The function which have to repress to flow inside Ca 2+ of the calcium Jie anti-, change myocardial, the excitement of smooth muscle-the constringency accidentally unites process, flabby afferent and smooth muscle, carry after ease, lower blood pressure.From 70’s the calcium Jie anti- was a blood vessel to extend a medicine application, is been apply in high blood pressure and coronary extensively to cure.The clinical application calcium Jie anti- general treatment quantity, sufferer often the ability be subjected to.It is badly familiar to respond an outside week dropsy, constipation, dizzy, the face tide be red, headache, skin rash and heart palpitates etc..Take four kinds of in common use calcium Jie anti- as an example, it badly responds occurrence circumstance as follows form: The Wei pulls the Pa rice sulphur nitrogen Zhuo Tong nitric benzene Ding non- Luo ground even
Ankle department dropsy+++++++++
Be constipated+++++00
Dizzy+++++or+++
The face tide is red+++++++
Have a headache++++++
Heart palpitates or once moved soon 00+s++
Skin rash++00
1. Outside week dropsy:See at the each kind of calcium Jie anti-, two hydrogen Mao Ding incidence rates are the tallest.Familiar at the ankle department, but may also is take place in a hand.The patient who often sits in silence a work easily takes place an outside week dropsy and is obvious in the evening.The outside week dropsy has something to do with calcium Jie anti- extending an afferent function.The blood vessel extends to cause the organization hair thin afferent pressure to increase Gao, accelerate liquid inside the blood vessel to filter thus, organization liquid increment, cause an outside week dropsy.
2. Be constipated:Familiar pull a Pa rice, AN oxygen Wei to pull a Pa rice at the benzene alkane An calcium Jie anti-,such as Wei, , may also is see in the sulphur nitrogen Zhuo Tong.Its occurrence degree becomes with the amount of use just related, the amount of is more big and degree happen as well heavy.Can ease gradually in the process of using over a long period of time in a row.
3. Headache and face swollen and inflamed:Also have something to do with blood vessel extend, generally and all can bear to be subjected to.In the process of using a medicine over a long period of time in, Be automatically regulated a mechanism by blood vessel, can disappear gradually.
4. Once moved soon or heart palpitates:Familiar fasten blood vessel to extend at 2 with the result that of the accelerative clinical performance of the glint heart Bo.The clinical application bigger was easy to occurrence when the clinical application bigger measure.Being subjected to the body Zu Zhi suitable for use with b can control that type of badly respond.While moreover and in great quantities applying the calcium Jie anti-, particularly giving through the vein path a medicine, it is proper of negative sex frequency function, take sex conduction a function and negative sex muscle dint the function can cause a heart rate to reduce slowly and the building room conduct a defer.The afferent and outside week resistance excessively lowers and can also cause the low blood pressure respond.
The recent years also discovers in the clinical usage process, some calcium Jie anti-,such as Wei, pulls the Er sulphur Zhuo Diltazem of Pa rice Verapamil, the Nifedipine of the nitric benzene Mao Ding and ground short date or over a long period of time cure may make blood dynamics and clinical prepare after the depravation.Owing to this, this text do the calcium Jie anti- all says in the bad reaction in the cardiovascular disease and cause the attention in the clinical usage by period.
1.Cure the mental exertion crock up
The calcium Jie anti- can extend whole body resistance blood vessel, carry after ease, the inflow myocardial cell inside Ca 2+ of Zu Zhi, decrease the calcium in the cell burden over-weight, the protection has already been placed in a myocardial of lack the blood appearance.Set out from that ories, the calcium Jie anti- is in the mental exertion crock up treatment in response to is that the safety is valid.But Elkayam[1] etc.s do random, the double be blind and cross of prospect research, more single use the nitric benzene Mao Ding or use effect and safety that the chronic Chong guts mental exertion of the ISDN treatment crock up with two nitric acids different suitable for use or list of the mountain pear Chun ester(ISDN), hint as a result cure an opposite and stable heart Shuai patient to add to use with the ISDN the heart Shuai obviously aggravates after the nitric benzene Mao Ding, 38% cases need to increase amount of diuretic, and 32% cases aggravate to stop halfway a research in advance because of the heart Shuai.Packer[2] etc. the research nitric benzene Mao Ding 20 mgs not whole to left heart function blood dynamics effect, have 55.2%(16 people) blood dynamics depravation as a result, the or so ventricles each Bo index number descend, average the right atrium press to go up, a year, existence rate only is 23%, but the heart Shuai worsenned of 13 people a year, the existence rate hints that the nitric benzene Mao Ding aggravates a patient heart Shuai degree for 67%(P<0.05).
