老年原发性高血压患者颈动脉内中膜增厚与C-反应蛋白水平的关系

目的:检测老年原发性高血压患者血清中C-反应蛋白水平及颈动脉内中膜厚度的变化,分析老年高血压患者颈动脉粥样硬化与C-反应蛋白水平的关系。方法:选择2004-03/2005-08在山东泰安市中心医院门诊就诊或住院的老年原发性高血压患者85例为观察对象,其中高血压1,2,3级分别为35,30,20例;选择同期健康老年体检者45例为对照组。用免疫浊度法测定C-反应蛋白水平,应用B型超声检测颈动脉内膜中层厚度及粥样斑块,分析C-反应蛋白水平变化与高血压患者收缩压及舒张压的关系,C-反应蛋白水平与颈动脉内膜中层厚度的关系。结果:130例受试者全部进入结果分析。①高血压1,2,3级组颈动脉内中膜厚度均大于对照组[(0.67±0.19),(0.86±0.24),(0.98±0.18),(0.59±0.13)mm,P<0.01],高血压级别越高,颈动脉内中膜厚度越大(P<0.05)。②高血压1,2,3级组C-反应蛋白水平均高于对照组[(7.48±1.35),(8.45±1.41),(10.59±1.95),(4.57±1.02)mg/L,P<0.01],高血压级别越高,颈动脉内中膜厚度越大(P<0.05)。③颈动脉内中膜厚度为0.8～1.0mm和>1.0mm者C-反应蛋白水平高于<0.8mm者[(8.15±1.58),(10.63±2.15),(5.67±1.65)mg/L,P<0.05]。④高血压组中血清C-反应蛋白水平高于对照组,C-反应蛋白水平随收缩压、舒张压水平的增高而增加,高血压3级高于1,2级(P<0.05)。结论:①老年原发性高血压患者血清中C-反应蛋白水平增高与颈动脉内中膜厚度关系密切,随着颈动脉内中膜增厚,C-反应蛋白亦增高。②C-反应蛋白水平随着高血压级别增大有增高的趋势,炎症反应可能参与了高血压病的发生、发展。     

缬沙坦对高血压患者左心室壁厚度和舒张功能的影响

目的观察缬沙坦的降压效果,及其对左心室壁厚度和舒张功能的影响。方法对55例高血压患者使用缬沙坦降压治疗6个月,观察其降压效果及对左心室功能影响。结果治疗6个月后患者血压明显下降,收缩压平均下降27.7 mm Hg(1 mm Hg=0.133 kPa),舒张压平均下降16.4 mm Hg,左心室壁厚度及左心室舒张末期内径也明显下降。结论缬沙坦降压效果较好,且不良反应轻微,并可逆转左心室肥厚及改善左心室舒张功能。     

苯磺酸左旋氨氯地平片联合叶酸片治疗H型高血压疗效观察

目的探讨苯磺酸左旋氨氯地平片联合叶酸片治疗H型高血压的疗效,评估长效钙离子拮抗剂类降压药联合叶酸片对H型高血压治疗及脑卒中预防的效果。方法选择符合标准的240例Ⅰ级、Ⅱ级原发性H型高血压患者,随机分为苯磺酸左旋氨氯地平联合叶酸组120例和马来酸依那普利叶酸组120例。在入组前测量所有患者的血压、血糖、血脂、血清同型半胱氨酸水平、以及颈动脉内中膜厚度及斑块积分,在干预3个月后复查两组患者的血压以及血清同型半胱氨酸水平;干预1年后复查颈动脉内中膜厚度及斑块积分;1年内随时记录患者的脑血管病事件的发生等指标。结果干预3个月后苯磺酸左旋氨氯地平联合叶酸组与马来酸依那普利叶酸组降压和降血清同型半胱氨酸作用明显,与干预前比较差异有统计学意义(P0.05);苯磺酸左旋氨氯地平联合叶酸组同时降压降血清同型半胱氨酸的有效率为83.3%(100/120),马来酸依那普利叶酸组为75.0%(90/120),两组间比较差异无统计学意义(χ2=2.526,P=0.112)。1年后复查颈动脉超声显示两组在颈动脉内中膜厚度和斑块积分上都较前明显改善,差异具有统计学意义(P0.05);但两组之间比较差异无统计学意义(P0.05)。随访1年内苯磺酸左旋氨氯地平联合叶酸组发生脑血管疾病7例,发生率为6.5%(7/108);马来酸依那普利叶酸组发生脑血管病5例,发生率是5.0%(5/100)。两组间比较差异无统计学意义(χ2=0.21,P=0.65)。结论苯磺酸左旋氨氯地平片联合叶酸片在治疗Ⅰ级、Ⅱ级H型高血压患者在同时降压降同型半胱氨酸方面效果显著,能够明显改善颈动脉内中膜厚度,缓解动脉粥样硬化速度,有效减少脑血管事件的发生,对H型高血压患者的疗效与马来酸依那普利叶酸片相当。     

