The systemic and coronary haemodynamic effects of felodipine in patients with coronary heart disease

The cardiovascular effects of felodipine, a new arteriolar vasodilator,were studied in 22 patients with coronary heart disease. Therewere significant falls in blood pressure and systemic vascularresistance of 16 and 38% respectively (P = 0.001), thus affectingafter-load. Cardiac index and stroke index increased by 35 and12% respectively. There was reflex tachycardia-from 75 ±3to 85 ±3 b.p.m. (P =0.005). Coronary sinus blood /lowincreased from 134±9 to 191 ±17 ml/min (P<0.005)and myocardial arterio- venous oxygen difference narrowed from12.l±0.5 to 9.0±0.4 vols% (P<0.001) indicatingless oxygen usage. With the heart rate held constant by atrialpacing, cardiac index and stroke index increased by 30 and 26%(P<0.001), whilst systolic blood pressure and systemic vascularresistance fell by 20 and 29% (P<0.001). This would suggestthat the improved haemodynamics were largely secondary to after-loadreduction.     

依那普利和非洛地平对原发性高血压患者TGF-β1、Bcl-2浓度的影响及临床意义的探讨

目的研究原发性高血压(EH)患者血清中转化生长因子β1(TGF-β1)、B细胞淋巴瘤/白血病-2(Bcl-2)的浓度在依那普利和非洛地平治疗前后浓度的变化及临床意义。方法采用酶联免疫吸附法(ELISA)测定60例EH患者分别应用依那普利、非洛地平前后血清Bcl-2、TGF-β1浓度,并与30例健康人对照。结果与健康对照组相比,所有EH患者的TGF-β1、Bcl-2浓度均增高(P<0.01),应用降压药物依那普利及非洛地平治疗10d,两者降压作用相似,且均能使TGF-β1和Bcl-2浓度下降,但依那普利使这两种蛋白浓度改变更明显。结论Bcl-2、TGF-β1可能通过介导血管增生、重塑及部分通过凋亡参与原发性高血压发生、发展的病理过程,依那普利可能通过肾素-血管紧张素系统部分介导凋亡,减少TGF-β1、Bcl-2的合成。保持一定的细胞凋亡对维持血管正常结构和功能有重要意义。为进一步阐明高血压病发病机制及治疗提供理论论据。     

非洛地平缓释片对原发性高血压的降压疗效及安全性

目的:观察非洛地平缓释片对Ⅰ～Ⅱ级原发性高血压降压治疗的可靠性、安全性。方法:随机入选就诊的高血压患者60例,停其他降压药2周,测血、尿常规及生化指标,检查眼底、心电图、胸透以了解靶器官受累情况。晨起口服非洛地平缓释片5mg每日一次,共4周,分别记录用药前及用药后1、2、3、4周血压、心率,第4周复查实验室指标。结果:60例患者中显效、有效及总有效率分别为47例(78.33％),5例(8.34％)及52例(86.67％)。服药2周后血压已有显著下降,各时点血压与用药前相比均有下降,统计学具显著性差异(P<0.05)。服药4周后收缩压(SBP)及舒张压(DBP)分别下降(26.11±14.40)mmHg及(18.36±9.47)mmHg。心率治疗前后比较无统计学差异(P<0.05)。结论:非洛地平缓释片对Ⅰ～Ⅱ级原发性高血压降压治疗安全有效。     

非洛地平缓释片对原发性高血压患者动态血压的影响及与细胞内胞浆游离钙浓度的关系

目的 观察非洛地平对高血压患者动态血压的影响及与细胞内胞浆游离钙浓度的关系。方法 检测28例原发性高血压患者及相应对照组之血压及淋巴细胞胞浆游离钙浓度及非洛地平缓释片治疗四周后血压及淋巴细胞胞浆游离钙浓度的变化,并观察其治疗前后24h动态血压的变化。结果 原发性高血压患者淋巴细胞胞浆游离钙浓度显著高于对照组,非洛地平缓释片治疗后淋巴细胞胞浆游离钙浓度和血压显著下降(P<0.01),淋巴细胞胞浆游离钙浓度的下降幅度与收缩压及舒张压下降幅度呈正相关(r=O.866,P<0.001及r=0.734,P<0.001)。治疗后24h平均收缩压、24h平均舒张压、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、日间收缩压负荷、日间舒张压负荷、夜间收缩压负荷、夜间舒张压负荷均较治疗前明显降低(P<0.05-P<0.01)。结论非洛地平是平稳有效的抗高血压药物,其降压作用可能是通过降低细胞内胞浆游离钙浓度而发挥作用。     

