而舒张功能往往已有异常表现。左室舒张功能不全是高血压患者心功能受累早期改变的敏感指标。本研究观察高血压患者在常规西药治疗基础上联合运用地奥心血康软胶囊对左室舒张功能不全的疗效,旨在探讨地奥心血康软胶囊对高血压患者左室舒张功能不全的影响。     

培哚普利抗高血压及对左室肥厚的逆转作用

目的观察培哚普利降压疗效及对原发性高血压(EH)左室肥厚(LVH)的逆转作用。方法120例患者予培哚普利4mg，po.qd，治疗32wk，观察EH患者的降压疗效，用超声心动图(UCG)测量患者LVH的改善情况。结果治疗后SBP、DBP均较治疗前明显降低。舒张早期流速峰值增加、A／E明显下降。室间隔舒张末期厚度、左室后壁舒张末期厚度均明显下降，舒张功能改善。结论培哚普利能有效降低BP，对EH的LVH有逆转作用。     

卡托普利对冠心病左室舒张功能的影响

17例冠心病患者(男性12例,女性5例,平均56±6a)采用多普勒血流图,在用卡托普利12.5mg, tid, po×4wk,测定治疗前后左室舒张功能参数,并作对比。治疗4wk后,在心绞痛组,E峰增加,A峰下降,DC增快;在心肌梗死组,A峰与DC均无明显变化。提示卡托普利可改善左室舒张功能。此外,该药可降低血压,但心率变化不大。     

依那普利和美托洛尔联合治疗舒张性心力衰竭疗效分析

目的：探讨依那普利和美托洛尔(倍他乐克)联合治疗舒张性心力衰竭的临床疗效。方法60例舒张性心力衰竭患者被随机分为观察组和对照组。每组30例。两组均给予基础治疗,对照组同时给予倍他乐克治疗,观察组同时给予倍他乐克和依那普利治疗。观察两组治疗效果和超声多普勒超声检查结果。结果观察组治疗前的左室射血分数、左心室早期和晚期充盈速度比值分别和对照组比较,差异无统计学意义(P>0.05);观察组治疗后的左室射血分数、左心室早期和晚期充盈速度比值和对照组比较,差异有统计学意义(P<0.05)。观察组总有效率(90.0%)高于对照组的总有效率(70.0%),差异有统计学意义(P<0.05)。结论依那普利和倍他乐克联合治疗有助于改善舒张性心力衰竭患者左心舒张功能,疗效显著,值得借鉴。     

曲美他嗪对高血压合并无症状性心肌缺血患者左室重构的影响

目的观察曲美他嗪对高血压合并无症性心肌缺血(SMI)患者左心室重量、功能特征的影响。方法选择80例SMI患者应用多谱勒超声检测心脏左室结构及功能,根据有无高血压分为对照组、高血压无症状性心肌缺血(HSMI)组,对比两组左室结构、功能异同,并给予曲美他嗪治疗,观察其对左室重构及功能的影响。结果与对照组比较,HSMI组的左室后壁厚度、室间隔厚度、左室重量显著增大,舒张早期与舒张晚期峰值流速的比值(E/A)显著减小,差异有显著性(P<0.01)。治疗后HMSI组左室重量、E/A与治疗前比较差异亦有显著性(P<0.01)。结论高血压合并SMI患者多有左室结构和功能的损害,曲美他嗪可减缓、逆转左室肥厚,从而改善心脏功能。     

血管紧张素转化酶基因多态性与依那普利降压疗效的相关性研究

目的：研究血管紧张素转化酶（angiotensinconverting enzyme,ACE）基因多态性与依那普利降压疗效的相关性。方法：采用聚合酶链式反应一限制性片断长度多态性（polymerase chain reaction-restriction fragment length polymorphism,PCR—RFLP）对68例原发性高血压患者进行ACE基因型分析,根据ACE三种基因型DD型、ID型和Ⅱ型将受试者分为三纽,所有受试者每天服用依那普利20mg进行2周的降压治疗,观察依那普利在三种不同ACE基因型中的降压疗效及差异。结果：在所有68例原发性高血压患者中,依那普利治疗前与治疗后每组SBP和DBP的降低均有统计学意义（P〈0．05）,其中DD型与Ⅱ型两组之间的SBP和DBP降压幅度（即治疗前与治疗后血压的差值）有统计学意义（P〈0．05）。DD型组依那普利的总有效率为91．30％,ID型组为85．71％,Ⅱ型组是79．16％。结论：原发性高血压患者中ACE基因多态性与依那普利降压疗效相关。     

