福辛普利治疗原发性高血压46例临床疗效观察

目的:观察福辛普利治疗原发性高血压临床疗效。方法:原发性高血压(轻、中度)46例服用福辛普利10mg/天,观察4周。服药2周降压不明显者,加服吲哒帕胺2.5mg/天。同期选择原发性高血压患者24例服用苯那普利10mg/天,作为对照组。结果:福辛普利组在治疗前、治疗第2周后、治疗第4周后的收缩压分别是(187±16)mmHg、(171±14)mmHg和(159±13)mmHg,舒张压分别是(95.2±5.1)mmHg、(90.6±4.9)mmHg和(84.3±6.3)mmHg;苯那普利组在治疗前、治疗第2周后、治疗第4周后的收缩压分别是(184±20)mmHg、(170±16)mmHg和(159±14)mmHg,舒张压分别是(93.9±7.2)mmHg、(89.2±5.9)mmHg和(83.4±4.8)mmHg,两组的收缩压和舒张压在治疗前后无统计学差异(P<0.05)。结论:轻、中度高血压患者,福辛普利是一安全的降压药物,与其他ACEI类制剂比较,可减少咳嗽的发生。     

非洛地平缓释片治疗肾性高血压的临床疗效及对生活质量的改善作用

目的探讨钙离子拮抗剂非洛地平缓释片治疗肾性高血压的临床疗效及对生活质量的影响。方法将100例肾性高血压患者随机分为2组,每组50例。对照组给予福辛普利钠片,观察组给予非洛地平缓释片。比较2组患者总体疗效,血压、尿蛋白、血肌酐、生活质量的改善以及不良反应发生率。结果观察组总有效率显著高于对照组;2组患者治疗后血压、尿蛋白及血肌酐水平均较治疗前显著改善,而观察组尿蛋白水平的改善幅度显著大于对照组;观察组生活质量核心问卷-30(QLQC-30)各项评分均显著高于对照组。观察组不良反应发生率有低于对照组的趋势,但差异无统计学意义。结论钙离子拮抗剂非洛地平缓释片治疗肾性高血压疗效显著,可明显提高患者治疗后生活质量,应在临床上加以推广应用。     

福辛普利联合缬沙坦治疗40例高血压的临床疗效分析

目的分析福辛普利联合缬沙坦ARB治疗高血压的临床疗效。方法120例原发性高血压患者随机分为研究组、对照组1、对照组2,每组40例。对照组1单独采用缬沙坦治疗,对照组2单独采用福辛普利治疗,研究组则联合应用缬沙坦与福辛普利治疗。结果三组治疗前的SBP、DBP均不存在统计学差异（P〉0.5）,治疗后研究组的SBP与DBP改善均显著优于对照组1和对照组2,有显著性统计学差异（P〈0．01）,对照组之间无统计学差异。研究组总有效率为85o％,高于对照组的725％与70．0％,有统计学差异（P〈0．05）,对照组之间的疗效无统计学差异（P〉0．05）。结论AKB与福辛普利联合治疗高血压具有良好的协同效应与安全性,     

Adverse drug reaction monitoring with angiotensin converting enzyme inhibitors: A prospective, randomized, open-label, comparative study

Objectives:

Angiotensin converting enzyme inhibitors (ACEIs) are known to possess different chemical structures, and change in structure of a drug can bring about change in its adverse drug reaction (ADR) profile. The study aims to observe the incidence and severity of ADRs between the di-carboxyl group containing ACEIs (d-ACEIs) versus phosphonate group containing ACEIs (p-ACEIs), in patients suffering from essential hypertension.

Materials and Methods:

One hundred and twenty patients with essential hypertension were randomized into four groups receiving enalapril, lisinopril, ramipril, and fosinopril. They were followed up for four months, to observe the clinical efficacy along with the associated ADRs.

