苯磺酸左旋氨氯地平在治疗老年轻中度高血压中的作用

目的：观察探讨苯磺酸左旋氨氯地平治疗老年轻中度高血压患者的临床疗效和安全性。方法：160例老年轻中度高血压患者随机分为研究组与对照组,研究组给予苯磺酸左旋氨氯地平;对照组给予苯磺酸氨氯地平,治疗过程中进行24h血压监测,总治疗8周为一疗程。结果：研究组4周末和8周末的总有效率分别为78.75%和96.25%,显著高于对照组的53.75%和86.25%,差异有统计学意义（P〈0.05）。治疗前后两组的舒张压和收缩压均有明显降低,其中研究组收缩压平均下降（29.0±3.2）mmHg,舒张压平均下降（15.3±2.3）mmHg,对照组则分别下降（18.5±2.8）mmHg和（9.0±2.5）mmHg,差异具有统计学意义（P〈0.05）。治疗8周末的24h、白昼和夜间的收缩压和舒张压均有明显降低,差异有统计学意义（P〈0.05）,但治疗组下降更明显,与对照组比较差异有统计学意义（P〈0.05）。治疗后两组的脉压均有明显降低,差异具有统计学意义（P〈0.05）,但研究组下降更明显。结论：苯磺酸左旋氨氯地平治疗老年轻中度高血压临床疗效好,不良反应少,且对心脏具有保护功能。     

缬沙坦联合苯磺酸左旋氨氯地平治疗201例高危高血压患者的疗效评价

目的探讨缬沙坦联合苯磺酸左旋氨氯地平治疗高危高血压患者的临床疗效。方法选择常州市新北区春江人民医院2014年6月至2016年6月收治的201例高危高血压患者,随机分为治疗组(n=101)和对照组(n=100)。对照组采用苯磺酸左旋氨氯地平治疗,治疗组在对照组的基础上联合缬沙坦治疗。观察比较两组收缩压和舒张压水平、血钾和血肌酐浓度、SF-36评分及不良反应发生情况。结果治疗后,两组收缩压和舒张压水平均显著降低(P0.05),且观察组低于对照组(P0.05);治疗后4周,观察组收缩压和舒张压水平亦均显著低于对照组(P0.05)。治疗后,两组血K+浓度、血肌酐浓度均显著降低(P0.05),且观察组低于对照组(P0.05);治疗后4周,观察组血K+浓度和对照组无差异(P0.05),血肌酐浓度亦低于对照组(P0.05)。两组SF-36评分均显著升高(P0.05),且观察组显著高于对照组(P0.05)。观察组不良反应率为5.94%,对照组为8.00%,两组比较无统计学意义(χ~2=1.612,P=0.880)。结论缬沙坦联合苯磺酸左旋氨氯地平治疗高危高血压临床疗效显著,安全性高,可以有效改善患者生活质量,值得推广应用。     

苯磺酸左旋氨氯地平片联合厄贝沙坦对老年难治性高血压的临床疗效

目的:探讨苯磺酸左旋氨氯地平片与厄贝沙坦的联合应用对老年难治性高血压患者临床疗效的影响及其可能机制。方法:选取我院确诊并治疗的老年难治性高血压患者72例作受试者,按随机数字表法分为两组,对照组36例予以利尿药联合厄贝沙坦进行血压调控,治疗组36例在对照组基础上予联合苯磺酸左旋氨氯地平片2.5 mg日一次进行治疗。观察两组患者的临床疗效,监控患者血压情况,比较治疗前后患者血清同型半胱氨酸(Hcy)、TNF-α及IL-6水平的变化。结果:对照组总有效率低于治疗组(P0.05);与对照组比较,治疗组患者血压控制情况较好,治疗后血清Hcy、TNF-α及IL-6水平降低,差异具有统计学意义(P0.05)。结论:苯磺酸左旋氨氯地平片与厄贝沙坦的联合应用可有效控制老年难治性高血压患者的血压、尽早恢复患者血压稳定,可能与其降低血清Hcy、TNF-α、IL-6的水平有关。     

