Московский государственный медико-стоматологический университет. 127473, Москва, Делегатская ул., 20/1 Антигипертензивная эффективность и вазопротективные свойства новой комбинации -бета-блокатора бисопролола (2,5/5 мг) и диуретика гидрохлортиазида (6,25 мг) О.Д. Остроумова*, А.Г. Сазонова, К.У. Резникова, А.В. Средняков, Е.А. Смолярчук Московский государственный медико-стоматологический университет. 127473, Москва, Делегатская ул., 20/1 Цель. Изучить влияние фиксированной комбинации бисопролола (БП) и гидрохлортиазида (ГХТ) на уровень артериального давления (АД) и кровоток в средней моз-говой артерии у пациентов с эссенциальной артериальной гипертонией (АГ) 1-й степени. Материал и методы. В несравнительное открытое исследование включено 18 пациентов с АГ 1-й степени (7 мужчин, 11 женщин; возраст 50,1±5,7 лет). Все па-циенты получали комбинацию селективного бета1-адреноблокатора БП 2,5-5 мг и диуретика ГХТ 6,25 мг. Всем пациентам исходно и в конце периода наблюдения выполнены стандартное клиническое обследование, суточное мониторирование АД (СМАД), ультразвуковое исследование среднемозговых артерий с оценкой це-реброваскулярной реактивности. Результаты. Через 12 недель лечения (12 пациентов БП 5 мг/ГХТ 6,25 мг, 6 пациентов -БП 2,5 мг/ГХТ 6,25 мг) целевой уровень АД (<140/90 мм рт.ст.) достиг-нут в 100% случаев. Отмечено значимое снижение АД, как по данным рутинного измерения, так и по результатам СМАД. Исследование кровотока в среднемозго-вых артериях выявило значимое увеличение коэффициента реактивности в ответ на пробы с гипер-и гиповентиляцией. Заключение. Фиксированная комбинация БП и ГХТ имеет высокую антигипертензивную и вазопротективную эффективность. Ключевые слова. Артериальная гипертония, фиксированная антигипертензивная комбинация, бисопролол, церебральная гемодинамика. Aim. To study influence of the fixed bisoprolol (BIS) + hydrochlorothiazide (HCT) combination on blood pressure (BP) level and a blood flow in middle cerebral artery in patients with a arterial hypertension (HT), 1 degree. Material and methods. 18 patients with HT 1 degree (7 men, 11 women; age 50,1±5,7 y.o.) were included in the non-comparative open study. All patients received a combination of selective beta1-adrenoblocker (BIS 2.5-5 mg) and diuretic (HCT 6,25 mg). Initially and in 12 weeks of the treatment all patients had a standard clinical examination, ambulatory BP monitoring, ultrasonography of mesencephalic arteries for evaluation of the cerebrovascular blood flow reactivity. Results. The target BP level (<140/90 mm Hg) in 12 weeks of the treatment (12 patients received BIS 5 mg/HCT 6,25 mg, 6 patients -BIS 2,5 mg/HCT 6,25 mg) was reached in 100% of patients. Besides, significant increase in cerebral blood flow reactivity was found in tests with hyper-and hypoventilation. Conclusion. The fixed BIS/HCT combination has high antihypertensive and vasoprotective efficacy.
The aim of this study was to investigate free radical and lipid disorders in idiopathic pulmonary fibrosis (IPF), to assess clinical efficacy of Fluimucil and to substantiate its administration in different stages of the disease. We observed 127 IPF patients, of them 59 were treated typically with prednisolone, colchicines, or azathioprin, 68 ones received immunosuppressors and Fluimucil. The diagnosis of IPF was verified morphologically in open lung biopsy samples. The patients’ age was 25 to 74 yrs, the mean age, 46.7 ± 9.8 yrs. A control group included 20 healthy donors, the mean age, 41.2 ± 1.2 yrs. N-acetylcysteine (Fluimucil, Zambon group) was administered initially IV 1800 mg a day for 14 days, then orally 1 800 mg a day for a month, then 600 mg a day for 3 months. Clinical and free radical conditions were monitored before the treatment and 3, 6 and 12 months starting the therapy. Fluimucil improved thrombocyte antioxidant activity and plasma antioxidant activity, reduced CT signs of IPF, provided a stable growth in FEV1 and FVC (by 10 % and 12 % respectively) and DLco. Fluimucil was well-tolerated, adverse effects (nausea, stomach ache) were noted in 7 patients (10.2 %). Thus, the results confirmed antioxidant efficacy of Fluimucil in IPF. The long-term administration of Fluimucil combined with the immunosuppressive drugs in IPF patients was safe and reasonable as this inhibited progression of the disease.
The paper gives the definition of blood pressure variability and lists its types. It considers the value of diurnal blood pressure variability as an independent risk factor of stroke and myocardial infarction in arterial hypertension. The authors present the data of their study of the effect of a fixed-dose combination of amlodipine and lisinopril on diurnal blood pressure levels and variability.
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