几种降压药物临床疗效分析

目的：对比几种降压药物在降压方面的疗效,为临床治疗药物选择奠定基础。方法选择2012年1月~2013年1月在本院心血管进行高血压治疗的123例高血压患者资料进行回顾性研究。8周后进行舒张压、收缩压的统计。结果降压疗效排名为氨氯地平、吲达帕胺、缬沙坦、美托洛尔和依那普利疗效相当。结论五种降压药均可以不同程度的降低血压,但是氨氯地平的疗效最好,吲达帕胺其次,临床医生应当视临床诊断而定药物的选取治疗。     

帕罗西汀治疗高龄老年高血压合并焦虑抑郁的临床疗效观察

目的 本研究评估帕罗西汀治疗高龄老年高血压合并焦虑抑郁的临床疗效.方法 本研究共纳入高龄老年高血压合并焦虑抑郁患者96例,随机分为观察组(n=48)和对照组(n=48),对照组给予单用氨氯地平降压治疗,观察组给予氨氯地平+帕罗西汀治疗,随访8周后比较两组治疗前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分及血压变化.结果 两组患者治疗后收缩压、舒张压均较治疗前均明显下降(P<0.05);与对照组相比,观察组SAS、SDS评分均明显下降(P<0.05),收缩压、舒张压明显下降(P<0.05),高血压治疗总有效率明显升高(P<0.05).结论 帕罗西汀配合降压药治疗高龄老年高血压合并焦虑抑郁患者,使降压疗效更佳.     

苯磺酸左旋氨氯地平治疗轻中度原发性高血压临床疗效观察

目的:观察苯磺酸左旋氨氯地平治疗轻中度原发性高血压的疗效.方法:对符合条件的110例高血压患者,每天苯磺酸左旋氨氯地平2.5mg口服,服药2、4、6、8周后,分别测定患者的血压、心率.结果:110例高血压患者治疗8周后,收缩压、舒张压平均降幅分别为22.5 mmHg、14.7 mmHg,服药8周后与服药前相比,收缩压、舒张压的下降差异均有显著性(P＜0.05),降压总有效率为97.3%.心率较基线时慢,差异有显著性(P＜0.05).结论:苯磺酸左旋氨氯地平降压疗效好,不良反应少,患者依从性好.     

苯磺酸左旋氨氯地平治疗老年高血压患者83例疗效观察

目的：观察苯磺酸左旋氨氯地平治疗老年高血压患者的临床治疗效果。方法165例原发性老年高血压患者,随机分为观察组83例和对照组82例。所有患者在接受治疗前停用一切抗高血压药物2周以上,观察组每日晨起口服苯磺酸左旋氨氯地平片,对照组每天口服硝苯地平片,2组患者均连续观察8周。结果经药物治疗8周后,观察组收缩压和舒张压平均降幅明显高于对照组,观察组总有效率明显高于对照组,对照组不良反应发生率明显高于观察组,差异均有统计学意义（ P＜0.05）。结论苯磺酸左旋氨氯地平对老年高血压患者的降压作用明显,可达到稳定而持久的连续降压效果,且不良反应少。     

贝那普利／氨氯地平复方制剂治疗轻中度高血压临床疗效分析

目的通过实际使用氨氯地平与贝那普利复方制剂治疗轻中度高血压,探讨该复方制剂的有效性以及不良反应情况。方法将中度高血压患者分为A、B两组,A组给予贝那普利／氨氯地平复方制剂5mg,每日1次;B组给予氨氯地平5mg,每日1次。结果两组患者治疗4周及8周后收缩压、舒张压均较治疗前显著下降（P〈0．05或〈0．01）,但治疗8周后A组收缩压、舒张压下降程度较B组更明显（P〈0．05）。结论使用贝那普N／氨氯地平复方制剂治疗轻中度高血压是可行的,而且临床效果显著,具有不良反应少等优点,利大于弊。     

左旋氨氯地平治疗原发性轻中度高血压疗效观察

目的观察左旋氨氯地平降低原发性轻中度高血压的疗效。方法对符合条件的98例高血压患者,1次/d口服左旋氨氯地平2.5 mg,服药2、4、6、8周后,分别测定患者的血压、心率。结果98例高血压患者治疗8周后,收缩压、舒张压平均降幅分别为24.0 mm Hg、13.1 mm Hg,服药8周后与服药前相比,收缩压、舒张压的降低差异均有显著性（P〈0.05）,降压总有效率为83.5%。心率较基线时慢,差异有统计学意义（P〈0.05）。结论左旋氨氯地平降压疗效较好,值得推广应用。     