Results:

Mild, dry brassy cough (% incidence; 95% CI) was observed with d-ACEIs (6.6%; 0 to 15.6) versus p-ACEI (20%; 5.7 to 34.3), in which the cough observed was moderate-to-severe in intensity and two patients required treatment discontinuation (P < 0.05). No cases of hypotension were observed with the use of d-ACEIs, whereas, two patients on p-ACEI (6.6%; 0 to15.6) had hypotension (P < 0.05). Three patients (10%; 0 to 20.7) on d-ACEIs had nausea, which was not observed with p-ACEI treatment (0%) (P < 0.05).

Conclusions:

The phosphonate group in p-ACEIs may have a probable relationship with increase in the incidence and severity of ADRs such as dry brassy cough and hypotension. The di-carboxyl group in d-ACEIs may have a probable relationship with increase in the incidence of ADRs like nausea.     

FOSIDIAL: a randomised placebo controlled trial of the effects of fosinopril on cardiovascular morbidity and mortality in haemodialysis patients. Study design and patients' baseline characteristics

The prevalence of end stage renal disease (ESRD) is growing in western countries. Patients with ESRD are more frequently elderly and diabetic and are exposed to very high cardiovascular morbidity and mortality. The main aim of the FOSIDIAL study is to assess the efficacy and safety of fosinopril, an angiotensin converting enzyme (ACE) inhibitor, in reducing the mortality and cardiovascular events in haemodialysis patients presenting with left ventricular hypertrophy. A total number of 397 patients are included in the study. They are aged 50-80 years (average 66.7 years) and have been undergoing haemodialysis for 4.8 years. All have left ventricular hypertrophy with cardiac mass index > 100 g/m2 in women and > 130 g/m2 in men, measured within 3 months prior to inclusion. Baseline cardiac mass index is 174 g/m2. After a 2 week placebo period, the patients are randomised into two groups receiving either fosinopril 5-20 mg/day, or a placebo for a duration of 24 months. The target dose is reached at the sixth, seventh or eighth week of treatment. Depending on tolerance, 300 patients reached the maximum recommended dose. Patients are subsequently assessed clinically every 3 months until the end of the study. The primary outcome is a composite endpoint of fatal and nonfatal major cardiovascular events. Secondary endpoints are individual cardiovascular events, event-free survival, overall mortality and all-cause hospitalisations. The trial began in October 1998. All patients were included by December 2000 and follow-up is ongoing. The last visit for the last patient is scheduled for 30 December 2002. We report here on the study design and the baseline characteristics of the study population.     

灯盏花素对高血压大鼠血小板游离钙浓度和聚集率及心脏重塑的影响

目的:研究灯盏花素、福辛普利、依那普利对自发性高血压大鼠(SHR)血小板游离钙浓度、血小板聚集率和心脏重塑的影响.方法:24只10月龄伴有左心室肥厚(LVH)的SHR 随机分为灯盏花素组、福辛普利组、依那普利组和生理氯化钠溶液组(NS组)4组进行为期8周的干预治疗,观察其对SHR收缩压、心率、左心室肥厚指数、心肌细胞超微结构、血小板胞浆游离钙和血小板聚集率的影响.结果:6只SHR的收缩压、左心室肥厚指数、血小板胞浆游离钙浓度和血小板聚集率均显著高于同龄Wistar Kyoto (WKY)大鼠(P均＜0.01).可见心肌细胞肥大、心肌肌浆网扩张和心肌线粒体增生等超微结构改变.血小板胞浆游离钙浓度和血小板聚集率与左心室肥厚指数呈显著正相关(P均＜0.01).与NS组比较,3药均能显著降低左心室肥厚指数、血小板胞浆游离钙浓度和血小板聚集率(P均＜0.01),并改善SHR的心肌细胞超微结构;福辛普利和依那普利还能显著降低SHR的收缩压(P均＜0.01).结论:血小板内钙代谢异常和血小板功能改变可能在SHR心脏重塑中起重要作用.灯盏花素、福辛普利和依那普利均能显著降低SHR的血小板胞浆游离钙浓度和血小板聚集率,从而改善SHR心脏重塑.     

