静脉应用尼卡地平和酚妥拉明治疗老年高血压急症的比较

目的：比较静脉滴注（静滴）尼卡地平与酚妥拉明对老年高血压急症病人的降压疗效。方法：老年高血压急症病人６３例，分成２组，尼卡地平组３４例，用尼卡地平注射液２５ｍｇ加入５％葡萄糖注射液（ＧＳ）２５０ｍＬ中静滴。酚妥拉明组２９例，用酚妥拉明１０ｍｇ溶于５％ＧＳ２５０ｍＬ中静滴，均于２ｈ内滴完。结果：尼卡地平降压显效率及总有效率分别为７９％和９７％，酚妥拉明分别为７２％和９３％（Ｐ＞０．０５）。治疗２ｈ后比较，尼卡地平组收缩压及舒张压分别下降６．５±２．０ｋＰａ和４．８±１．８ｋＰａ，而酚妥拉明组分别下降５±３ｋＰａ（２组比较Ｐ＞０．０５）和３．３±１．４ｋＰａ（２组比较Ｐ＜０．０５）。尼卡地平组起效（５ｍｉｎ）快于酚妥拉明组（１５ｍｉｎ）（Ｐ＜０．０１）。结论：静脉应用尼卡地平治疗老年高血压急症优于酚妥拉明     

西拉普利与依那普利治疗原发性高血压的比较

原发性高血压４１例，其中２１例（男性１２例，女性９例；年龄５４±ｓ８ａ采用西拉普利平均每天口服３．６±１．３ｍｇ，共４ｗｋ。另２０例（男性６例，女性１４例；年龄５４±７ａ）采用依那普利平均每天口服１１±３ｍｇ，共４ｗｋ。结果：２组均于１ｗｋ即开始有显降压作用，随疗程增加，疗效日益显（Ｐ＜０．０１）。下降幅度２组间相似（Ｐ＞０．０５）。西拉普利尚有对体重及血清钠，氯减低的作用，且无明显不良反应。     

拉西地平(88例)与尼群地平(82例)治疗高血压病的比较

目的：比较拉西地平与尼群地平治疗中，老年高血压病的疗效。方法：高血压病人共１７０例，分为治疗组８８例［男性７２ 例，女性１６例；年龄（６４±ｓ９） ａ］和对照组 ８２例［男性 ７０ 便，女性 １２例；年龄（６３±９）ａ］。治疗组给拉西地平４ ｍｇ，ｐｏ，ｑｍ。对照组给尼群地平 １０ ｍｇ，ｐｏ， ｔｉｄ。 ２组均共服 １ｍｏ。结果：拉西地平组治疗１ｍｏ后，ＳＢＰ／ＤＢＰ从（２２．６／１３．８ ±１． ９ ／０． ８） ｋＰａ降至（ １８ ／１１． ０ ± ３／０． ９） ｋＰａ（ Ｐ＜０．０１）；尼群地平组分别为（２２．４ ／１３．６±１． ５／０． ７） ｋＰａ（ １９． ０ ／１２． ０± １． ８ ／０．９） ｋＰａ（ Ｐ＜０． ０１）； ２组组间比较，差别均有显著意义（ Ｐ＜ ０． ０５和Ｐ＜０．０１）。结论：拉西地平治疗中、老年高血压降压疗效优于尼群地平组。     

卡托普利对高血压病患者心肌和心脏传导系统的影响

研究对象为４０例高血压病患者，其中临床Ⅰ期者１０例，Ⅱ期者３０例（按照世界卫生组织分类标准）。均有头痛、工作能力下降、睡眠障碍和心前区隐痛（但无其他冠心病证据）。年龄为２８～６２岁（平均４５．２±６．５岁），患高血压病２～１８年（平均１０．８±４．６年），收缩压２１．６±１．３ｋＰａ，舒张压１４．０±１．２ｋＰａ，２２例有典型的高血压家族史。以卡托普利５０～１００ｍｇ·ｄ－１纠正血压４周，上述症状消失，动脉收缩压由２１．６±１．３ｋＰａ降至１７．９±１．２ｋＰａ，平均动脉压由１６．４±１．２ｋＰ…     