通心络联合降压治疗改善老年男性高血压患者动脉硬化相关指标的研究

目的:探讨通心络联合常规降压治疗对老年男性高血压患者的抗动脉硬化作用。方法:将65～80岁男性高血压患者81例,随机分为常规降压治疗组(41例,单用坎地沙坦治疗)及通心络联合治疗组(40例,通心络联合坎地沙坦治疗)。两组在治疗前后分别检测胰岛素、总睾酮、HDL、血浆同型半胱氨酸(Hcy)水平、颈动脉内中膜厚度(CIMT)等指标。43例血压正常者作为对照组,但不进行治疗。结果:除血压异常外,老年男性高血压患者还有内分泌紊乱、血浆Hcy水平较高和HDL水平较低等的重要特征。与常规降压治疗组比较,通心络联合治疗组能有效地降低收缩压(P<0.05),血浆Hcy水平(P<0.01),有效地升高血浆HDL水平(P<0.05)。两种治疗均不能改善CIMT。结论:通心络联合常规降压治疗能明显改善动脉硬化相关的心脑血管疾病风险因素,有利于老年男性高血压患者的抗动脉硬化治疗。     

老年原发性高血压患者动态脉压与颈动脉重构、粥样硬化及心律失常的关系

目的探讨老年原发性高血压患者动态脉压与颈动脉重构、粥样硬化及心律失常的关系。方法51例老年原发性高血压患者按动态脉压分为脉压>60 mm Hg(1 mm Hg=0.133 kPa)组25例和脉压40~60 mm Hg组26例,入选者做24小时动态心电图,应用超声检测颈动脉结构、功能及粥样斑块。结果脉压>60 mm Hg组与脉压40~60 mm Hg组的颈总动脉内膜中层厚度为(0.94±0.15)mm vs(0.76±0.11)mm、颈动脉分叉处内膜中层厚度为(1.46±0.32)mm vs(0.94±0.21)mm,颈动脉僵硬度为(3 007.3±1 022.4)vs(1 724.3±672.7),脉压>60mm Hg组明显升高(P<0.01或P<0.05),颈动脉扩张性为(0.12±0.08)vs(0.29±0.09),及紧张度为(2.31±1.03)vs(4.82±1.18),脉压>60 mm Hg组下降(P<0.05或P<0.01),颈动脉粥样斑块发生率为(23/25,92%vs13/26,50%)、心律失常发生率为(16/25,68%vs 10/26,38.46%),脉压>60 mm Hg组升高(P<0.01或P<0.05)。直线相关分析显示:颈总动脉内膜中层厚度、颈动脉分叉处内膜中层厚度、颈动脉僵硬度与脉压呈正相关(r分别为0.789、0.752、0.596,P<0.01或P<0.05)。颈动脉紧张度及颈动脉扩张性与脉压呈负相关(r别为-0.626、-0.598,P<0.05)。结论老年原发性高血压患者颈动脉重构与脉压增高有关;脉压升高,颈动脉粥样斑块及心律失常发生率增加。     

