OBJECTIVE: To evaluate the effect and safety of domestic moxonidine hydrochloride on mild to moderate hypertension METHOD: This multicentre clinical trial used clonidine as control, and it was single blind and randomly parellel. There were 302 patients in moxonidine group, (101 of them were compared with clonidine group, the other 201 were set as open treatment group.) and there were 100 patients in clonidine group. The start dose were 0.2 and 0.15mg· d-1, respectively. After two weeks, if the blood pressure was higher than 140/90 mmHg, the doses were added to 0.4 and 0.3mg · d-1, respectively. The total course of treatment was 4 weeks. Patients who were reactive to moxonidine continued to use it for 6 months, and 19 of them were carried out ambulatory blood pressure monitoring before and after treatment, then analysed with T/P ratio. RESULT: Blood pressure began to decline in the first week of treatment. After 4 weeks,the mean systolic and diastolic blood pressure in seat of moxonidine group declined 12.1%-12.6% and 12%-13.5%, respectively. And those of control group declined 12.9% and 13.4%. The total efficacy rates of the two kinds of drug were 82.5% and 74%. There was no remarkable difference between the clinical efficacy rates of the two kinds of drug . Six months treatment with moxonidine could maintain its anti-hypertensive effect. The frequent adverse reaction of moxonidine is dizziness,drowsiness and inertia, et al. But they were all gently, the patients had better tolerance. And moxonidine had no side effect on biochemistry exams. CONCLUSION: Moxonidine has affirmed effect on mild to moderate hypertension, with little side effects, good patients tolerance. Moxonidine is better than clonidine by total clinical evaluation.

目的:对国内研制的注射用基因重组人尿激酶型纤溶酶原激活剂(pro-urokinase,u-PA)进行I期临床试验,以评价其用于中国健康成人受试者的安全性和耐受性.方法:试验日期;健康受试者2 3例(男11例,女12例),随机分为5,20,35mg和50mg四个剂量组.静脉给药:其中1/4剂量在1min内静脉推注,其余3/4剂量在60min内静脉滴注完毕.给药前和给药后2,24h取外周血测定血液生化指标、凝血和纤溶指标,并随时观察受试者的全身状态和可能出现的药物不良反应.结果:全部受试者用药前后的血压,心率/律、呼吸等重要生命体征未见异常变化;血、尿常规、肝肾功能,电解质、空腹血糖等亦未见明显变化.与溶栓有关的血液学指标(活化的部分凝血活酶时间,凝血酶原时间,凝血酶原活动度,纤维蛋白原,α2-抗纤溶酶和纤维蛋白降解产物),在部分受试者有改变,但变化均在正常范围内、且与剂量无明显相关,无明确临床意义.全部受试者注射药物的局部皮肤,无刺激性炎症和皮下淤血、出血等变化.结论:中国健康成人受试者对于上述剂量的基因重组人尿型纤溶酶原激活剂的安全性及耐受性良好.

高血压病是世界性的多发病,尤其是在发达国家,对高血压一直作为重点项目投入研究.1999年WHO/ISH,美国JNC第六次报告,英国高血压学会第三次报告,都相继提出了新的高血压标准及处理指南.这些年来,我们国家对高血压病的防治工作一直非常重视.因为它是常见病,慢性病,多发病,它是心血管疾病发病、致残和死亡的重要危险因素之一,而广大患者往往对它的严重危害性认识不足.1999年10月,中央卫生部曾组织了全国多学科专家在总结近年来防治高血压病的基础上,参考国外的经验,制订了对高血压病的防治指南,无疑,这对我们广大从事心血管病工作者来说有很重要的意义,对基层工作有了更明确更加具体的方向和目标.

形态学上,正常成人肾脏间质的纤维结缔组织很少,肾小管之间仅有少量间质分割.肾脏间质对维护正常肾功能非常重要.间质纤维化、肾小球硬化、动脉硬化是老年人肾脏的特征性形态改变[1].

1 资料和方法 对我院1994年1月至1998年6月收治的260例老年高血压患者的动态血压资料进行分析,并进一步探讨合并严重脏器损伤患者的动态血压特征及意义.所有患者符合1978年WHO制定的高血压诊断标准.260例中,男215例,女45例,平均年龄74岁;合并严重脏器损伤(Ⅲ期高血压)68例,其中心功能不全19例,脑卒中22例和肾功能不全27例.

为与血管紧张素转换酶抑制剂(ACEI)苯那普利比较,研究新一代降压药血管紧张素Ⅱ受体拮抗剂芦沙坦对自发性高血压大鼠(SHR)肾功能的影响,以及两药减轻SHR肾损害可能的机制,设立苯那普利治疗组、芦沙坦治疗组、未治疗组及正常血压对照组,治疗3个月后,检测肾功能、肾组织病理改变,血浆及肾组织内皮素(ET)水平和肾组织中碱性成纤维细胞生长因子(bFGF)的表达.结果显示,芦沙坦降压、延缓SHR尿白蛋白排泄率与苯那普利比较差异无显著性意义,两治疗组肾组织病理损害轻,芦沙坦组血浆、肾组织中ET及苯那普利组肾组织中ET均明显降低,两组肾组织中bFGF的表达均减弱.结果表明,芦沙坦能延缓SHR肾损害,苯那普利和芦沙坦减轻SHR肾损害与其降低ET、抑制bFGF表达可能有关.

高血压大鼠肾损害与早期肾脏分泌血管紧张素Ⅱ(ATⅡ)、内皮素(ET)增多的关系已引起人们重视.近年发现,丝裂素活化蛋白激酶(MAPK)是其细胞信息传递的重要酶系之一,后者可引起细胞的分化、增殖、肥大[1].本研究通过观察自发高血压大鼠(SHR)肾脏MAPK、ET、ATⅡ的变化,探讨其在高血压肾损害中的作用和意义.

随着对高血压发生机制研究的不断深入，临床药理研究已从常规的生理、生化扩大到内分泌、细胞膜离子转运等新的领域。为了探讨血管紧张素转换酶抑制剂卡托普利及钙通道阻滞剂硝苯啶对高血压病（ＥＨ）患者治疗前、后血浆内皮素（ＥＴ）、肾素活性（ＰＲＡ）、血管紧张素Ⅱ...

本文对２４例原发性高血压（ＥＨ）患者随机分为应用升博通组及硝苯啶组，各１２例，均进行１４ｄ治疗，探讨这两种药物对血浆内皮素（ＦＴ）、肾素（ＰＲＡ）、皿管紧张素Ⅱ（ＡＴⅡ）及醛固酮（ＡＬＤ）系统、血压和心率的影响。结果表明：ＥＨ患者治疗前血浆ＦＴ、ＰＲＡ、ＡＴⅡ及ＡＬＤ浓度与正常对照组相比差异有显著性意义（Ｐ＜Ｏ．０１和Ｐ＜０．０５）．开博通组治疗后，血浆ＡＴⅡ、ＡＬＤ、血压及心率平均值与治疗前相比差异有显著性意义（Ｐ＜０．０１和Ｐ＜０．０５），ＦＴ和ＰＲＡ差异无显著意义（Ｐ＞０．０５）；硝苯啶组治疗后血浆ＥＴ、血压平均值与治疗前相比差异有极显著性意义（Ｐ＜０．０１）、ＡＴⅡ、ＡＬＤ虽有下降但差异无显著性意义（Ｐ＞０．０５），心率平均值增加（Ｐ＜０．０１）。以上两种药物从不同作用机制影响血管活性物质的皿浆浓度来降低血压，提示将此两种药物联合使用，呵更有效地发挥降压效果。