卡托普利对老年高血压患者糖代谢的影响

用卡托普利治疗老年高血压６４例（男性３４例，女性３０例；年龄６５±ｓ８ａ）。卡托普利从每次１２．５ｍｇ开始，ｐｏ，ｔｉｄ。最大剂量为１１２．５ｍｇ／ｄ。观察３ｗｋ。结果：除患收缩压和舒张压下降外，空腹血糖和胰岛素无明变化，但餐后分别由１０．２±２．４降至７．５±２．２ｍｍｏｌ／Ｌ和１３８±３２降至１０１±３０ｍＵ／Ｌ（Ｐ均＜０．０１）。提示该药在降压同时，能降低血糖和胰岛素。     

伊拉地平缓释胶囊对高血压和肾功能的影响

目的：观察伊拉地平对１１例轻、中度高血压及其中６例合并肾功能损害的疗效。方法：高血压病人１１例（男性７例，女性４例；年龄５４±ｓ１３ａ）采用伊拉地平缓释胶囊５￣１０ｍｇ／ｄ单一口服，疗程１￣３ｍｏ。结果：收缩压平均降低２．４±０．５ｋＰａ，舒张压平均降低２．５±０．４ｋＰａ，１１例中随机取７例作了有效肾血浆流量（ＥＲＰＦ）肾小球滤过率（ＧＦＲ）检查，其中ＥＲＰＦ明显增加，平均增加１６０±６６ｍＬ     

肌内注射维生素K3对中重度高血压病的疗效

目的：观察维生素Ｋ３治疗高血压病的疗效。方法：２８例高血压病人（男性２１例，女性７例；年龄５５±ｓ１１ａ）交叉肌内注射维生素Ｋ３８ｍｇ和维生素Ｂ１１００ｍｇ各１次，观察用药前后３ｈ内的血压变化，其中１０例应用动态血压监测评价。结果：用维生素Ｋ３１．５ｈ时血压较用药前下降幅度与维生素Ｂ１相比差别非常显著（收缩压前者下降４．０±２．５，后者增加０．１±１．８ｋＰａ，Ｐ＜０．０１；舒张压前者下降２．４±１．８，后者增加０．３±１．４ｋＰａ，Ｐ＜０．０１）。结论：维生素Ｋ３降压有效，适用于伴发鼻出血，胆、肾绞痛的高血压病人     

西拉普利与依那普利治疗原发性高血压的比较

原发性高血压４１例，其中２１例（男性１２例，女性９例：年龄５４±ｓ８ａ）采用西拉普利平均每天口服３６±１３ｍｇ，共４ｗｋ。另２０例（男性６例，女性１４例；年龄５４±７ａ）采用依那普利平均每天口服１１±３ｍｇ，共４ｗｋ。结果：２组均于治疗１Ｗｋ即开始有显著降压作用，随疗程增加，疗效日益显著（Ｐ＜０．０１）。下降幅度２组组间相似（Ｐ＞０．０５）。西拉普利尚有对体重及血清钠、氯减低的作用，且无明显不良反应。     

高血压大鼠学习记忆障碍及降压药物疗效

目的：观察高血压大鼠学习记忆功能的损害并评价比较降压药物的治疗效果。方法：自发性高血压大鼠（ＳＨＲ，１６ｗｋ）分３组（ｎ＝６），其中两组分别使用尼群地平、卡托普利，另一组为对照组；肾血管性高血压Ｗｉｓｔａｒ－Ｋｙｏｔｏ（ＷＫＹ）大鼠（ＲＨＲ，１６ｗｋ）共６组（ｎ＝６），其中５组分别使用卡托普利、美多洛尔、普萘洛尔、硝苯地平、哌唑嗪，另一组不用药。再设一正常对照ＷＫＹ（１６ｗｋ，ｎ＝６）组。治疗８ｗｋ后，连续５ｄ进行跳台试验，每天１０次。结果：两种未经治疗的高血压大鼠ｄ５的主动回避反应计分均有不同程度的下降（ＳＨＲ：０．９±１．１，ＲＨＲ：４．２±１．２ｖｓ，ＷＫＹ：８．７±１．８，Ｐ均＜０．０１）；用药ＳＨＲ两组与对照ＳＨＲ组相比（３．６±１６，４．３±１．８ｖｓ０．９±１．１，Ｐ＜０．０５），记分明显改善；ＲＨＲ美多洛尔７．７±１．６，ＲＨＲ普萘洛尔８．３±１．９，ＲＨＲ卡托普利８．０±２．０，ＲＨＲ硝苯地平７．２±１．７，ＲＨＲ哌唑嗪７．３±１．７，与ＲＨＲ对照（４．２±１．２）比较，Ｐ均＜０．０１；主动回避反应计分有显著提高。进一步比较不同药物治疗组，当降压程度相似时，各组主动回避反应计分无明显差别。?     