坎地沙坦联合胺碘酮预防心房颤动复发效果分析

目的 通过观察坎地沙坦联合胺碘酮预防心房颤动(简称房颤)复发的疗效,探讨坎地沙坦在房颤预防中的作用.方法 将持续性房颤转复后患者60例按随机数字表法分为坎地沙坦与胺碘酮联合治疗组(治疗组)与胺碘酮治疗组(对照组),进行预防复发治疗,共观察9个月,观察复发率、复发时限、左房内径,并进行对比分析.结果 治疗组与对照组相比,其房颤复发率显著降低(36.7%vs 63.3%,P<0.05),复发时限显著延长[(175.3±41.5)d vs(90.9±36.5)d,P<0.05].治疗组左房内径于6个月及9个月后明显缩小,与治疗前及对照组比较差异均有统计学意义(P＜0.05).结论 血管紧张素受体拮抗剂坎地沙坦在维持房颤患者窦性节律方面有明显作用.     

老年性甲状腺功能减低的替代治疗对原发性高血压患者血压波动的影响观察

目的观察不同剂量的优甲乐对老年原发性高血压患者血压波动的影响。方法服用优甲乐患者分为25～50μg组和50～75μg组,分别检测1、3、6个月甲状腺功能的变化情况及临床甲状腺功能减退的改善情况及优甲乐对原发性高血压患者血压水平的变化情况。结果老年患者服用优甲乐后第1个月开始明显改善甲状腺功能低下症状,3个月可完全达到较理想的水平,25～50μg组治疗前平均收缩压为（136±12）mm Hg（1 mm Hg=0.133 kPa）,服药1、3、6个月后分别升高为（137±11）、（147±7）、（150±6）mm Hg;50～75μg组治疗前平均血压为（137±11）mm Hg,服药1、3、6个月后分别升高为（147±10）、（154±8）、（155±7）mm Hg。结论优甲乐能有效地改善老年患者甲状腺功能不足引起的相关并发症,但对原发性高血压患者的收缩压有明显的升高作用,小剂量开始给药能有效地减少外源性激素替代治疗引起的相关并发症。     

坎地沙坦联合胺碘酮治疗阵发性心房颤动的疗效观察

目的:观察坎地沙坦和胺碘酮联合应用对阵发性心房颤动的疗效。方法:将66例阵发性心房颤动患者随机分为治疗组(n=34)及对照组(n=32),两组均口服胺碘酮,治疗组加用坎地沙坦8mg/d,疗程均为12个月。观察比较两组心房颤动复发率以及治疗前、治疗后6、12个月的左心房内径值。结果:对照组房颤复发14例,治疗组房颤复发7例,治疗组房颤复发率明显低于对照组(P<0.05)。治疗前及治疗后6个月两组左房内径差异无统计学意义(P>0.05);治疗12个月后对照组左房内径显著大于治疗组(P<0.01)。结论:坎地沙坦和胺碘酮联合应用可降低阵发性心房颤动复发率,并能抑制左心房的扩大。     

坎地沙坦酯及氨氯地平对中重度高血压患者左心室肥厚的影响

目的 观察坎地沙坦酯、氨氯地平对中、重度原发性高血压患者左心室肥厚(LVH)的影响.方法 80例原发性高血压合并左心室肥厚患者口服坎地沙坦酯8 mg/d,苯磺酸氨氯地平5～10 mg/d.服药前和服药后24、36周,应用超声心动图测量左心室的结构变化.结果 80例患者顺利完成研究,超声心动图显示坎地沙坦酯、苯磺酸氨氯地平治疗24周后,左心室重量(LVM)、左心室重量指数(LVMI)降低,舒张末期室间隔厚度(IVST)和左心室后壁厚度(PWT)变薄;继续治疗至36周,上述指标降低更明显.结论 坎地沙坦酯、苯磺酸氨氯地平对中、重度高血压患者在有效降低血压的同时,可逆转心室肥厚.     