左旋氨氯地平联合依那普利治疗尿毒症肾性高血压的效果分析

目的分析左旋氨氯地平联合依那普利治疗尿毒症肾性高血压的临床效果。方法80例尿毒症肾性高血压患者,根据治疗方法不同分为对照组和联合治疗组,每组40例。对照组给予左旋氨氯地平治疗,联合治疗组给予左旋氨氯地平联合依那普利治疗。比较两组生存质量评分,治疗前后肾功能指标、收缩压和舒张压水平,临床疗效。结果联合治疗组患者的生存质量评分(92.21±3.45)分高于对照组的(75.26±3.12)分,差异具有统计学意义(P<0.05)。治疗后,两组24 h蛋白尿、血肌酐、尿素氮、收缩压和舒张压水平均较治疗前降低,且联合治疗组24 h蛋白尿、血肌酐、尿素氮、收缩压和舒张压水平均显著低于对照组,差异具有统计学意义(P<0.05)。联合治疗组患者的治疗总有效率95.00%显著高于对照组的75.00%,差异具有统计学意义(P<0.05)。结论左旋氨氯地平联合依那普利治疗尿毒症肾性高血压的疗效确切,可一定程度改善生存质量和肾功能,降低患者收缩压和舒张压,提高治疗效果,值得推广。     

氨氯地平联合依那普利治疗高血压病左心室舒张功能不全的临床观察

目的:观察氨氯地平联合依那普利治疗高血压病左心室舒张功能不全的临床疗效。方法:2009年3月～2010年3月,我院42例高血压病左心室舒张功能不全患者,采用氨氯地平联合依那普利治疗,观察治疗前后血压、心功能指标的变化,评价临床疗效。结果:氨氯地平联合依那普利治疗高血压病左心室舒张功能不全的临床有效率为90.5%。与治疗前比较,治疗后收缩压、舒张压和脉搏压发生明显下降(P<0.05);E峰、E/A明显增加(P<0.05),A峰、左室后壁舒张末期厚度(LVPWT)和室间隔舒张末期厚度(IVST)明显下降(P<0.05)。结论:对高血压病左心室舒张功能不全患者采用氨氯地平联合依那普利治疗,临床疗效高,不仅能够明显降低血压,还能够改善患者的心功能状态。     

Efficacy and tolerability of trandolapril in mild to moderate hypertension--a double blind comparative clinical trial with enalapril in Indian population

Several large scale clinical trials have demonstrated that angiotensin converting enzyme inhibitors offer cardiovascular and renal protection independent of their effects on systolic BP. Trandolapril is a new angiotensin converting enzyme inhibitor approved for the treatment of hypertension. The potential advantages of this drug are long duration of action and better tolerability. The objective of the study was to compare the efficacy and tolerability of trandolapril with that of enalapril in mild to moderate hypertension in Indian population. In this double blind, multicentric, parallel comparative clinical study, 120 patients with mild to moderate hypertension were randomly assigned to receive trandolapril 2 mg or enalapril 5 mg once daily for 8 weeks. The attainment of sitting diastolic blood pressure <90 mmHg at the end of 8th week was considered as primary outcome measure and attainment of diastolic blood pressure <90 mmHg or reduction of at least 10 mmHg diastolic blood pressure compared to baseline at any visit was considered as secondary outcome measures. 98.4% patients treated with trandolapril and 92.6% patients treated with enalapril fulfilled the primary outcome measure. 54, 72 and 62% patients on trandolapril and 52, 61 & 64% patients on enalapril fulfilled secondary outcome measure at the end of 2nd, 4th and 8th week respectively. Also trandolapril was better tolerated than enalapril with no significant abnormality in lab parameters.     

培多普利和依那普利治疗原发性高血压的疗效比较

目的:比较培多普利和依那普利治疗原发性高血压的疗效和安全性。方法:将76例高血压患者随机分成两组:培多普利组和依那普利组,疗程24周,观察治疗前后血压的变化。结果:两药均能显著降低血压,培多普利有效率为89.5%,依那普利有效率为81.5%,两者差异无显著性。培多普利的收缩压和舒张压的降压谷/峰比值均大于依那普利。结论:对原发性高血压,培多普利是一种有效、安全且易耐受的降压药,每日1次能维持24 h降压效应。     

The efficacy of hydrochlorothiazide, timolol and enalapril in Ethiopians with essential hypertension.

A double-blind trial of hydrochlorothiazide, timolol and enalapril was carried out in Ethiopians with essential hypertension at the Tikur Anbessa Hospital, Addis Abeba, between 1987 and 1990. Patients with a supine diastolic blood pleasure of 95-120 mmHg after a washout period of 2 weeks were randomized to receive hydrochlorothiazide 25 mg daily, timolol 10 mg daily or enalapril 10 mg daily. Doses were doubled at 4 weeks if the diastolic blood pressure remained above 95 mmHg. At the end of 8 weeks of treatment, there were 9 patients taking hydrochlorothiazide, 10 patients taking timolol and 7 patients taking enalapril. Hydrochlorothiazide significantly lowered both systolic and diastolic blood pressure at 4 and 8 weeks compared with pre-treatment levels. Timolol and enalapril did not significantly lower the systolic blood pressure, but each lowered the diastolic blood pressure at 4 weeks and 8 weeks respectively. More patients on hydrochlorothiazide attained a diastolic blood pressure of less than 90 mmHg while less patients required doubling of dosage compared to timolol and enalapril. It is concluded that Ethiopian hypertensives may respond better to diuretics than to beta-blockers or angiotensin converting enzyme inhibitors, as found in other black populations.     