小檗碱与硝苯地平治疗原发性高血压的比较

原发性高血压７８例，采用小檗碱治疗３８例（男性３６例，女性２例；年龄６４±ｓ５ａ）；剂量０．３－０．６ｇ，ｔｉｄ或ｑｉｄ。另外４０例采用硝苯地平治疗（男性３８例，女性２例；年龄６５±５ａ），剂量１０－２０ｍｇ，ｔｉｄ或ｑｉｄ。２组均以４ｗｋ为一个疗程。结果提示小檗碱对高血压患者的舒张压有降压效果，但疗效远不及常用量之硝苯地平（３４％ｖｓ９０％）（Ｐ＜０．０１），惟不良反应轻微。     

Antihypertensive effects of lacidipine during effort in mild to moderate hypertension

The aim of this study was to evaluate the effects of chronic treatment with lacidipine on blood pressure, heart rate and double product during and immediately after physical effort in mild to moderate hypertensive patients. This was a single-center, randomized, double-blind, crossover, placebo-controlled clinical trial. Eighteen hypertensive patients (56% males, median age 53 years) were randomized to lacidipine 4 mg o.i.d. followed by placebo or to placebo followed by lacidipine 4 mg o.i.d. Lacidipine compared with placebo exerted a significant antihypertensive effect, lowering SBP and DBP both at baseline and either during or after exercise test. The average incremental changes of SBP and DBP between pre-exercise stage and maximal effort did not show any significant differences between treatments. HR during treatment with lacidipine was higher than during treatment with placebo both at rest and after exercise, but at maximal effort, HR was not different from placebo. The average values of DP at maximal effort, and during recovery, did not show any significant differences. Lacidipine 4 mg was effective in lowering blood pressure and in maintaining its antihypertensive effect throughout and after physical exercise, without enhancing double product value, which is an indirect index of myocardial oxygen consumption.     

Lacidipine: a calcium antagonist with potent and long-lasting antihypertensive effects in animal studies.

Lacidipine, currently being evaluated as a once-daily antihypertensive agent, acted as a calcium entry blocker on rabbit ear artery (pA2 = 9.4) with a markedly slower onset of action than that of nitrendipine; this effect was not reversed after 9 h of drug washout. Calcium entry blocker activity was also evaluated on nonvascular smooth muscles: Lacidipine showed a more pronounced vascular selectivity than nitrendipine; for both drugs, concentrations required to induce negative inotropic effects in guinea pig ventricular strip were approximately 100 times higher than concentrations needed to antagonize calcium contraction in vascular smooth muscle. In spontaneously hypertensive rats (SHR), by the tail-cuff method, lacidipine (ED25 = 0.35 mg/kg orally, p.o.) proved approximately 30 times more potent, slower in onset, and longer-acting than nitrendipine in reducing blood pressure. These features were confirmed in chronically implanted SHR after oral and intravenous (i.v.) administration (ED25 = 0.19 mg/kg p.o. and 0.006 mg/kg i.v.). A short-lasting tachycardia was detected with both drugs. No evidence of acquired tolerance emerged after repeated oral administrations over a 3-week period. Lacidipine induced a natriuretic effect in saline-loaded SHR at antihypertensive doses. In renal hypertensive dogs, lacidipine proved more potent (three to seven times), slower in onset, and longer-lasting than nitrendipine after p.o. (ED25 = 0.22 mg/kg) and i.v. (ED25 = 0.004 mg/kg) administrations.     