左旋氨氯地平联合心理干预治疗高血压伴更年期综合征患者的疗效观察

目的:探讨左旋氨氯地平联合心理干预治疗高血压伴更年期综合征的疗效;方法:将100例高血压伴更年期综合征患者随机分为两组,对照组给予左旋氨氯地平+常规更年期综合征治疗,联合组给予左旋氨氯地平+心理干预+常规更年期综合征治疗,采用汉密尔顿焦虑量表(HAMA)和抑郁量表(HAMD)评分评估患者主要症状改善情况,对比两组临床疗效及卵巢功能。结果:治疗1个月后,两组患者血压均降低,联合组降压总有效率为92.0%,优于对照组的52.0%,比较有显著性差异(P0.05);与对照组相比,联合组血清促卵泡成熟激素(FSH)和促黄体生成素(LH)下降明显,雌激素(E2)水平显著上升,两组比较有显著性差异(P0.01);联合组症状积分改善较为显著,明显优于对照组(P0.01)。结论:左旋氨氯地平联合心理干预对治疗高血压伴更年期综合征具有显著的疗效,可有效降低患者血压,改善负性情绪。     

左旋氨氯地平联合综合性心理干预治疗高血压伴围绝经综合征患者的临床观察

目的:探讨左旋氨氯地平联合综合性心理干预治疗高血压伴围绝经综合征患者的临床治疗效果,为临床治疗提供参考。方法:按照随机数字表法将2014年7月-2015年7月三峡大学仁和医院收治的113例高血压伴围绝经综合征患者分为两组,观察组(n=57例)采用左旋氨氯地平联合综合性心理干预,对照组(n=56例)仅予以左旋氨氯地平治疗。治疗1个月后,采用汉密尔顿焦虑量表(HAMA)和抑郁量表(HAMD)评分对两组患者的主要症状改善进行评估,测量两组治疗前后卵巢功能指标促黄体生成素(Luteinizing hormone,LH)、血清促卵泡成熟激素(Follicle stimulating hormone,FSH)以及雌激素(Estrogen,E2),并比较两组患者治疗后的临床疗效。结果:两组患者治疗后的LH、FSH以及E2水平均较治疗前明显改善,且观察组改善的幅度明显优于对照组,差异有统计学意义(P0.05)。两组治疗后的HAMA、HAMD评分均较治疗前降低,且观察组降低的幅度明显优于对照组,差异有统计学意义(P0.05)。观察组治疗后的临床疗效优于对照组,差异有统计学意义(P0.05)。结论:左旋氨氯地平联合综合性心理干预可明显改善患者的负性情绪和提高临床治疗效果,有较高的临床推广价值。     

苯磺酸左旋氨氯地平片联合脂必泰治疗糖尿病合并冠心病痰瘀交阻证的临床疗效观察

摘要目的：观察苯磺酸左旋氨氯地平片联合脂必泰胶囊治疗糖尿病合并冠心病痰瘀交阻证的临床疗效。方法：120例糖尿病性冠心病痰瘀交阻证患者随机分为两组,均给与注射胰岛素控制血糖。对照组（n=60）给与阿托伐他汀10mg,每日1次口服。治疗组（n=60）给与苯磺酸左旋氨氯地平片5mg,每天1次口服;脂必泰胶囊1粒,每天2次口服。两组均治疗3个月。分析比较治疗前后空腹血糖（FBG）、总胆固醇（TC）等指标,心电图（ECG）,并记录中医症状积分。结果：治疗组总有效率86．67％,对照组总有效率51．67％,两组相比较,差异有显著性（P〈0．01）。两组空腹血糖（VBO）、糖化血红蛋白（HbAlc）、甘油三酯（TO）等指标治疗后与治疗前比较,差异有统计学意义（P〈0．05或P〈0．01）。治疗后治疗组总胆固醇（TC）、高密度脂蛋白（HDL．C）与对照组相比较,变化显著（P〈0．05）。治疗组中医症状积分下降较对照组明显（P〈O．05或P〈0．01）。结论：苯磺酸左旋氨氯地平片联合脂必泰胶囊治疗糖尿病性冠心病痰瘀交阻证疗效确切。     