超声射频信号技术分析妊娠高血压综合征孕妇颈动脉血管功能的研究

目的采用超声射频信号血管分析技术对妊娠高血压综合征(PIH)孕妇颈动脉内中膜厚度及弹性进行综合评估,并与正常妊娠孕妇比较,观察PIH孕妇颈动脉血管功能的变化.方法PIH孕妇27例(PIH组),平均动脉压108 mm Hg(1 mm Hg=0.133 kPa),采用年龄及孕周匹配的30名正常妊娠孕妇作为健康对照组.彩色多普勒超声诊断仪分别启用超声射频信号技术中的血管内-中膜定量技术(QIMT)及血管硬度定量分析技术(QAS)测量两组孕妇颈动脉内-中膜厚度IMT及弹性.结果 PIH组孕妇颈总动脉IMT、脉搏波传播速度(PWV)、等容收缩期到射血期转折点压力(PT1)、动脉增强压(AP)及动脉压增强指数(AIx)分别为(466.84±118.50)μm、(7.09±1.97)m/s、(127.50±14.29)mm Hg、(5.14±3.39) mm Hg及(7.58±8.73)%,健康对照组分别为(386.58±125.79)μm、(5.95±1.11) m/s、(105.89±11.02)mm Hg、(1.98±2.19)mm Hg及(-4.79±7.92)%.两组比较差异有统计学意义(t值分别为2.660、2.660、3.460、3.460、3.460,P值均＜0.01).结论 与正常妊娠孕妇比较,PIH孕妇颈动脉内中膜明显增厚,弹性减低.超声射频信号血管分析技术可敏感地反映弹性血管结构和功能变化.     

坎地沙坦西酯治疗原发性高血压的疗效及对心血管重构的影响

目的评价坎地沙坦西酯的降压效果及其对原发性高血压患者心血管重构的影响。方法198例原发性高血压患者，随机分成坎地沙坦西酯组和非洛地平缓释片组．治疗24周，测治疗前，治疗后第4、8、16及24周的血压，其中85倒于治疗前、治疗结束后各检查一次超声心动图及颈动脉超声，对比分析组内治疗前后左心室重量指数、左心功能参数及颈动脉的内膜一中层厚度（IMT）、内径（ID）及IMT/ID比值。结果①治疗后第4、8、16及24周与治疗前比较，坎地沙坦西酯组收缩压明显下降（t分别=12．66、14．13、17．30、19．11，P均〈0.05），舒张压也明显下降（t分别=19．26、21．32、24．27、25．02，P均〈0．05）。②坎地沙坦西酯治疗24周后，左心房内径（LAD）、左室舒张末期内径（LVIDd）、室间隔舒张末期厚度（IVSd）、射血分数（LVEF），左室舒张早期充盈峰值流速（E峰），与较治疗前有极显著的改善（t分别=4．02、6．31、4．49、4．94、2．88，P均〈0．05），左室后壁舒张末期厚度（PWTd）、左室重量（LVM）及左室重量指数（LVMI）、心房收缩期充盈峰值流速（A峰）减小显著（t分别=2．24、2．03、2．19、2．00，P均〈0．05）；而在非洛地平治疗24周后IVSd、PWTd、LVM及LVMI下降显著（t分别=2.38、2．19、2．02、2．01，P均〈0．05），两组间比较有显著差异（t分别=4．13、5．27、2．00、5．88、1．99、2．86、2．35、2．15、2．04、2．01．P均〈0．05），⑧坎地沙坦西酯治疗24周后，颈总动脉和颈内动脉IMT减小、ID增加IMT/ID比值改善（t分别=2．20、2．00、2．50、2．00、2．37、2．02．P均〈0．05），两组间比较有显著差异（t分别=2．16、1．97、2．13、0.24、2．35、1．99，P均〈0．05）。结论坎地沙坦西酯和非洛地平均具备良好降压效应的降压药，坎地沙坦西酯对心脏血管重构及心功能?     

Protective vascular effect of angiotensin receptor blocker (ARB)

To determine the mechanism of protective vascular effect of angiotensin receptor blocker(ARB), the effect of candesartan on blood pressure(BP), ultrasonographically assessed carotid intima-media thickness(IMT), plasma superoxide dismutase activity (SOD), and lipid peroxides(LPO) were measured, and compared with the effects of diuretics in 20 patients with essential hypertension. Candesartan significantly reduced BP similarly with diuretics. However, IMT was significantly reduced by candesartan, but not by diuretics. Also, candesartan increased SOD, and decreased LPO. There were significant relationship between changes in IMT and SOD, and LPO. These results suggest that protective vascular effect of ARB may be through its effect on angiotensin induced oxidative stress independent of BP reduction.     