拉西地平对糖尿病合并高血压的疗效及代谢指标的影响

目的评价拉西地平对糖尿病合并高血压的疗效及代谢指标的影响。方法应用拉西地平对90例2型糖尿病合并高血压患者治疗6周,并与66例单纯高血压患者对照。观察治疗前后血压及空腹血糖、餐后2h血糖、糖化血红蛋白、丙氨酸转氨酶、肾功能、血脂的变化。结果降压作用显著(P<0.001),两组降压效果及服药量差异无显著性(P>0.05)。糖尿病合并高血压患者治疗前后空腹血糖、餐后2h血糖、糖化血红蛋白、丙氨酸转氨酶、肾功能、血脂无明显改变(P>0.05)。结论拉西地平对糖尿病合并高血压有较好的疗效,对血糖、糖化血红蛋白、肝肾功能、血脂无明显的影响。     

The hemodynamic effects of lacidipine in anesthetized dogs: comparison with nitrendipine, amlodipine, verapamil, and diltiazem.

The hemodynamic effects of lacidipine in anesthetized, open-chest dogs were compared with those of nitrendipine, amlodipine, verapamil and diltiazem. Lacidipine administered intravenously induced dose-related, long-lasting reductions in systemic and coronary vascular resistance with corresponding increases in aortic flow and coronary blood flow. The hypotensive effect (ED25 for mean blood pressure reduction = 0.006 mg/kg) was still significant 120 min after administration with all doses tested. Nitrendipine was equipotent with lacidipine in reducing the mean blood pressure (ED25 = 0.005 mg/kg), but its effect was shorter acting (significant effect at 120 min only with the highest dose tested). Amlodipine caused a marked and long-lasting hypotension though at higher doses than lacidipine (ED25 = 0.50 mg/kg). Short-lasting hypotensive responses were also detected with verapamil (ED25 = 0.1 mg/kg) and diltiazem (ED25 = 0.12 mg/kg). A reflex increase in heart rate was observed with lacidipine, nitrendipine, and amlodipine, whereas verapamil and diltiazem showed a dose-related bradycardia. No effect on AV conduction was observed with lacidipine and nitrendipine, whereas amlodipine, verapamil, and diltiazem produced second- to third-degree AV block at the highest doses tested. Lacidipine and nitrendipine caused a reflex increase in contractile index at all doses, whereas amlodipine was more similar to verapamil since a marked decrease in contractile index was detected at the highest dose. Diltiazem was practically devoid of negative inotropic effect.     

地尔硫缓释片与倍他洛尔治疗轻中度高血压病的疗效比较

目的 :比较地尔硫缓释片与倍他洛尔治疗轻、中度高血压病的疗效与安全性。方法 :随机开放对照试验 ,经 2wk安慰剂导入期 ,4 0例轻、中度高血压病人分成 2组 ,各 2 0例 ,进入 6wk治疗期。2组病人分别服地尔硫缓释片 2 0 0mg或倍他洛尔 10mg ,qd ,2wk后如舒张压≥ 12kPa ,则增量至地尔硫缓释片 30 0mg或倍他洛尔 2 0mg至疗程结束。结果 :2组药物均能明显降低血压 (P <0 .0 1) ,有效率分别为 79%及 84 % (P >0 .0 5)。同时 2种药物均有降低心率的作用。动态血压显示 2药持续降压作用达 2 4h。结论 :地尔硫缓释片每日 1次能有效降低轻、中度高血压病病人的血压     

氯沙坦治疗原发性高血压病的疗效及对昼夜血压的影响

目的：评价氯沙坦（Losartan,Los）治疗高血压病的疗效及安全性。方法：90例原发性高血压病患者随机分为氯沙坦组和氯氯地平组各45例,分别给予氯沙坦50－100mg/d,po和氨氯地平5－10mg/d,po,疗程均为8wk,疗程结束前后行24小时动脉血压监测。结果：2组用药后24h动态血压监测指标均较用药前有显著下降（P＜0．01）,治疗后2组间各项指标差异无统计学意义（P＞0．05）。结论：氯沙坦50－100mg/d治疗轻、中度原发性高血压病疗效确切,耐受性好,其作用与氨氯地平相似。     