左旋氨氯地平联合氯沙坦治疗2 型糖尿病肾病合并高血压的疗效及对血 压和肾功能的影响*

目的:探讨左旋氨氯地平联合氯沙坦治疗2型糖尿病肾病(T2DN)合并高血压的疗效及对血压和肾功能的影响。方法:采用随机数字表法将2010年1月至2013年1月本院门诊及住院部收治的260例T2DN合并高血压患者分为实验组和对照组,每组患者130例,实验组给予左旋氨氯地平和氯沙坦口服联合治疗,对照组仅给予左旋氨氯地平口服治疗,对比两组疗效,并观察两组治疗前后的收缩压(SBP)和舒张压(DBP)、血肌酐(Scr)水平、尿微量白蛋白(UMALB)/尿肌酐(Ucr)水平和24 h UMALB水平。结果:实验组的总有效率90.77%显著高于对照组的78.46%(P0.05);治疗后两组SBP、DBP、脉压差、SCr、UMALB/Ucr及24h UMALB水平均有显著下降(P0.05),且实验组均显著低于对照组(P0.05)。结论:左旋氨氯地平联合氯沙坦不仅可有效降低T2DN合并高血压患者血压,还可有效减少尿液中蛋白的排放,保护患者的肾脏功能,疗效显著,值得推广。     

氨氯地平联合美托洛尔治疗原发性高血压的临床疗效观察

目的：观察氨氯地平联合美托洛尔治疗高血压的临床效果及安全性。方法：对2012年4月至2012年11月期间在我科住院治疗的102例患者随机分成两组,对照组接受氨氯地平治疗,治疗组在对照组的基础上使用美托洛尔治疗,分析比较两组的疗效。结果：治疗组和对照组的血压以及心率较治疗前明显降低,差异有统计学意义（P〈0．01）;治疗组治疗后的舒张压与对照组治疗后的舒张压相比,差异有统计学意思（P〈0．01）;治疗组的总有效率高于对照组（P〈0．05）;治疗组的副反应低于对照组（P〈0．05）。结论：氨氯地平联合美托洛尔治疗高血压效果显著,优于单纯应用氨氯地平。     

氨氯地平与依那普利在高血压合并冠心病患者中的联合应用

目的:评价固定药物组合的疗效和耐受性:在舒张压≤85mmHg情况下,氨氯地平+依那普利组与氨氯地平组在高血压合并冠心痛患者的应用比较.方法:双盲,随机研究,入选患者为舒张压在≥90和<110mmHg之间同时具有冠状动脉疾病.将患者随即分成两组,A组采取联合用药治疗,B组单用氨氯地平治疗,疗程12周.结果:在80名入选怠者中,两组患者治疗前后的舒张压(DAP)和收缩压(SAP)下降有显著差异,(p<0.01);但是,组间比较没有统计学差异.在12周中,A组患者比B组患者下肢水肿发病率低.结论:联合用药与单用氨氯地平一样,对于高血压合并冠心痛患者和心绞痛(SAH)Ⅰ、Ⅱ级的患者有效.另外,联合应用依那普利和氨氯地平可阻滞肾素血管紧张素系统的作用,减少下肢水肿的发生.     

