氨氯地平联合特拉唑嗪治疗原发性高血压的短期疗效和安全性

目的 探讨氨氯地平联合特拉唑嗪治疗中老年男性原发性高血压的短期疗效与安全性.方法 2005-08-2006-02在安徽省安庆市及其周边地区,采用随机开放平行前瞻性实验,开展了氨氯地平联合特拉唑嗪治疗中老年男性原发性高血压的研究.本文选择完成4周随访的研究对象508例,分析氨氯地平与特拉唑嗪联合用药的降压疗效和安全性.结果 治疗4周后,特拉唑嗪、氨氯地平、联合用药组收缩压的下降值分别为(4.0±15.0)、(17.5±15.8)、(20.0±15.9)mm Hg(P＜0.01);舒张压的下降值分别为(1.2±7.2)、(8.0±7.1)、(10.7±7.2)mm Hg(P＜0.01);降压总有效率分别为20.7%、53.8%、67.7%,联合用药组明显优于单独用药组(P＜0.01).3组研究对象的心率,在治疗前后组间组内差异均无统计学意义.4周治疗期间,特拉唑嗪、氨氯地平、联合用药组不良反应的发生率分别为4.1%、12.3%、13.2%(P＜0.05);各组均未见体位性低血压的发生.结论 氨氯地平联合特拉唑嗪治疗高血压的短期临床疗效优于单一用药组;耐受性较好,未见明显的不良反应.     

氨氯地平并特拉唑嗪治疗中老年高血压的疗效与安全性

目的：观察氨氯地平联合特拉唑嗪治疗中老年男性原发性高血压的短期临床疗效及安全性。方法：选择我院2011年1月～2012年2月收治的患有原发性高血压的中老年男性患者64例,随机分为氨氯地平组（单用氨氯地平治疗）和联合用药组（采用氨氯地平联合特拉唑嗪治疗）,每组各32例。结果：联合用药组总有效率为93.75％,明显高于氨氯地平组的65.63％（P ＝0.028）;两组治疗后收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、甘油三酯（TG）及空腹血糖（FPG）水平均明显降低（P ＜0.05～＜0.01）;与氨氯地平组比较,联合用药组降低更为显著[SBP：（138.55±7.96）mmHg 比（110.65±7.28）mmHg,DBP：（93.35±5.86）mmHg 比（80.11±5.93） mmHg,TC：（5.67±0.76）mmol/L 比（4.22±0.63）mmol/L,TG：（2.67±0.86）mmol/L 比（2.01±0.75） mmol/L,FBG：（5.69±0.86）mmol/L 比（4.31±0.58）mmol/L],P 均＜0.05;联合用药组不良反应发生率（6.25％）明显低于氨氯地平组（18.75％）,P ＜0.05。结论：氨氯地平联合特拉唑嗪治疗中老年男性原发性高血压临床效果显著,可有效降低患者收缩压和舒张压,不良反应少,值得临床推广。     

吸烟影响α_1受体阻滞剂和Ca~(2+)通道拮抗剂的降压疗效

目的探讨吸烟对α_1受体阻滞剂类药物和 Ca~(2+)通道拮抗剂类药物降压疗效的影响。方法氨氯地平,特拉唑嗪单一或联合用药对入选的355例原发性高血压患者进行四周治疗,并分析吸烟史对不同降压药物降压疗效的影响。结果单用特拉唑嗪在无吸烟史的人群中有效率达到79%,而在有吸烟史的人群中只能达到40%,且不管患者在近一年内是否戒烟,有效率均是40%,远低于非抽烟人群;对于单用氨氯地平的患者,有吸烟史对氨氯地平的降压疗效也有影响的趋势,但差异无统计学意义(P>0.05)。结论吸烟会降低α_1受体阻滞剂特拉唑嗪的降压疗效,但对 Ca~(2+)通道拮抗剂氨氯地平则无影响。     

吸烟影响α1受体阻滞剂和Ca2+通道拮抗剂的降压疗效

目的 探讨吸烟对α1受体阻滞剂类药物和Ca2 通道拮抗剂类药物降压疗效的影响.方法 氨氯地平,特拉唑嗪单一或联合用药对入选的355例原发性高血压患者进行四周治疗,并分析吸烟史对不同降压药物降压疗效的影响.结果 单用特拉唑嗪在无吸烟史的人群中有效率达到79%,而在有吸烟史的人群中只能达到40%,且不管患者在近一年内是否戒烟,有效率均是4Q%,远低于非抽烟人群;对于单用氨氯地平的患者,有吸烟史对氨氯地平的降压疗效也有影响的趋势,但差异无统计学意义(P0.05).结论 吸烟会降低α1受体阻滞剂特拉唑嗪的降压疗效,但对Ca2 通道拮抗剂氨氯地平则无影响.     