国产缬沙坦治疗2型糖尿病合并高血压患者的疗效观察

目的研究国产血管紧张素Ⅱ受体拮抗剂（ARB）类药物穗悦对2型糖尿病合并高血压患者的治疗效果。方法选取符合WHO的1999年2型糖尿病诊断标准,尿常规蛋白阴性的患者166例,年龄35～70岁,男90例,女76例,其中合并高血压者137例,按是否使用穗悦治疗分为穗悦组与非穗悦组,血压正常者29例,为对照组。所有患者每月测定血压,测定基线及治疗1年、2年时肝肾功能、血糖、糖化血红蛋白、8 h尿蛋白排泄率（UAER）、颈动脉内膜中层厚度（IMT）。结果（1）基线时穗悦组与非穗悦组及对照组比较,年龄、糖尿病病程、体质指数、肝肾功能、血糖、8 h UAER无显著差异（P＞0.05）。（2）基线时穗悦组高血压病程较长,收缩压及舒张压较非穗悦组显著增高（P＜0.05）;治疗1年及2年时,穗悦组收缩压与舒张压较治疗前均有显著下降（P＜0.05）,收缩压仍稍高于非穗悦组与对照组,舒张压与非穗悦组及对照组无显著差异（P＞0.05）;非穗悦组仅2年时舒张压有显著下降（P＜0.05）。（3）基线时颈动脉IMT在穗悦组与非穗悦组间无明显差异,较对照组稍增厚;治疗1年及2年时,穗悦组与非穗悦组比较颈动脉IMT无显著差异（P＞0.05）,较对照组仍稍增厚（P＜0.05）。（4）基线时8 h UAER穗悦组与非穗悦组比较,穗悦组与对照组比较均无显著差异（P＞0.05）;治疗2年时穗悦组8 h UAER有显著下降（P＜0.05）。结论穗悦在2型糖尿病合并高血压,尿常规蛋白阴性的患者中,能有效降低血压,尤其是舒张压,减少尿微量白蛋白排泄率,可能对动脉硬化有一定保护作用。     

Candesartan cilexetil: an angiotensin II receptor blocker

OBJECTIVE: To summarize and critique the medical literature on candesartan cilexetil, an angiotensin II receptor blocker (ARB). DATA SOURCES: MEDLINE searches (January 1966-January 1999) and manufacturer prescribing literature were used to identify articles on candesartan cilexetil. Bibliographies were also reviewed for germane articles. STUDY SELECTION: Study and review articles describing the chemistry, human pharmacology, pharmacodynamics, pharmacokinetics, placebo-controlled trials, comparative trials, and clinical application of candesartan cilexetil based on the published literature and premarketing clinical trials were reviewed. DATA EXTRACTION: All literature on the use of candesartan cilexetil for treating hypertension and congestive heart failure were included. DATA SYNTHESIS: ARBs are a new class of drugs with increasing use in treating hypertension. Studies are ongoing to determine the role of these agents in preventing remodeling after myocardial infarction and in patients with congestive heart failure. Candesartan cilexetil is among the newest drugs in the class that includes losartan, irbesartan, and valsartan. Candesartan cilexetil has more than 1000 times more affinity for the angiotensin II, type AT1 receptor ARBs, and the binding affinity and competitive angiotensin II receptor antagonism is stronger than that of losartan. Clinical studies in patients with hypertension have demonstrated that candesartan cilexetil, in doses of 4-16 mg, is more effective in reducing sitting diastolic blood pressure than are placebo and losartan 50 mg. Candesartan cilexetil has demonstrated reductions in blood pressure comparable to those of enalapril, with the rate of adverse events greater in the enalapril group. Dosage adjustments are not necessary in elderly patients or in patients with mild hepatic or renal dysfunction. In diabetic patients, blood glucose, hemoglobinA1c, and serum lipids are not affected. The clinical studies demonstrated that the adverse effect profile of candesartan cilexetil was similar to that of placebo and there were no dose-dependent adverse effects. CONCLUSIONS: Candesartan cilexetil provides an alternative antihypertensive therapy that is well tolerated and effective in reducing blood pressure in a wide range of patients. Due to its greater binding affinity to the angiotensin II receptor, candesartan cilexetil appears to have a longer antihypertensive effect than losartan. This may be advantageous in decreasing morbidity and mortality associated with hypertension, although further studies are required to validate this potential advantage.     

