贝那普利和氨氯地平对自发性高血压大鼠血压和肠道微生物的影响

目的观察贝那普利和氨氯地平对自发性高血压大鼠(SHR)血压及肠道微生物的影响。方法 18只14周龄雄性SHR随机分为模型组(Mod组,n=6)、贝那普利组[Bph组,盐酸贝那普利灌服0.90 mg/(kg·d),n=6]、氨氯地平组[Aml组,苯磺酸氨氯地平灌服0.45 mg/(kg·d),n=6],另以Wistar-Kyoto(WKY)大鼠作为正常对照组(NC组,n=6), NC组和Mod组每日给予蒸馏水灌胃,干预8周后测定各组大鼠血压,观察结束处死大鼠取空肠粪便,进行16S rDNA V4区扩增子信息采集与分析。结果贝那普利和氨氯地平对SHR具有明显的降压作用,用药后对SHR肠道微生物的门属组成、α多样性、β多样性有一定影响;根据关系热图分析菌群和环境因子血压的关系,拟杆菌属(Bacteroidetes)、厚壁菌属(Firmicutes)和粪球菌属(Coprococcus)与收缩压(SBP)相关,拟杆菌属与平均动脉压(MBP)相关。结论贝那普利和氨氯地平具有明确的降压作用,并对SHR肠道微生物有一定的影响。     

Automated gas chromatographic assay for amlodipine in plasma and gingival crevicular fluid

This paper describes an automated capillary gas chromatographic method for the determination of amlodipine in plasma, and in sub-microlitre volumes of gingival crevicular fluid (GCF), in order to assess if amlodipine is present in GCF under conditions of gingival overgrowth, as has been shown for nifedipine, another dihydropyridine drug. Liquid-liquid extraction followed by derivatisation was employed to isolate amlodipine and render it suitable for gas chromatography. Amlodipine was analysed in plasma and GCF of four patients undergoing amlodipine therapy for cardiovascular disorders, three of whom had significant gingival overgrowth. Amlodipine was detected in the plasma of all patients and in massive concentrations in the GCG of those patients with overgrowth, 23- to 290-fold greater than in their plasma. Like nifedipine, amlodipine sequestration into GCF appears to be linked with gingival overgrowth.     

In vivo receptor binding of benidipine and amlodipine in mesenteric arteries and other tissues of spontaneously hypertensive rats

The present study was undertaken to characterize the in vivo 1,4-dihydropyridine (DHP) receptor binding of long-acting 1,4-DHP calcium channel antagonists in the mesenteric artery and other tissues of SHR. In vivo specific binding of (+)-[3H]PN 200-110 in the SHR mesenteric artery was significantly (36.6-49.7 %) reduced 1-8 h after oral administration of benidipine (1.84 micromol/kg). A greater reduction in (+)-[3H]PN 200-110 binding in the mesenteric artery was observed at a higher dose (5.53 micromol/kg) of this drug. This dose of benidipine also reduced significantly the in vivo specific (+)-[3H]PN 200-110 binding in the aorta but not in the myocardium and cerebral cortex. Following oral administration of amlodipine (17.6 micromol/kg), a significant (51.7-94.2 %) reduction in (+)-[3H]PN 200-110 binding was seen at 1-18 h in the mesenteric artery and at 1-12 h in the aorta. Only a slight reduction in myocardial and cerebral cortical (+)-[3H]PN 200-110 binding was seen following amlodipine administration. In contrast, oral administration of nifedipine (28.9 micromol/kg) reduced markedly in vivo (+)-[3H]PN 200-110 binding in all the tissues of SHR at 1-6 h, and the degree and time-course of the reduction did not differ significantly among the tissues. The area under the curve (AUC) for the receptor occupancy vs time was calculated from the reduction rate (%) of in vivo specific (+)-[3H]PN 200-110 binding. The ratios of the AUCmesenteric artery to AUCaorta or AUCmesenteric artery to AUCmyocardium after oral administration of benidipine and amlodipine were greater than the corresponding value for nifedipine. The degree and time-course of arterial receptor occupancy by benidipine and amlodipine agreed well with those of their hypotensive effects in the conscious SHR. In conclusion, the present study demonstrates that benidipine and amlodipine may occupy, in a more selective and sustained manner, 1,4-DHP receptors in arterial tissues than in other tissues of SHR, and thus, such receptor binding specificity may be responsible for the long-lasting hypotensive effects of these drugs.     