贝那普利联合氨氯地平治疗原发性高血压的临床研究

目的：探讨贝那普利联合氨氯地平治疗原发性高血压的降压效果。方法：将152例原发性高血压患者随机分为两组,治疗组（n=76）采用贝那普利＋氨氯地平进行治疗,对照组（n=76）采用贝那普利进行治疗,疗程8周,在治疗前、治疗后4周和8周进行24h动态血压监测（ABPM）,分别记录24h平均血压、白天及夜间平均血压、心率等指标,分析并比较临床疗效。结果：两组患者治疗前后24h平均血压、白天及夜间平均血压明显低于治疗前,差异具有显著性意义（P〈0．05）;治疗组和对照组总有效率分别为97．4％和80-3％,差异均具有显著性意义（P〈0．01）。结论：应用贝那普利＋氨氯地平对原发性高血压进行治疗,其降压效果明显,有效控制血压降低,不良反应少,是理想的联合降压方法,值得临床推荐。     

Effect of tryptophan and 5-hydroxytryptophan on the blood pressure of patients with mild to moderate hypertension

Summary Chronic treatment with L-tryptophan (4 g/day) reduced mean blood pressure in 8 of 9 patients with mild to moderate essential hypertension. No significant side effects of treatment were observed. An additional group of 8 patients was treated chronically with L-5-hydroxytryptophan (800 mg/day), the immediate precursor of serotonin. Five of the 8 patients had a significant reduction in mean arterial pressure. No significant side effects of treatment were observed. The reduction of blood pressure accompanying treatment with L-5-hydroxytryptophan suggests that at least a portion of the antihypertensive effect of L-tryptophan is mediated via serotonin.     

12周太极拳运动对中老年轻度高血压患者微血管反应性的影响及机制*

目的:研究12周太极拳运动对中老年轻度高血压患者微血管反应性的影响,并探讨微血管反应性变化的机制。方法:将30名轻度高血压患者分为运动组(53.8±6.3岁)和对照组(52.6±7.5岁),两组人数及性别比例相同。运动组进行12周的太极拳运动,对照组保持原先的生活方式且不做其它规律性的体育运动。两组受试者分别于运动干预前、第6周和第12周结束后进行微血管反应性、血压及血清一氧化氮含量 、一氧化氮合酶活性测试。结果:试验前,两组受试者各指标的基础值均无显著差异(P＞0.05)。运动组,第6周微血管反应性、收缩压、舒张压、一氧化氮含量、一氧化氮合酶活性较基础值无显著变化(P＞0.05),第12周微血管反应性、一氧化氮含量和钙依赖型一氧化氮合酶活性较基础值及对照组显著升高(P＜0.05),收缩压和舒张压较基础值和对照组显著下降(P＜0.05)。对照组,第6周、第12周各指标较基础值均无显著变化(P＞0.05)。结论:12周太极拳运动能提高中老年轻度高血压患者微血管反应性、降低血压,并能提高患者一氧化氮含量、钙依赖型一氧化氮合酶活性,内源性一氧化氮生成增加是太极拳运动提高高血压患者微血管反应性的生物学机制之一。     

老年男性原发性高血压患者脉压与颈动脉狭窄的相关分析

目的：探讨老年男性原发性高血压（EH）患者脉压（PP）与动脉粥样硬化性颈动脉狭窄（CS）的关系。方法：对入选的157例伴有颈动脉粥样硬化的老年男性EH患者行颈动脉超声检查,并收集行颈动脉超声检查前1年内的多次血压水平及临床资料,根据颈动脉狭窄程度分为：CS〈50％组（n=66）及CS≥50％组（n=91）,并进一步将颈动脉狭窄程度分级（I—V级）,分析颈动脉狭窄的危险因素及与脉压的相关性。结果：①CS≥50％组收缩压（SBP）及PP显著高于CS〈50％组,而舒张压（DBP）显著低于CS〈50％组（P〈0．05）,CS≥50％组的独立危险因素是外周动脉疾病（OR：4．543,95％CI：1．415．14．590）及脉压（OR：1．096,95％CI：1．038．1．157）;②CS分级与PP（r=0．402,P〈0．01）及血浆纤维蛋白原（FIB）（r=0．200,P〈0．05）呈正相关,经校正年龄、体重指数（BMI）、SBP、DBP、总胆固醇（TO）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、D-二聚体（D-dimer）、血尿酸（UA）、空腹血糖（FBG）、氨基酸末端脑利钠肽前体（NT-proBNP）、总胆红素（TBIL）及直接胆红素（DBIL）等危险因素后,CS分级仍与PP及FIB有关。结论：老年男性原发性高血压患者脉压与颈动脉狭窄有关,治疗高血压的同时应当尽量减小脉压。     