A double-blind comparison of amlodipine and placebo added to open enalapril in patients with moderate to severe essential hypertension

The antihypertensive efficacy and tolerability of amlodipine in combination with enalapril were assessed in this two-center study. Patients with moderate to severe hypertension and with diastolic blood pressure > 95 mm Hg after 4 weeks of treatment with open-label enalapril 5-10 mg daily were randomized to receive amlodipine 10 mg daily or placebo, double-blind for a further 4 weeks, in combination with open-label enalapril. There were significantly larger falls in mean supine and standing blood pressure in patients treated with enalapril plus amlodipine than in those treated with enalapril plus placebo. There was no clinically or statistically significant difference between treatment groups in pulse rate, ECG, or body weight. Side effects were generally mild or moderate with a similar incidence in both treatment groups. The study showed once-daily amlodipine to be effective and well tolerated when administered as add-on therapy to enalapril.     

Treatment of essential hypertension in Asians: enalapril as monotherapy versus combination therapy with hydrochlorothiazide

This study compared enalapril maleate (Enaprin) as a single antihypertensive agent and enalapril plus hydrochlorothiazide in Korean patients to determine if one regimen is superior to the other in terms of efficacy and subjective adverse effects. After a 1-week washout period, 12 patients were randomized to receive enalapril 10 mg daily and 13 patients to receive enalapril 10 mg daily plus hydrochlorothiazide 25 mg daily. After 2 weeks, enalapril was increased to 20 mg daily if diastolic blood pressure was greater than 90 mm Hg. The study period was 12 weeks. The mean changes in diastolic blood pressure in mm Hg were enalapril alone -10.7 +/- 10.5 mm Hg and enalapril plus hydrochlorothiazide -25.1 +/- 12.1 mm Hg (difference between the two groups significant at p less than 0.01). Mean dose of enalapril required to achieve goal blood pressure was 18.8 mg for monotherapy and 13.0 mg for combination therapy (p less than 0.05). Adverse effects were comparable. We concluded that enalapril in combination with hydrochlorothiazide is more effective and safe, and allows for lower dosing of enalapril than the drug as monotherapy in Korean hypertensives.     

Left ventricular changes after chronic therapy with enalapril maleate in moderate to severe hypertensive patients

A randomized double-blind trial was carried out to determine the relationship of the changes in blood pressure and heart rate with changes in echocardiographic left ventricular indices in moderate to severe hypertensive patients with established left ventricular hypertrophy who were being treated chronically with enalapril or hydrochlorothiazide plus propranolol for 26 weeks. After a 2-week period on placebo, drug dosages in the two groups were adjusted to individual needs until blood pressure was normalized (diastolic less than 90 mmHg). Patients in Group I received 10 to 40 mg enalapril/day; those in Group II received 50 mg hydrochlorothiazide plus 80 to 240 mg propranolol/day. Echocardiographic measurements were made at the end of the placebo and 26-week active treatment periods. Significant correlations were observed between the changes in four pairs of variables in each group. In the 8 patients receiving enalapril, there were negative correlations between interventricular septal thickness and supine systolic blood pressure, erect and supine heart rates, and a positive correlation between relative wall thickness and erect diastolic blood pressure. In the 7 patients on hydrochlorothiazide plus propranolol, there were negative correlations between relative wall thickness and erect and supine heart rate, and positive correlations between left ventricular mass and erect diastolic blood pressure, and the percentage change in internal diameter of the left ventricle and supine systolic blood pressure. Possible explanations for and implications of these regional changes are discussed.     

苯磺酸左旋氨氯地平与依那普利对老年脑卒中患者血压调控的效果比较

目的观察苯磺酸左旋氨氯地平与依那普利对老年脑卒中患者血压调控的临床效果。方法将80例老年脑卒中患者随机分为氨氯地平组和依那普利组各40例。氨氯地平组予苯磺酸左旋氨氯地平片治疗;依那普利组予依那普利片治疗。观察2组血压及颈动脉IMT和狭窄程度变化情况。结果治疗后,2组收缩压及舒张压均低于治疗前,差异均有统计学意义（P〈0.05）;治疗后2组间血压差异无统计学意义（P〉0.05）。氨氯地平组IMT增厚率及颈动脉中、重度狭窄率均低于依那普利组,差异均有统计学意义（P〈0.05）。结论苯磺酸左旋氨氯地平能平稳调整老年脑卒中患者急性期血压,且对于血管内皮有一定的保护作用,能消除或稳定老年脑卒中患者的颈动脉粥样硬化斑块,值得临床推广应用。