应激状态下应用缓释维拉帕米及合用西拉普利的有益作用

目的 :探讨应激状态下缓释维拉帕米 (VerSR)及合用西拉普利 (Cil)的有益作用。方法 :5 4例原发性高血压病人 ,随机分为 3组 :VerSR组 19例(VerSR 2 4 0～ 36 0mg ,po ,qd) ,Cil组 14例 (Cil 2 .5～ 5mg ,po ,qd) ,VerSR +Cil组 2 1例 (VerSR 12 0～ 2 4 0mg ,po ,qd +Cil 2 .5～ 5mg ,po ,qd)。 (1)随访服药后 1,2和 4wk后坐位血压 (BP)及心率(HR) ;(2 )服药前及服药后 4wk做心算、冷压、握掌试验及运动激发试验 ,观察BP ,HR及血浆去甲肾上腺素 (NE) ,肾上腺素 (E) ,多巴胺 (DA)的变化。结果 :(1)VerSR组总有效率 93% ,Cil组总有效率77% ,VerSR +Cil组总有效率 10 0 % (P >0 .0 5 ) ;(2 )VerSR能明显降低心算试验后的BP(1.7± 0 .9/1.3± 0 .7)kPa(P <0 .0 1)、冷压试验后的BP(2 .5±1.4 /1.2± 0 .9)kPa(P <0 .0 1)及握掌试验后的收缩压 (SBP) (1.6± 1.4 )kPa(P <0 .0 1) ;Cil仅能降低握掌试验后的SBP ,(1.1± 1.4 )kPa(P <0 .0 5 ) ;VerSR +Cil则明显降低心算试验后的BP(3.0± 2 .9/2 .1± 1.1)kPa(P <0 .0 1)和HR(10± 9)次·min- 1(P <0 .0 1)、握掌试验后BP(1.8± 1.6 /1.8± 0 .9)kPa(P <0 .0 1)和HR(6± 7)次·min- 1(P <0 .0 5 )及冷压试验后的SBP(1.9± 1.8)kPa(P <0 .0 1)。Cil对运动激发试?

Beneficial effects of therapies with verapamil sustained release alone and combined with cilazapril in state of stress

AIM:To discuss the beneficial effects of the therapies with verapamil sustained release( Ver SR) alone and combined with cilazapril(Cil) in hypertensive patients in the state of stress. METHODS: Fifty four hypertensive patients(M 43, F 11; age (46± s 9) a were divided into three groups: Ver SR group ninteen patients( Ver SR 240 360 mg, po , qd), Cil group 14 patients(Cil 2.5 5 mg, po , qd), Ver SR+Cil group twenty one patients( Ver SR 120 240 mg, po , qd+Cil 2.5 5 mg, po , qd).(1)To compare the variances of sitting blood pressures and heart rates after 1 wk, 2 wk and 4 wk treatment in these patients. (2)To observe the variances of blood pressures(BP) and heart rates(HR), serum noradrenaline (NE), epinephrin (E) and dopamine (DA) in the stress tests such as mental arithmetic test, cold pressure test, hand grip test and the exercise stimulate test before and after 4 wk treatment in these patients. RESULTS: (1)After 4 wk treatment the total effective rates of Ver SR group, Cil group and Ver SR+ Cil group were 93 %, 77 % and 100 %, respectively( P >0.05). (2)Ver SR could reduce the SBP/DBP((1.7±0.9/1.3±0.7)kPa, P <0.01)in the mental arithmetic test, the SBP/DBP((2.5± 1.4 /1.2±0.9)kPa, P <0.01) in the cold pressure test and the SBP((1.6±1.4)kPa, P < 0.01) in the hand grip test; Cil could only reduce the SBP ((1.1±1.4) kPa , P <0.05)in the hand grip test; Ver SR+Cil could reduce the SBP/DBP (( 3.0 ±2.9/ 2.1 ±1.1)kPa, P <0.01) and the HR ((10±9) beat·min -1 , P <0.01) in the mental arithmetic test, the SBP/DBP((1.8±1.6/ 1.8 ±0.9)kPa, P <0.01)and the HR ((6±7) beat·min -1 , P <0.05)in the hand grip test and the SBP(1.9±1.8) kPa, P <0.01)in the cold pressure test. There was no significant difference in BP and HR after 4 wk treatment with Cil in the exercise stimulate test; Ver SR could reduce the HR ((6±8) beat·min -1 , P <0.05)and the concentration of serum noradrenaline ((0.4±0.6 )ln -1 ng·L -1 , P <0.05); Ver SR+Cil could reduce the HR((8±12 )beat·min -1 , P <0.05)and the SBP((1.6±1.4)kPa, P <0.01)in the exercise stimulate test. CONCLUSION:Ver SR can reduce the BP in the state of both rest and stress apparently, If combined with ACEI, it may do better effect to lower the BP.