高龄老年男性高血压患者腔隙性脑梗死与血清尿酸水平的相关性研究

目的：探讨男性高龄高血压患者腔隙性脑梗死（LI）与血清尿酸水平的相关性。方法：以98例男性高龄高血压患者为对象,均行颅脑磁共振成像（MRI）检查和血清尿酸水平测定,同时收集患者的临床和其他实验室数据。根据患者尿酸水平分为1、2、3三组（n=32、32、34）。结果：以尿酸水平分组的患者一般资料比较,单因素方差分析提示,随着尿酸水平的增高,三组的LI个数、血肌酐、尿素水平增高,而高密度脂蛋白（HDL）水平降低,差异有统计学意义（P〈0.05）。三组患者的24 h收缩压、舒张压、年龄、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）和空腹血糖比较,差异无统计学意义（P〉0.05）;LI个数与影响因素的Spearman相关分析提示尿酸及尿素水平与腔梗个数相关（P〈0.05）;LI个数与影响因素的多元线性回归分析提示血清尿酸水平是影响LI个数的独立危险因素（P〈0.01）。结论：在高龄高血压患者中,尿酸水平的增高可能是LI的危险因素之一。     

Effects of essential fatty acids on mild to moderate essential hypertension

A double-blind placebo-controlled study with a crossover design was conducted on 25 non-obese black patients with mild-moderate uncomplicated essential hypertension. They were randomly assigned into two groups. After having received placebo capsules for 4 weeks, they received dietary supplementation with either Efamol-marine (containing desaturated n-6 and n3 essential fatty acids), or sunflower seed and linseed oil capsules for 12 weeks. Thereafter a second 4 weeks placebo phase and a subsequent second 12-week active phase were entered into during which a crossover of the dietary supplementation of the groups was brought about. The mean systolic blood pressure of patients receiving Efamol-marine was significantly lowered after 8 and 12 weeks, while those receiving sunflower/linseed oil supplementation had no significant reduction of blood pressure. This observation may indicate that defective desaturation of the essential fatty acids by the enzyme delta-6-desaturase, could play an important role in the etiology of essential hypertension.     

First derivative synchronous spectrofluorimetric method for the simultaneous determination of propofol and cisatracurium besylate in biological fluids

Propofol and cisatracurium besylate have been simultaneously determined using a highly sensitive first derivative synchronous spectrofluorometric method. The method is based on measuring first derivative synchronous spectrofluorimetric amplitude at Δλ = 40 nm with a scanning rate of 600 nm/min. The different experimental parameters affecting the fluorescence intensity of the two drugs were carefully studied and optimized. The amplitude–concentration plots were rectilinear over the range 40.0–400.0 ng/mL and 20.0–280.0 ng/mL for propofol and cisatracurium, respectively with lower detection limits of 4.0 and 2.35 ng/mL and quantification limits of 12.1 and 7.1 ng/mL for propofol and cisatracurium, respectively. The proposed method was successfully applied for the determination of the two compounds in synthetic mixtures and in commercial ampoules. The high sensitivity attained using the proposed method allowed the simultaneous determination of both drugs in spiked plasma samples. The mean % recoveries in spiked human plasma (n = 3) were 96.53 ± 0.90 and 96.20 ± 1.64 for each of propofol and cisatracurium, respectively. The method was validated in compliance with International Council of Harmonization (ICH) Guidelines.     

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels

[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness.[Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed.[Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups.[Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.