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[动脉高血压:维持治疗的问题]

[Arterial hypertension: problems of maintenance therapy].

作者信息

Kozlovskiĭ I V

出版信息

Ter Arkh. 2006;78(4):50-3.

Abstract

AIM

To study hypotensive reactions in patients taking hypotensive drugs and to specify peculiarities of blood pressure elevation in patients with a long history of taking hypotensive drugs, especially atenolol.

MATERIAL AND METHODS

ECG, ultrasound investigation, chest x-ray, cholesterol, lipoprotein, urea, creatinine assays, tests for serum transaminase and transpeptidase activity were made in 200 patients with essential hypertension of the 1-3 degree (110 males, 90 females, age 30-80 years) to elucidate effects of 24-h and prolonged administration of peripheral vasodilators, diuretics, beta-adrenoblockers. The following drugs were given: nitroglycerin (sublingually, 0.0005 g--3 tablets or intraveous drops), lasix (40 mg), anaprilin (0.04-0.12 g per os), verapamil (0.04 g) or nifedipine (0.01 g 3 times a day), enap or diroton (per os, once a day). Blood pressure was measured each 3-4 hours in the first 24 hours.

CONCLUSIONS

Hypotensive drugs can normalize blood pressure and control it for a long time but their effect has some specific features. In hypertension of the 2-3 degree, beta-blockers are more effective than blockers of Ca channels, ACE, diuretics and nitroglycerin. Hypertensive patients on beta-adrenergic drugs maintenance have sometimes hypertensive crises which should be managed with nitroglycerin, ACE drugs (enap, as a rule) and diuretics (less frequently).

摘要

目的

研究服用降压药患者的降压反应,并明确长期服用降压药尤其是阿替洛尔患者血压升高的特点。

材料与方法

对200例1 - 3级原发性高血压患者(男性110例,女性90例,年龄30 - 80岁)进行心电图、超声检查、胸部X线检查、胆固醇、脂蛋白、尿素、肌酐检测以及血清转氨酶和转肽酶活性检测,以阐明外周血管扩张剂、利尿剂、β - 肾上腺素能阻滞剂24小时及长期给药的效果。给予以下药物:硝酸甘油(舌下含服,0.0005 g - 3片或静脉滴注)、速尿(40 mg)、心得安(口服,0.04 - 0.12 g)、维拉帕米(0.04 g)或硝苯地平(0.01 g,每日3次)、依那普利或地洛汀(口服,每日1次)。在最初24小时内每3 - 4小时测量一次血压。

结论

降压药可使血压正常化并长期控制血压,但其作用有一些特定特征。在2 - 3级高血压中,β受体阻滞剂比钙通道阻滞剂、血管紧张素转换酶抑制剂、利尿剂和硝酸甘油更有效。服用β - 肾上腺素能药物维持治疗的高血压患者有时会出现高血压危象,应使用硝酸甘油、血管紧张素转换酶抑制剂(通常为依那普利)和利尿剂(较少使用)进行处理。

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