2型糖尿病伴高血压的联合降压方案的疗效评价

目的通过动态血压监测探讨不同类型的降压药组合对糖尿病伴高血压患者的血压的影响,为合理选择降压药物提供依据。方法将2型糖尿病伴高血压患者40例随机分为两组,一组(20例)用依那普利 氨氯地平治疗,另一组(20例)用依那普利 钠催离治疗,两组均治疗4周,观察动态血压参数。结果两组药物治疗第4周末24h动态血压发现,24h平均收缩压、舒张压、脉压均较服药前明显降低,统计学上有显著性差异,依那普利 氨氯地平组24h平均收缩压下降了25.5mmHg,24h平均舒张压下降了16.4mmHg;依那普利 钠催离组24h平均收缩压下降了17.2mmHg,24h平均舒张压下降了11.5mmHg。依那普利 氨氯地平组24h脉压下降幅度为11.1mmHg和依那普利 钠催离组24h脉压下降幅度为5.7mmHg,依那普利 氨氯地平组优于依那普利 钠催离组,经检验有统计学差异(p<0.001);依那普利 氨氯地平组和依那普利 钠催离组降压达标率分别为60%和50%。结论对2型糖尿病伴高血压患者早期联合使用2种降压药物,可尽快达到<130/80mmHg的目标血压。依那普利 氨氯地平组降压幅度优于依那普利 钠催离组。     

左旋氨氯平治疗肾脏移植术后高血压的临床研究

目的研究左旋氨氯地平抗肾脏移植术后高血压的临床效果.方法肾脏移植术后高血压患者20例,停用其它抗高血压药物后7～10天,服用左旋氨氯地平2.5～5.0mg/d,一天1次,疗程8周.治疗期间每周测血压和心率2次,并全面监测血、尿常规,肝肾功能,电解质,血糖,胆固醇和血环孢素A浓度的变化.结果治疗8周后,收缩压下降2.18±1.14 kPa,舒张压下降2.06±1.02kPa,与治疗前比较,P＜0.01,总有效率达85%.患者的血、尿常规及肝肾功能、电解质、血糖、胆固醇和血环孢素A浓度没有明显的变化.结论左旋氨氯地平对肾脏移植术后的高血压有良好的降压作用.     

苯磺酸氨氯地平治疗老年高血压128例疗效观察

目的观察苯磺酸氨氯地平对老年高血压的治疗效果。方法选取128例老年高血压患者每天口服5mg氨氯地平1次,连续4～8周,测量治疗前后血压情况。结果4周后,显效79例（61.7%）,有效45例（35.2%）,总有效率为96.9%;与治疗前相比,苯磺酸氨氯地平治疗后收缩压和舒张压水平显著降低。结论苯磺酸氨氯地平是治疗老年高血压的理想药物。     

降压药在老年高血压患者中的临床药学探析

目的：分析老年高血压患者降压药的临床应用情况,为临床工作提供借鉴。方法800例高血压患者的基本资料进行记录,包括患者的身高、体重、血压以及使用的降压药物等;记录患者的血压控制情况,观察不良反应,整理并回顾性分析。结果35.5%的患者使用缬沙坦,21.0%的患者使用氨氯地平;舒张压得到控制的患者占70.0%,收缩压得到控制的患者占51.0%;主要不良反应有踝部水肿、心动过缓、低钾血症、体位性低血压、干咳等。结论老年高血压患者,使用较多的药物为缬沙坦和氨氯地平,舒张压的控制比率要高于收缩压,同时,虽然有部分患者出现不良反应,但是降压药的使用基本符合规范。     

Effects of a fixed-dose ACE inhibitor-diuretic combination on ambulatory blood pressure and arterial properties in isolated systolic hypertension

