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心得安治疗原发性高血压(作者译)

[Treatment of essential hypertension with propranolol (author's transl)].

作者信息

Klumpp F, Braun B, Klaus D, Lemke R, Zehner J

出版信息

Dtsch Med Wochenschr. 1976 Oct 8;101(41):1482-8. doi: 10.1055/s-0028-1104295.

Abstract

Effect of long-term administration of propranolol was studied in 90 unselected patients with essential hypertension. At a dose of 180 and 360 mg daily it dropped the blood pressure to at least 155/95 mm Hg in 31 patients (34.4%). Those who responded to propranolol had lower systolic and diastolic blood pre-treatment pressures than those who failed, were younger by an average of eight years, and in no case had decreased plasma-renin activity and demonstrated greater plasma-renin activity after furosemide. After a titration phase with increasing doses of propranolol those who responded were treated in a crossed double-blind test with propranolol or placebo. There was a significant difference in systolic blood pressure (standing and lying) and diastolic pressure (standing) between the two. There was also a highly significant difference in heart rate. During chronic beta blockade the basal and stimulated plasma-renin activity fell. But percentage stimulation of renin secretion was fully maintained. However, aldosterone response was decreased. Serum potassium rose slightly but significantly, cAMP 24-hour urine excretion fell significantly. Electrolyte excretion did not differ between the two treatment periods.

摘要

对90例未经挑选的原发性高血压患者进行了长期服用普萘洛尔的效果研究。每日剂量为180毫克和360毫克时,31例患者(34.4%)的血压降至至少155/95毫米汞柱。对普萘洛尔有反应的患者治疗前的收缩压和舒张压低于无反应者,平均年轻8岁,无一例血浆肾素活性降低,且服用速尿后血浆肾素活性更高。在普萘洛尔剂量递增的滴定阶段后,对有反应者进行了普萘洛尔或安慰剂的交叉双盲试验。两者之间的收缩压(站立和卧位)和舒张压(站立)存在显著差异。心率也有极显著差异。在慢性β受体阻滞期间,基础和刺激后的血浆肾素活性下降。但肾素分泌的刺激百分比得以完全维持。然而,醛固酮反应降低。血清钾略有但显著升高,24小时尿中环磷酸腺苷排泄显著下降。两个治疗阶段的电解质排泄无差异。

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