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甲基多巴与普萘洛尔或心得宁用于中度高血压治疗

Methyldopa and propranolol or practolol in moderate hypertension.

作者信息

Petrie J C, Galloway D B, Jeffers T A, Millar H R, Smith M C, Wood R A, Lewis J A, Simpson W T

出版信息

Br Med J. 1976 Jul 17;2(6028):137-9. doi: 10.1136/bmj.2.6028.137.

Abstract

The effect of a low dose of methyldopa combined with (a) a non-selective and (b) a selective beta-adrenoceptor antagonist was studied in a double-blind crossover trial in 24 carefully selected patients with moderate hypertension (mean initial lying blood pressure 189/117 mm Hg). Each patient received methyldopa 750 mg/day, propranolol 240 mg/day, practolol 600 mg/day, methyldopa 750 mg/day combined with propranolol 240 mg/day, methyldopa 750 mg/day combined with practolol 600 mg/day, and placebo for four weeks each according to a random sequence. After four weeks of therapy the most effective treatment, methyldopa combined with propranolol, reduced lying and standing blood pressures by 36-5/21-4 mm Hg and 44-7/25 mm Hg respectively. Thic combination had similar effects to those of the combination of methyldopa with the cardioselective agent practolol except that it reduced lying diastolic pressure further. The combination was more effective than either treatment alone. No significant differences were found between the effects of propranolol, practolol, or methyldopa at the doses used.

摘要

在一项双盲交叉试验中,对24例精心挑选的中度高血压患者(平均初始卧位血压189/117 mmHg)研究了低剂量甲基多巴联合(a)非选择性和(b)选择性β-肾上腺素能受体拮抗剂的效果。每位患者按照随机顺序,依次接受甲基多巴750 mg/天、普萘洛尔240 mg/天、醋丁洛尔600 mg/天、甲基多巴750 mg/天联合普萘洛尔240 mg/天、甲基多巴750 mg/天联合醋丁洛尔600 mg/天以及安慰剂治疗,每种治疗持续4周。治疗4周后,最有效的治疗方案——甲基多巴联合普萘洛尔,可使卧位和立位血压分别降低36.5/21.4 mmHg和44.7/25 mmHg。该联合用药与甲基多巴联合心脏选择性药物醋丁洛尔的效果相似,只是进一步降低了卧位舒张压。联合用药比单独使用任何一种药物都更有效。在所使用的剂量下,普萘洛尔、醋丁洛尔或甲基多巴的效果之间未发现显著差异。

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A random-zero sphygmomanometer.随机零位血压计。
Lancet. 1970 Feb 14;1(7642):337-8. doi: 10.1016/s0140-6736(70)90709-9.

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