Comparison of candesartan and felodipine alone and combined in the treatment of hypertension: a single-center, double-blind, randomized, crossover trial

Background: In the past decade, many studies have indicated that the combination of low doses of different classes of antihypertensive agents may be more efficacious than monotherapy while minimizing the likelihood of dose-dependent adverse effects (AEs).Objective: The aim of this study was to determine whether combination therapy with lower doses of candesartan and a calcium antagonist, felodipine, would be more effective and tolerable in controlling mild to moderate hypertension compared with either drug used alone.Methods: In this 18-week, single-center, double-blind, crossover study, patients with mild to moderate essential hypertension were randomized to 1 of 2 treatment groups after a 2-week placebo washout period. Patients in group 1 received candesartan 16 mg once daily and patients in group 2 received felodipine 5 mg once daily, for 6 weeks. All patients then received half-dose combination therapy (candesartan 8 mg plus felodipine 2.5 mg, once daily) for 6 weeks. Finally, patients received 6 weeks of monotherapy with the alternate medication (group 1 received felodipine 5 mg once daily and group 2 received candesartan 16 mg once daily).Results: Thirty patients (18 men, 12 women; mean [SD] age, 54.0 [4.9] years; range, 39-62 years) were included in the study. During both monotherapy periods, candesartan and felodipine significantly reduced blood pressure (BP) (both P<0.001). BP further decreased with combination therapy (P<0.001 in both groups). Overall, 90.0% (27/30) of the patients achieved the target BP at the end of combination therapy. The incidence of AEs was similar with combination therapy compared with either monotherapy.Conclusions: In this study population, candesartan and felodipine had additive effects when used in combination, even at low doses, in the treatment of hypertension. Therefore, the combination of candesartan and felodipine is an effective alternative to that of candesartan and hydrochlorothiazide.     

A randomized,double-blind,controlled, parallel-group comparison of perindopril and candesartan in hypertensive patients with type 2 diabetes mellitus

BACKGROUND: When choosing an antihypertensive drug for patients with hypertension and diabetes mellitus (DM), the metabolic side effects, possibility of improving some metabolic parameters, and need for adequate blood pressure control must all be considered. OBJECTIVE: The goal of this study was to compare the impacts of perindopril and candesartan on blood pressure, glucose metabolism, serum lipid profile, and metabolic parameters in patients with mild hypertension and type 2 DM during therapy and after a 1-month washout period. METHODS: Type 2 DM patients with mild hypertension and good glucose control who were not taking hypercholesterolemic drugs were enrolled. Perindopril 4 mg QD or candesartan 16 mg QD was administered for 12 months in this randomized, double-blind, controlled, parallel-group clinical trial. Fasting plasma glucose (FPG), fasting plasma insulin (FPI), glycosylated hemoglobin, homeostasis model assessment (HOMA) index, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, lipoprotein(a) (Lp[a]), plasminogen activator inhibitor 1 (PAI-1), homocysteine, body mass index (BMI), and albumin excretion rate (AER) were assessed. RESULTS: Ninety-six patients (49 women and 47 men; mean [SD] ages, 53 [10] years [perindopril] and 55 [9] years [candesartan]) were enrolled. Mean (SD) body weight, height, and BMI were 78.2 (9.4) kg, 1.69 (0.05) m, and 27.2 (2.0) kg/m(2) in the perindopril group and 77.5 (8.6) kg, 1.70 (0.06) m, and 26.8 (2.5) kg/m(2) in the candesartan group. A significant change occurred from baseline to month 12 during treatment with perindopril in SBP and DBP (both P < 0.01), FPG (P < 0.05), FPI (P < 0.05), TC (P < 0.05), LDL-C (P < 0.05), Lp(a) (P < 0.05), PAM (P < 0.05), and AER (P < 0.05). Significant changes from baseline to month 12 occurred with candesartan in SBP and DBP (both P < 0.01) and AER (P < 0.05). The HOMA index was significantly lower at month 12 in the perindopril group than in the candesartan group (P < 0.05). When we interrupted perindopril and candesartan therapy for a 1-month washout period, changes in SBP and DBP values were significant compared with month 12 in both groups (all P < 0.05). Changes in TC and LDL-C from month 12 to the end of washout were significant only in the perindopril group (both P < 0.05). CONCLUSIONS: Perindopril and candesartan both effectively lowered blood pressure in this group of patients with mild hypertension and type 2 DM. Perindopril showed an improvement on some metabolic parameters compared with candesartan. However, the inclusion/exclusion criteria could limit the ability to extrapolate the results to a general population.     