ANP在大鼠高血压进展为心力衰竭中的作用

目的：探讨心房钠尿钛ANP 在高血压心力衰竭发展过程中的变化和氨氯地平保护心肌细胞的作用。方法：对大鼠行腹主动 脉结扎术，术后随机选择40 只大鼠分为氨氯地平（中、高、低剂量）组以及模型组，另外选取10 只健康雄性SD 大鼠作为假手术 组。采用ELISA 方法检测各组血清ANP 浓度变化。结果：随着心功能不全加重，ANP 水平逐渐上升。氨氯地平用药组大鼠的心功 能改善明显优于模型组，ANP 明显降低，且随着氨氯地平用药量上升，心功能不断改善，ANP显著下降，P<0.05。结论：对血清 ANP浓度进行测定能够反映出高血压大鼠模型心室功能不全及充血性心力衰竭严重程度。而氨氯地平能够影响机体的ANP 分 泌对心肌细胞起到保护作用，从而有效抑制心室重构，延缓高血压心力衰竭疾病进展。     

氨氯地平对自发性高血压大鼠血管平滑肌细胞生长的影响

本文采用自发性高血压大鼠（ＳＨＲ）动脉平滑肌细胞培养,３Ｈ－胸腺嘧啶核苷（３Ｈ－ＴｄＲ）和３Ｈ－亮氨酸（３Ｈ－Ｌｅｕｃｉｎｅ）掺入方法,观察到用氨氯地平（Ａｍｌｏｄｉｐｉｎｅ）作用４８小时后,与神经肽Ｙ（ＮＰＹ）组比较,其离体培养的ＳＨＲ动脉平滑肌细胞３Ｈ－ＴｄＲ掺入量降低５０．５％,３Ｈ－Ｌｅｕｃｉｎｅ掺入量降低５６．５％。氨氯地平组与对照组比较其３Ｈ－ＴｄＲ和３Ｈ－Ｌｅｕｃｉｎｅ掺入量分别降低５７．６％和３２．３％。用ＮＰＹ作用２４小时后,与对照组比较动脉平滑肌细胞３Ｈ－ＴｄＲ和３Ｈ－Ｌｅｕｃｉｎｅ掺入量却分别增加２０％和５４．６％。而细胞计数均无显著性差异（Ｐ＞０．０５）。结果表明,氨氯地平能有效地抑制ＳＨＲ血管平滑肌细胞（ＶＳＭＣ）的ＤＮＡ和蛋白质合成,以及显著的抑制ＮＰＹ引起的ＶＳＭＣ的ＤＮＡ合成和蛋白质合成增加效应。提示氨氯地平在阻遏高血压致心血管壁肥厚的发生发展中起着不容忽视的作用     

氨氯地平联合阿托伐他汀钙对高血压合并冠心病的疗效分析

目的:研究氨氯地平联合阿托伐他汀钙对高血压合并冠心病的临床疗效,对该方法的安全性和有效性进行评价。方法:选取80例高血压合并冠心病患者,随机分为两组,即对照组和观察组。对照组患者给予阿托伐他汀钙片,观察组患者给予氨氯地平阿托伐他汀钙片。观察并记录两组患者治疗前后的收缩压、舒张压水平,以及心绞痛发生情况,治疗前后检测患者体内TG、TC、LDL-C及HDL-C表达水平。结果:和对照组患者相比,观察组患者降压作用及心绞痛改善作用均显效率显著提高(P0.05);和治疗前相比,两组患者收缩压、舒张压,以及TG、TC、LDL-C表达水平均显著降低,HDL-C表达水平均显著升高(P0.05);和对照组患者相比,观察组患者治疗后收缩压、舒张压,以及TG、TC、LDL-C表达水平降低更显著,HDL-C表达水平升高更显著(P0.05)。结论:和单独应用阿托伐他汀钙相比,氨氯地平联合阿托伐他汀钙治疗高血压合并冠心病具有更好的的临床疗效,能有效的控制血压及血脂水平。     

阿托伐他汀治疗冠心病合并脑梗死的临床研究

目的:研究阿托伐他汀联合苯磺酸氨氯地平治疗冠心病合并脑梗死的临床效果。方法:从2011年1月到2013年1月,在我院共有96例病患被诊断为冠心病合并脑梗死。以数字法随机分成观察组(48例)和对照组(48例)。对照组每天口服苯磺酸氨氯地平,观察组在对照组的基础上口服阿托伐他汀钙片。对比两组疗效及病患血脂水平。结果:观察组疗效为优者占比62.50%(30/48),优良率为91.67%(44/48),均显著高于对照组的39.58%(19/48),75.00%(36/48),差异均有统计学意义(均P0.05);观察组治疗后TC(4.74±1.20)mmol/L,显著性低于对照组(5.22±1.15)mmol/L,TG(1.06±0.30)mmol/L,显著性低于对照组(1.51±0.28)mmol/L,LDL-C(3.19±0.51)mmol/L,显著性低于对照组(3.87±0.25)mmol/L,上述差异均有统计学意义(P0.05)。结论:阿托伐他汀联合苯磺酸氨氯地平治疗冠心病合并脑梗死,不仅可明显提升治疗效果,还可减少病患的并发症的发生。方便安全,值得临床推荐。     