非洛地平缓释片治疗慢性心功能不全的临床观察

目的：评价非洛地平治疗慢性心功能不全的疗效与安全性。方法：采用随机对照的方法,将80例慢性心功能不全患者随机分为对照组与治疗组,对照组以洋地黄、利尿剂及血管紧张素转换酶抑制剂等类药物治疗,治疗组在对照组治疗基础上加用非洛地平缓释片2．5～5．0mg/d。比较两组左室射血分数(LVEF)、左室舒张末期内径(LVDd)、尿常规、电解质、肝肾功能、血压、心率等指标。结果：治疗4周后两组心功能均有显著改善,血压、心率、LVDd降低,LVEF升高,治疗前后比较,有显著性差异(P＜0．05)；与对照组相比治疗组收缩压下降,LVEF升高的幅度更显著(P＜0．01)。两组患者在治疗期间尿常规、电解质及肝肾功能均无明显改变。结论：治疗剂量的非洛地平是治疗慢性心功能不全较为理想的药物。     

赖诺普利与非洛地平缓释片联用对高血压伴左室肥厚的逆转作用

目的 :观察赖诺普利与非洛地平联用对原发性高血压 (EH)伴左室肥厚 (LVH)的逆转效果。方法 :将 82例EH伴LVH患者随机分为A组 (单用赖诺普利 ) 4 0例 ,B组 (赖诺普利与非洛地平缓释片联用 ) 4 2例。观察两组治疗前后及两组间血压及LVH指标的变化。结果 :6个月后两组血压均较治疗前明显下降 (P <0 .0 1) ,组间降压幅度差异无显著性意义 (P >0 .0 5 ) ;两组左室重量指数均较治疗前明显降低 (P <0 .0 1) ,B组较A组更明显 (P <0 .0 5 )。结论 :两药联用对LVH逆转有协同作用。     

Once daily felodipine in patients with primary Raynaud's phenomenon

Summary The symptomatic effects of felodipine (Plendil^R) have been assessed in 10 patients with primary Raynaud's phenomenon in a single blind study. After 2 weeks on placebo, the patients were treated for 6 weeks with felodipine, the dose being titrated stepwise every 2 weeks, starting with 5 mg, and increasing to 10 mg and 20 mg once daily if symptoms persisted. After the drug period the patients received placebo for 2 weeks.Objective measurement by cold exposure finger plethysmography did not show any benefit of felodipine in the higher temperature range, taking 33°C as reference point. However, when using 24°C as the reference point, the area under the plethysmography versus temperature curve (AUC) for 5 mg felodipine were significantly larger than the initial placebo area. The AUC during recovery from cold exposure for the maximal accepted dose of felodipine was significantly larger than for the initial placebo period.Subjective judgement by the patients showed a significant reduction in the number of Raynaud attacks and a trend to a shorter duration of attacks with the maximal dose of felodipine. Two patients became free from attacks of Raynaud's phenomenon. Felodipine 10 mg once daily was well tolerated. It was regarded as the optimal dose to treat patients with Raynaud's symptoms.     

坎地沙坦和非洛地平治疗糖尿病肾病（附120例疗效观察）

目的：观察比较坎地沙坦与非洛地平对于糖尿病肾病患者微量白蛋白尿及肾功能的疗效。方法：120例糖尿病肾病患者随机分为坎地沙坦酯治疗组（60例）和非洛地平治疗组（60例）,疗程24周,观察治疗前后血压及肾功能指标的变化。结果：两药均可以降低患者动脉压（均P〈0．01）,且两组间比较无显著性差异（P〉0．05）,但坎地沙坦酯治疗组微量白蛋白尿显著减少（P〈0．001）,而非洛地平治疗组治疗前后比较白蛋白尿无明显变化（P〉0．05）。结论：坎地沙坦酯改善微量蛋白尿作用不依赖于动脉血压的降低,其机制可能与改善肾脏血流量或肾小球通透性有关。     

珍菊降压片与其他一线降压药治疗原发性高血压临床研究

目的：比较珍菊降压片与其他一线降压药小剂量单用及联用对原发性高血压的有效治疗率。方法：原发性高血压466例分别给予珍菊降压片、CCB(非洛地平或硝苯地平）、ACEI（苯那普利或卡托普利）、美托洛尔或吲达帕胺治疗,未达治疗目标者二药、三药乃至四药合用,直至达到目标血压（＜140／90mmHg)为止。结果：珍菊降压片单用的有效治疗率72．8％,高压其他4类一线降压药（46．2％－54．0％）（P＜0．05）;与ACEI与CCB合用可进一步提高有效控制率（92．9％、97．1％）,且耐受性良好。结论：珍菊降压片价廉效好,可作为一线降压药。