坎地沙坦联合比索洛尔治疗对老年高血压患者左心室肥厚及心功能不全的影响

目的观察坎地沙坦联合比索洛尔治疗对老年高血压患者左心室肥厚及心功能不全的影响。方法将2011年7月-2012年8月收治的60岁以上的门诊或住院高血压患者117例随机分为对照组58例和试验组59例。对照组给予比索洛尔及苯磺酸左旋氨氯地平治疗,试验组给予坎地沙坦联合比索洛尔治疗。结果两组患者治疗3个月后的血压与治疗前比较均下降差异有统计学意义（P〈0.05）,两组患者治疗后的血压比较差异无统计学意义（P〉0.05）;两组患者治疗12个月后左心室舒张末期内径、室间隔舒张末期厚度、左心室后壁舒张末期厚度、心肌质量及左心室质量指数与治疗前后比较均下降,差异有统计学意义（P〈0.05）,射血分数与E/A升高,差异有统计学意义（P〈0.05）,且试验组结果优于对照组,差异有统计学意义。结论比索洛尔联合苯磺酸左旋氨氯地平或坎地沙坦均能有效控制老年高血压患者的血压及逆转左心室肥厚与心功能不全,但比索洛尔联合坎地沙坦的效果优于联合苯磺酸左旋氨氯地平。     

阿托伐他丁对2型糖尿病颈内动脉内-中膜增厚的干预研究

目的观察阿托伐他丁对2型糖尿病颈内动脉内-中膜增厚的影响,探讨阿托伐他丁在2型糖尿病治疗中的作用。方法从收治的2型糖尿病患者中选取颈动脉轻中度增厚的120例,随机分为阿托伐他汀治疗组和对照组,每组60例。对照组在控制饮食、健康锻炼的基础上予以降血糖治疗,治疗组在对照组的基础上给予口服阿托伐他汀治疗。结果经过严格治疗6个月后,治疗组患者颈内-中膜的厚度较治疗前显著降低,差异有统计学意义（P〈0.05）。对照组患者颈内-中膜的厚度较治疗前无明显变化,差异无统计学意义（P〉0.05）。结论阿托伐他丁对2型糖尿病颈内动脉内-中膜增厚的干预效果明显,能降低颈内动脉内-中膜厚度,稳定并逆转粥样斑块,具有良好的临床价值。     

Dynamics of primary hemostasis activity in patients with arterial hypertension and metabolic syndrome treated with candesartan

The aim of the study was to elucidate normalizing effect of candesartan on disturbed thrombocytic hemostasis in patients with arterial hypertension and metabolic syndrome. The drug was given for 16 weeks to 31 patients in whom dynamics of lipid peroxidation in plasma and platelets, the antioxidative potential of candesartan, and parameters of thrombocytic hemostasis were assessed. Treatment with candesartan improved lipid peroxidation and primary hemostasis. It is expected that continuation of therapy following this scheme can stabilize the obtained effect.