Pharmacokinetic behaviour of R-(+)- and S-(−)-amlodipine after single enantiomer administration

Amlodipine, 3-ethyl 5-methyl-2-[(2-aminoethoxymethyl]-4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5-pyridinedicarboxylate, is a chiral calcium antagonist, currently on the market and in therapeutic use as a racemate. The pharmacokinetic behaviour of R-(+)- and S-(−)-amlodipine after single enantiomer administration to healthy male human volunteers together with comparative administration of the racemic mixture of both enantiomers were studied. Plasma levels were studied as a function of time and assayed using an enantioselective chromatographic method (coupled chiral and achiral HPLC) with on-line solid-phase extraction and UV absorbance detection. The method was validated separately for the R-(+)- and S-(−)-enantiomer, respectively. Results of the study indicate that the pharmacokinetic behaviour of R-(+)- and S-(−)-amlodipine after single enantiomer administration is comparable to that of each enantiomer after administration of the racemate. No racemization occurs in vivo in human plasma after single enantiomer administration.     

Effects of the calcium channel blocker amlodipine on serum and aortic cholesterol,lipid peroxidation,antioxidant status and aortic histology in cholesterol-fed rabbits

Reactive oxygen metabolites and oxidized fatty acids are proinflammatory and are involved in the pathophysiology of atherosclerosis. Amlodipine, a unique third-generation dihydropyridine-type calcium channel blocker, seems to exert atheroprotective effects through its antioxidant properties related to its chemical structure and independent of its calcium channel-blocking effect. In this study, the interactions of amlodipine with major cellular antioxidants were investigated in order to elucidate the mechanisms underlying its atheroprotective effects. New Zealand white male rabbits were fed regular chow (group 1), chow with 1% cholesterol (group 2), regular chow plus 5 mg/kg/day amlodipine per os (group 3) and 1% cholesterol plus amlodipine (group 4) for 8 weeks. Total cholesterol, malondialdehyde (MDA) and vitamin E concentrations and catalase and superoxide dismutase (SOD) activities were determined in blood drawn before and after the experimental period. Aortic tissue was examined for atherosclerotic changes and aortic total cholesterol, MDA, catalase and SOD were determined. At the end of the 8-week treatment period, serum total cholesterol and plasma MDA were elevated in groups 2 and 4. In group 2, serum vitamin E and plasma SOD diminished (p < 0.05) and catalase increased (p < 0.05). In group 4, SOD activity increased at the end of treatment. MDA levels were lower and plasma SOD activities were higher in group 4 than in group 2. Aortic tissue investigations revealed higher total cholesterol and MDA concentrations and catalase activities in group 2 than in group 4, and the highest tissue SOD activity was recorded in group 4 (p < 0.05 for all comparisons). Morphological examination of aortic tissues exhibited endothelial disarrangement and lipid deposition in group 2. Histopathological alterations related to atherogenesis were less in group 4 than in group 2. Amlodipine seems to exert atheroprotective effects by reducing aortic cholesterol accumulation and blood and aortic lipid peroxidation, enhancing SOD activity both in blood and aortic tissue and suppressing the consumption of vitamin E. On the other hand, the suppression of catalase activity in blood and the aorta interferes with the drug's well-known antioxidant effects.     

氨氯地平联合依那普利治疗原发性高血压的临床疗效及对患者左心室肥厚的影响

摘要目的：探讨氨氯地平联合依那普利治疗原发性高血压的临床效果,观察联合用药对左心室肥厚的影响。方法：选择本院收治的原发性高血压患者92例,随机分为观察组和对照组,各46例,对照组给予苯磺酸左旋氨氯地平5mg,1次／d,口服;观察组在对照组基础上加用马来酸依那普利10mg,2次／d,口服,疗程均为24周。观察两组治疗前后血压变化,应用超声心动图测量两组左心室厚度变化。结果：治疗后,观察组总有效率为91_3％;对照组总有效率为73．9％,观察组总有效率高于对照组（P〈0．05）。治疗前两组心率、血压比较无统计学差异（P〉0．05）,治疗后两组血压均明显降低,观察组收缩压、舒张压明显低于对照组（P〈O．05）;观察组心率明显低于对照组（P〈0．01）。治疗前两组左心室舒张末期室间隔厚度（Leaventricularend—diastolicventricularseptalthickness,IVST）、左心室后壁厚度（1eftventricularposteriorwallthickness,U,PwT）和左室射血分数（Leftventricularejectionfxaction,LVEF）比较无统计学差异（P〉0．05）;治疗后观察组IVST、L、,PwT明显低于对照组,LVEF明显高于对照组（P〈0．05）。结论：氨氯地平联合依那普利治疗原发性高血压能有效扭转左心室肥厚,降压效果较单独应用氨氯地平更佳。