The ideal therapy for patients with isolated systolic hypertension remains unclear; diuretics, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors are all used in clinical practice. The aim of this study was to determine whether a fixed-dose ACE inhibitor/diuretic combination would reduce ambulatory blood pressures (BP) and arterial stiffness in isolated systolic hypertension more than antihypertensive monotherapy. In this randomized, double-blind study, 8 weeks of fosinopril/hydrochlorothiazide combination (10/12.5 mg titrated up to 20/12.5 mg) was compared with the calcium channel blocker (amlodipine, 5 mg titrated up to 10 mg) and diuretic (indapamide, 2.5 mg) monotherapy in 28 patients with isolated systolic hypertension. Each patient received all 3 therapies. Assessments included 24-hour ambulatory BP, clinic BP, and applanation tonometry-derived augmentation index. At 8 weeks, the fall in average 24-hour systolic BP and night time systolic BP were significantly greater in the fosinopril-hydrochlorothiazide group, compared to amlodipine and indapamide. The decrease in augmentation index and central aortic systolic BP was also greater in the fosinopril-hydrochlorothiazide group, compared to either amlodipine or indapamide. There was no difference between therapies in decrease in clinic systolic or diastolic BP, or diastolic ABP (average 24-h, diurnal, or nocturnal). Compared with either calcium channel blocker or diuretic therapy, a fixed-dose ACE inhibitor-diuretic combination induces greater reductions in systolic ABP, particularly at night, favorable effects that may be related to a decrease in the intensity of or delay in arterial wave reflections. ACE inhibitor-diuretic combination therapy is a useful approach to cardiovascular risk reduction in isolated systolic hypertension.     

应用动态血压监测评估氨氯地平、培哚普利治疗高血压效果分析

目的观察氨氯地平、培哚普利治疗高血压的效果扣安全性。方法选取42例高血压患者给予氨氟地平、培哚普利联合治疗,通过24h动态血压监测评估治疗4周后患者治疗效果。结果治疗4周后患者收缩压、舒张压均低于治疗前,差异均有统计学意义（P〈0．05）。治疗4周后患者24h、白昼、夜间的收缩压和舒张压均低于治疗前,差异均有统计学意义（P〈0．05）。结论氨氯地平、培哚普利可以有效地降低血压水平,减轻血压负荷。     

Efficacy and tolerability of amlodipine in patients with mild-to-moderate hypertension.

Twenty-one subjects with mild or moderate systemic hypertension were treated for 12 weeks with amlodipine, a new calcium antagonist of the dihydropyridine group. Initial amlodipine dose was 5 mg once daily, but the dose could be increased after four or eight weeks to 10 mg once daily if diastolic blood pressure was not less than or equal to 90 mmHg (12.0 kPa). At the end of the study, a substantial reduction of systolic blood pressure (20 mmHg-2.7 kPa-from baseline) and diastolic blood pressure (14 mmHg-1.9 kPa-from baseline) was observed. Statistically significant changes in systolic and diastolic blood pressure were produced after four weeks of treatment. There were no statistically significant changes in heart rate throughout the study. Six patients with mild and five patients with moderate hypertension became normotensive after amlodipine treatment (64%). Two with mild hypertension finished the trial without change in hypertensive status, and four with initially moderate hypertension changed to mild at the end of the study. Only one patient dropped out due to an adverse reaction, two adverse events were rated severe, but did not require discontinuation. Overall impressions of efficacy were excellent or good in two-thirds of cases and poor in 10%; overall impressions of toleration were excellent or good in 71% of cases and poor in 10%. It is concluded that amlodipine is useful and well tolerated in patients with mild or moderate hypertension.     

辛伐他汀联合氨氯地平治疗对血压变异性的影响分析

目的:观察辛伐他汀联合氨氯地平对高血压患者血压变异性的影响。方法:100例原发性高血压患者随机分为治疗组和对照组(各50例),两组均给予氨氯地平2.5mg/d治疗,治疗组在此基础上加用辛伐他汀20mg/d。治疗12周后,比较两组治疗前后血脂变化,并进行24h动态血压监测,比较两组治疗前后血压平均值、血压变异性的变化。结果:治疗组12周后较治疗前相比,血总胆固醇、三酰甘油、低密度脂蛋白明显降低,高密度脂蛋白升高;治疗组12周后与治疗前比较,动态血压平均值、血压变异性均显著下降,24h平均收缩压、白昼平均收缩压、夜间平均收缩压、24h收缩压变异性、白昼收缩压变异性、白昼舒张压变异性、夜间收缩压变异性较对照组降低。结论:辛伐他汀联合氨氯地平可有效降压,调节血脂,并可显著改善原发性高血压患者的血压变异性。     

Biochemical changes during amlodipine treatment in hypertensive patients

Twenty adult hypertensive patients mean age (52 (1.73) y) were treated with amlodipine 5 mg (8 patients) and 10 mg (12 patients) once daily for 12 weeks. There was a reduction in sitting and standing diastolic and systolic blood pressures in male and female patients.Plasma calcium, sodium, potassium, total proteins, albumin, globulins, phosphate, chloride, urea and haematological parameters were not significantly altered by amlodipine therapy in any patient. An increase in creatinine level was noted, which was not related to kidney dysfunction. We conclude that amlodipine 5 mg or 10 mg once daily is effective in male and female patients, and it does not alter biochemical and haematological values in hypertensive African patients.     