特拉唑嗪联合硝苯地平治疗老年高血压疗效观察

目的探讨老年原发性高血压(EH)患者药物联合治疗的效果。方法对28例老年EH患者进行特拉唑嗪和硝苯地平联合治疗,观察其临床和心电图疗效。结果降压显效22例(78.6%),有效5例(17.9%),无效1例(3.5%),总有效率达96.5%,平均收缩压下降46mmHg,舒张压下降15mmHg(P均<0.01),同时兼有改善心、肾功能,轻微降血糖的作用。结论特拉唑嗪和硝苯地平联合应用降压安全可靠,无明显副作用。     

特拉唑嗪治疗难治性心力衰竭患者短期和长期疗效观察

目的观察难治性心力衰竭患者在指南引导药物治疗(GDMT)的基础上加服特拉唑嗪干预后的短期和长期临床疗效。方法筛选符合难治性心力衰竭的患者128例,随机分为试验组和对照组,各64例。所有患者GDMT基础上加服盐酸特拉唑嗪治疗4周,观察短期疗效;1年随访中,试验组死亡4例、退出4例、失访1例,对照组分别为5例、6例和3例。最终试验组55例(GDMT且继续服特拉唑嗪)和对照组50例(GDMT),治疗1年,观察长期疗效。结果与治疗前比较,患者服用4周特拉唑嗪治疗后LVEF明显升高[(29.54±4.75)%vs(27.73±6.54)%,P0.01],中心静脉压(P0.01)和NT-proBNP明显减低[(2316.22±899.44)ng/L vs(4766.40±497.40)ng/L,P0.01]。患者服用1年特拉唑嗪后,与对照组比较,试验组LVEF明显升高[(28.75±4.16)%vs(22.46±3.51)%,P0.01],N末端B型钠尿肽前体明显降低[(2138.85±669.28)ng/L vs(3526.68±1116.11)ng/L,P0.01],6min步行距离明显延长[(349.00±23.52)mvs(276.12±103.28)m,P0.01],再住院次数明显减少[(1.12±1.15)次vs(4.12±1.56)次,P0.01];肌酐和天冬氨酸转氨酶均明显降低(P0.01)。结论难治性心力衰竭在GDMT基础上,短期和长期联合应用盐酸特拉唑嗪均有较好的临床疗效,值得推广和应用。     

小剂量氨氯地平联合用药治疗老年高血压的疗效和安全性评价

目的 评价小剂量氨氯地平联合复方阿米洛利或者替米沙坦治疗老年高血压的临床疗效和安全性.方法 采用随机开放对照盲终点评估的方法,入选老年原发性高血压患者106例,随机分为氨氯地平+复方阿米洛利(阿米洛利组)和氨氯地平+替米沙坦组(替米沙坦组),均服药12 w,每2周随访一次,观察收缩压、舒张压、心率、降压达标率、有效率和不良反应.结果 治疗第2周末,阿米洛利组和替米沙坦组的达标率分别为58.5%和47.2%,组间比较有统计学差异(P<0.05).而治疗12 w后,两组降压达标率分别为67.9%和71.7%,有效率分别为81.1%和83.0%,组间比较差异均无统计学意义(P>0.05).阿米洛利组收缩压下降值为(24.3±15.8)mmHg,舒张压下降值为(15.2±9.2)mmHg,替米沙坦组收缩压下降值为(26.8±13.4)mmHg,舒张压下降值为(15.7±9.4)mmHg,较治疗前均有显著差异(P<0.01);两组不良反应发生率分别为9.4%和7.6%(P>0.05),实验室检查均无明显改变,未见低血钾及体位性低血压的发生.结论 小剂量氨氯地平联合复方阿米洛利或替米沙坦能显著降低老年高血压患者血压,耐受性好,不良反应少;氨氯地平联合复方阿米洛利方案在尽早达标方面更具优势.     

前列通瘀胶囊联合特拉唑嗪治疗ⅢB型前列腺炎疗效观察

目的 观察前列通瘀胶囊联合特拉唑嗪治疗ⅢB型前列腺炎的临床疗效.方法 将116例ⅢB型前列腺炎患者随机分为两组,治疗组口服特拉唑嗪2 mg,每晚1次,同时服用前列通瘀胶囊2 g,3次/d;对照组仅服用相同剂量的特拉唑嗪,疗程均为12周.根据两组服药前后的美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)及最大尿流率(Qmax)和平均尿流率(Qave)的变化情况进行疗效评定.结果 治疗组和对照组总有效率分别为80.7%及39.2%(P<0.01),治疗组治疗后NIH-CPSI评分及MFR变化较对照组明显(P＜0.05).结论 前列通瘀胶囊联合特拉唑嗪治疗ⅢB型前列腺炎疗效显著.     

动态血压观察特拉唑嗪的降压疗效

目的观察特拉唑嗪降压疗效。方法采用动态血压分析测定特拉唑嗪２～４ｍｇ／ｄ治疗轻中度高血压患者２４例（男性６例，女性１８例，年龄６０．４±４．６岁）。结果２～４ｍｇ／ｄ治疗２周后２４ｈ平均血压、日昼及夜间平均血压、血压负荷值均较用药前显著下降。特拉唑嗪降低收缩压和舒张压的谷／峰比值分别为６０．２％和８２．４％。结论特拉唑嗪每日１次投药能有效地控制轻中度高血压病人２４ｈ血压水平     

氨氯地平治疗原发性高血压150例疗效观察

目的观察氨氯地平治疗原发性高血压的临床疗效及不良反应。方法选择本院近年来诊治的原发性高血压患者150例,均给予氨氯地平5 mg,1次/d,治疗2周,如血压未达到标准增至10 mg,1次/d,疗程4周。观察临床疗效和患者用药前、用药期间及用药后血压变化情况及不良反应。结果本组显效117例(78.0%),有效21例(14.0%),无效12例(8.0%),总有效率92.0%,治疗4周后收缩压由(153.6±19.4)mmHg降至(130.6±16.2)mmHg(P0.01)。没有明显不良反应出现。结论氨氯地平具有较好的降压效果和依从性,是理想的降压药物,适用于原发性高血压患者长期治疗。     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.