福辛普利对去窦弓神经大鼠器官损伤的保护作用

目的研究血压波动性在福辛普利治疗去窦弓神经大鼠器官保护中的重要作用。方法在去窦弓神经(SAD)大鼠饲料中给予福辛普利15 mg·kg^-1·d^-1（根据体重和每日消耗的饲料总量计算，每周调整1次），16周后在清醒状态下记录24　h血压波动性，用光镜和计算机图象分析技术观察心脏、肾脏和胸主动脉的组织病理学改变。结果与SAD大鼠相比，福辛普利治疗组大鼠的血压波动性明显降低，左心室壁厚、肾小球硬化积分、心肌胶原容积分数与血压波动性呈正相关，福辛普利可明显减轻去窦弓神经大鼠引起的器官损伤。结论福辛普利长期治疗可有效减轻去窦弓神经大鼠的器官损伤。降低血压波动性在福辛普利的器官保护中可能具有重要的作用。     

慢性心力衰竭患者血浆细胞因子的变化及福辛普利和美托洛尔的干预作用

目的：探讨单独或联合应用美托洛尔和福辛普利对心衰患者血浆中细胞因子的影响。方法：将80例心力衰竭患者随机分为福辛普利组（n=26）、美托洛尔组（n=27）和联合用药组（n=27）。分别在人院和治疗12个月时检测肿瘤坏死因子α（TNF-α）、白细胞介素1β和白细胞介素6、心功能分级和心脏超声。结果：治疗12个月后除福辛普利组TNF—α无明显变化外，其余组均有降低。福辛普利组与美托洛尔组各项指标间无明显差异．而联合用药组相对于另外两组比较血浆3种细胞因子水平均显著降低（均P〈0．01）。3组心功能分级、左室射血分数和左心室舒张末期内径均显著改善（P〈0．01。P〈0．05，P〈0．01）。福辛普利组和美托洛尔组之间无明显差异，联合用药组较另两组改善更明显（P〈0．05）。结论：福辛普利和美托洛尔能改善心衰患者血浆细胞因子水平及改善心力衰竭患者心脏功能。逆转左室重构，合用时效果更好。     

福辛普利治疗慢性肾脏疾病

目的观察肾素血管紧张素转换酶抑制剂(ACEI)———福辛普利在治疗小儿慢性肾脏疾病中的作用、不良反应,探讨其合理使用。方法选取使用福辛普利治疗并有完整随访资料的慢性肾脏疾病患儿58例,记录一般情况,包括使用剂量、疗程、适用范围;评价福辛普利作用及不良反应。结果福辛普利降低高血压、减少蛋白尿、保护肾功能作用显著,在肾功能明显减退前用福辛普利能更好地保护肾功能;小儿中少见高钾血症、干咳、血管神经性水肿等不良反应发生。结论福辛普利是一种安全有效的延缓小儿慢性肾脏疾病进展的药物。     

美托洛尔联合福辛普利对急性ST段抬高型心肌梗死患者心功能的影响

目的研究分析美托洛尔联合福辛普利对急性ST段抬高型心肌梗死患者心功能的影响。方法选取2015年1月—2016年8月本院收治的122例急性ST段抬高型心肌梗死患者作为研究对象,将所有患者按照随机数字表法分为2组各61例。对照组患者给予常规治疗,观察组在对照组治疗的基础上采用美托洛尔联合福辛普利治疗,对比两组临床疗效、治疗前后心功能指标变化、主要心脏不良事件发生率。结果对照组患者临床有效率为67.21%,低于观察组95.08%,差异有统计学意义(P0.05);治疗后,对照组患者左心室舒张末期内径及左心室收缩末期内径均大于观察组,左心室射血分数小于观察组,差异有统计学意义(P0.05);2组患者心力衰竭、心律失常、非致命性再梗死、梗死后心绞痛发生率比较,差异无统计学意义(P0.05)。结论对于急性ST段抬高型心肌梗死患者,采用美托洛尔联合福辛普利治疗可较好的恢复患者心功能水平,具有较高的安全性,。