氨氯地平联合氢氯噻嗪或依那普利治疗老年高血压的效果

目的评价氨氯地平联合依那普利或氢氯噻嗪治疗老年高血压的降压效果。方法老年原发性高血压患者86例,随机入组氨氯地平联合氢氯噻嗪(A组,43例)和氨氯地平联合依那普利(B组,43例),随访12周,比较两组的降压效果和血压变异性。结果与治疗前相比,治疗12周后,两组收缩压、舒张压均明显下降(P<0.01);A组平均收缩压标准差(dSBPV)、平均收缩压变异系数(dSBPCV、nSBPCV)、平均舒张压变异系数(dDBPCV、nDBPCV)均明显低于B组(P<0.05)。结论氨氯地平联合依那普利或氢氯噻嗪均能进一步显著降低老年高血压患者血压水平;氨氯地平联合氢氯噻嗪在降低老年患者的血压变异性方面更具优势。     

国产西尼地平治疗原发性高血压的多中心随机双盲双模拟临床研究

目的 对西尼地平治疗原发性高血压患者的疗效与安全性进行临床评价。方法 用多中心双盲双摸拟随机平行对照的试验方法,研究国产西尼地平与对照药苯磺酸氨氯地平对233例轻中度原发性高血压患者的降压疗效及药物不良反应。结果 治疗8周后,西尼地平组平均坐位收缩压(SBP)及舒张压(DBP)下降幅度分别为16.2,1 2.7 mmHg,苯磺酸氨氯地平组分别下降23.1,15.1 mmHg;两药总有效率分别为76.6％和87.7％,与治疗前比较有显著性差异(P<0.01);两药对心率无明显影响;两组药物不良反应的发生率分别为16.7％和12.9％。长期服用西尼地平疗效能持续,并有良好的耐受性。结论 西尼地平治疗轻中度原发性高血压具有明确的降压疗效与良好的安全性。     

Open evaluation of amlodipine in the monotherapeutic treatment of systolic hypertension in the elderly

The antihypertensive efficacy and safety of amlodipine (5-10 mg once daily for 10 weeks) was assessed in elderly patients with primary systolic hypertension (average sitting and standing systolic blood pressure > or = 160 mm Hg and diastolic blood pressure < or = 95 mm Hg). Interim analysis of data from 25 patients shows that amlodipine treatment produced significant decreases in sitting blood pressure (-26.8/-11.4 mm Hg; p < 0.05). Efficacy assessments after 8 weeks of therapy showed 15 of 21 (71.4%) evaluable patients were considered therapeutic successes with amlodipine (defined as a fall from baseline in sitting systolic blood pressure of > or = 20 mm Hg or to < or = 150 mm Hg with a fall of > or = 10 mm Hg). Of the six evaluable patients who were not considered therapeutic successes using this definition, three had clinically beneficial falls in systolic blood pressure of 16-18 mm Hg. Fourteen patients were considered therapy successes on the basis of assessments taken 48 h postdose at the end of the study. Investigators' overall impression of efficacy was excellent or good in 21 patients (84%). Amlodipine treatment had no significant effect on heart rate. Amlodipine was generally well tolerated, with no patients being withdrawn due to side effects. Investigators' evaluation of toleration was excellent or good in 22 patients (88%).     

氨氯地平对原发性高血压患者血管内皮功能及胰岛素抵抗的影响

目的探讨氨氯地平对原发性高血压患者内皮功能及胰岛素抵抗的影响。方法选择42例原发性高血压患者为治疗组,血压正常的健康人30例为对照组。治疗组口服氨氯地平8周,并在治疗前后采取静脉血测定空腹血糖及胰岛素,计算胰岛素敏感性指数（ISI）;采用血管外超声法检测治疗前后肱动脉内皮依赖性血管舒张功能（FDM）,并观察肱动脉内径基础值（D0）变化。结果治疗组治疗前收缩压、舒张压、空腹血糖、空腹胰岛素均明显高于对照组,且D0、ISI、FMD均低于对照组,差异均有统计学意义（P〈0.01）;治疗8周后患者收缩压、舒张压、空腹胰岛素水平降低,ISI升高,D0及血流介导的FDM明显改善,与治疗前比较差异均有统计学意义（P〈0.01）。结论氨氯地平在有效降压的同时,能改善原发性高血压患者胰岛素抵抗及肱动脉内皮依赖性血管舒张功能。