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用钙拮抗剂科林法治疗高血压及其与奥布齐丹联合治疗

[Treatment of hypertension with the calcium antagonist korinfar and its combination with obzidan].

作者信息

Shkhvatsabaia I K, Erina E V, Prokopova T N, Charyev Kh E, D'iakonova E G

出版信息

Ter Arkh. 1986;58(6):122-7.

PMID:3764704
Abstract

A hypotensive effect of corinfar and its effect on the indices of the central and peripheral hemodynamics were studied in 50 patients with stage II hypertension. In 3 weeks BP was lowered at the expense of a considerable decrease in the total peripheral vascular resistance (TPVR) (by 29.6%) and regional vascular resistance (by 48%). It was accompanied by an increase in the peripheral blood flow (by 61%), a reflex activation of the sympathetic-adrenal system with an increase in heart rate and cardiac output (by 22%, p less than 0.001). An index of vein distensibility remained unchanged. The addition of propranolol removed signs of the sympathetic stimulation of the cardiac activity, improved vasodilatator tolerance, enhanced a hypotensive effect of corinfar causing a transient increase in TPVR and tension of the resistive vessels only. By the end of the 4th month of therapy these indices significantly decreased. A prolonged combined therapy with corinfar and propranolol resulted in a significant decrease in the resistance of resistive vessels in maximum vasodilatation characterizing the regression of arteriole structural changes. Besides there was a decrease in the wall thickness (p less than 0.01) and left ventricular myocardial mass (by 7.88 +/- 2.66 g, p less than 0.05) that was interpreted as a tendency to a decrease in a degree of hypertrophy of the left ventricle. The efficacy of corinfar therapy was higher in the patients with hypertension with a high initial tension of the peripheral vessels.

摘要

对50例II期高血压患者研究了冠心宁的降压作用及其对中心和外周血流动力学指标的影响。3周内血压下降,这是以总外周血管阻力(TPVR)显著降低(29.6%)和局部血管阻力降低(48%)为代价的。同时外周血流量增加(61%),交感 - 肾上腺系统反射性激活,心率和心输出量增加(22%,p<0.001)。静脉扩张指数保持不变。加用普萘洛尔消除了心脏活动交感神经刺激的征象,改善了血管舒张耐受性,增强了冠心宁的降压作用,仅使TPVR和阻力血管张力短暂增加。到治疗第4个月末,这些指标显著下降。冠心宁与普萘洛尔的长期联合治疗导致最大血管舒张时阻力血管阻力显著降低,这表明小动脉结构变化的消退。此外,血管壁厚度降低(p<0.01),左心室心肌质量降低(7.88±2.66 g,p<0.05),这被解释为左心室肥厚程度有降低的趋势。冠心宁治疗对外周血管初始张力高的高血压患者疗效更高。

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