厄贝沙坦单用及合用治疗轻、中度原发性高血压60例

目的 :比较国产厄贝沙坦单用以及与非洛地平或雷米普利合用对轻、中度原发性高血压的降压疗效。方法 :6 0例轻、中度高血压病人 ,经 2wk安慰剂导入期后 ,单服厄贝沙坦 15 0mg ,qd。 4wk后随机分 2组 ,分别联合服用非洛地平 5mg ,qd ,或雷米普利 5mg ,qd ,均为 4wk。治疗前及治疗后 4wk和 8wk行 2 4h动态血压监测 ,并测治疗前后坐位血压。结果 :厄贝沙坦单用 4wk后 ,坐位血压和2 4h动态血压均下降 (P <0 .0 5或P <0 .0 1) ,收缩压和舒张压的谷峰比值为 0 .82和 0 .86。厄贝沙坦与非洛地平或雷米普利合用 4wk后 ,坐位血压总有效率从 4 0 %增加为 89%和 70 % ;动态血压显示联合用药降压作用较明显。结论 :厄贝沙坦单用有长效的降压作用 ,与非洛地平或雷米普利联合用药有叠加降压作用     

坎地沙坦酯片治疗原发性高血压118例

目的:比较国产坎地沙坦酯片与氯沙坦治疗轻、中度原发性高血压的疗效和安全性。方法:多中心、随机、双盲、双模拟、阳性药平行对照试验。经2 wk安慰剂导入期,238例原发性高血压病人进入8 wk治疗期,每日1次服用坎地沙坦酯片8 mg(n=118),或氯沙坦片50 mg(n=120),2 wk后如舒张压≥12 kPa则剂量加倍。结果:2组病人的血压均得到明显地降低(P<0.01);坎地沙坦酯组总有效率为82.2%,氯沙坦组为84.2%,2组间没有显著差异。坎地沙坦酯组和氯沙坦组收缩压和舒张压的降压谷峰(T/P)比值分别为0.75,0.71和0.76,0.94。结论:对轻、中度原发性高血压病人坎地沙坦酯片是一种有效、安全且易耐受的降压药,每日1次能维持24 h降压效应。     

卡维地洛与拉贝洛尔治疗轻、中度高血压病399例的比较

目的：比较国产卡维地洛与拉贝洛尔降压疗效及安全性。方法：轻、中度高血压病病人３９９例（男性 ２２８例,女性 １７１例;年龄 ５２ ａ± ｓ ９ ａ）,其中２００例采用随机、单盲、平行对照方法,卡维地洛与拉贝洛尔组各 １００例,起始剂量分别为 １０ ｍｇ,ｐｏ,ｂｉｄ与 ５０ ｍｇ,ｐｏ, ｂｉｄ, ２ ｗｋ后按血压决定维持原量或增加到 ２０ ｍｇ,ｐｏ, ｂｉｄ或 １００ ｍｐ,ｐｏ, ｂｉｄ,总疗程 ４ ｗｋ。开放组 １９９例服卡维地洛 １０～２０ ｍｇ,ｐｏ, ｂｉｄ × ４ ｗｂ。其中 ４９例延长到 ６ ｍｏ。结果：随机单盲各１００例用药 １ｗｋ血压、心率均明显下降,治疗 ４ ｗｂ总有效率分别为 ７６％及 ６６％,卡维地洛组优于拉贝洛尔组（ Ｐ＜ ０． ０５）。用卡维地洛共 ２９９例总有效率 ８６． ０％。开放组中 ４９例降压从 ４ ｗｋ～６ ｍｏ呈稳定下降。 ２药不良反应依次为 １５％及１３％,均较轻,可耐受。结论： ２药均是治疗轻、中度高血压病的有效而安全的药物,卡维地洛略优于拉贝洛尔。