Not only the nitric benzene Mao Ding has this kind of report way and have another central Geng according to the Diltazem clay-cold experiment of second cluster analysis[3] show, in the ventricles shoot the blood score<0.40 patients, 297 example patient’s 21% appear the Chong guts mental exertion in later period to crock up and the placebo set is 326 only 12%s.(P<0.01)The research result hint ground Er sulphur the Zhuo can aggravate original Chong guts the mental exertion crock up degree, dangerous rate and ventricles of its depravation shoot a blood score closely related.Another according to the MDPIT[4] experiment, have the second set patient of lung blood clot to the heart X image manifestation to carry on analysis, discover a ground of Er sulphur Zhuo a treatment a patient as a result the heart Shuai has already aggravated trend, heart ill the rate obviously increase.
What is the function mechanism which aggravate Chong guts mental exertion to crock up of the calcium Jie anti- ?Think currently[5] is mainly because of negative sex muscle dint function of calcium Jie anti-.It uses to repress a myocardial over a long period of time and make the origin have been already lower of heart constringency the function descends further and the blood dynamics worsen.Moreover the activity that can increase blood plasma to go to AN adrenaline and kidney vegetable of the calcium Jie anti-, activate system inside the source nerve hormone, particularly is a kidney vegetable?Afferent nervous plain system, cause afferent nervous plain II level to go up, produce Suo blood vessel to respond and the water sodium Zhu stay.This also is the important factor which results in the heart Shuai aggravate.The accurate mechanism is treat in a further research currently.
The clinical research has already express the generation short effect calcium Jie anti- the application often causes heart Shuai to aggravate in the heart Shuai the patient, poor suggest a clinical treatment Chong guts after prepare the mental exertion crocks up a patient should carefully use that type of medicine.
2.Cure angina pectoris
The calcium Jie anti- can repress a myocardial excitement hour flow inside Ca 2+, lower myocardial constringency dint, raise a myocardial to be subjected to sex towards lacking bear of blood, and extend blood vessel, increase hat vein a blood quantity, lower artery blood pressure, carry after easing heart, extensively used for anti- angina pectoris.But the recent years contain research enunciation, the hat vein for cause of the calcium Jie anti- extends rightness obviously from hat vein spasm with the result that angina pectoris(such as variation type angina pectoris, non- heart rate related concealment angina pectoris and excessively ventilate with part cold induct of angina pectoris) specially valid, if used for other type angina pectoris then a treatment is invalid even harmful.
Egstrup[although 6] nitric benzene Mao Dings can increase a normal myocardial to infuse to note area blood to provide, can’t change to even reduce hat vein a side to pay circulation to supply an area blood, have latent Cu part to provide a blood function, in the stability type the angina pectoris patient, any coronal side pays circulation blood better patient, this function is obvious and often make the angina pectoris symptom aggravate.
Muller[7] points out in early in the morning the period the research, the nitric benzene Mao Ding compares long effect nitric acid ester and the Pu Mao Luo Er curative effect in the aspects of controling unsteady lready set angina pectoris bad.Give the Luo Er and suitable for use with the nitric benzene Mao Ding or the United States according to the Trial(HINT) research of the Nifedipine/Metoprolol of the Hobland Interuiversity two medicine or use placebo to carry on a myocardial to lack blood to the unsteady already set angina pectoris experiment, result enunciation the nitric benzene Mao Ding to have already accepted the b Zu Zhi the unsteady lready set angina pectoris of the treatment a sufferer effectively, for have never give b Zu Zhi treatment sufferer, the nitric benzene Mao Ding and the United States give the consociation of Luo Er to use a medicine unlike the United States give Luo Er alone cure like.It is thus clear that, the b Zu Zhi is the head which cures unsteady already set angina pectoris to choose a project.But can choose the usage calcium Jie anti- for can’t bear to be subjected to the b Zu Zhi a sufferer(particularly is a merger breath way asthma sufferer).Moreover at the b Zu Zhi foundation up the consociation usage calcium Jie anti- can reduce side effect occurrence, to use the b Zu Zhi an invalid sufferer to add to use the nitric benzene Mao Ding to probably improve symptom alone.Currently in having already used the b Zu Zhi foundation the consociation usage calcium Jie anti- or the Wei’s pulling Pa rice’s etc. not 2 to used for in early days an unsteady already set angina pectoris treatment is notbetter choice.
3.Cure high blood pressure
The calcium Jie anti- gets into smooth muscle cell through Ca 2= of Zu Zhi, repress afferent and smooth muscle constringency, lower outside week artery resistance to make the blood pressure descend and be applicable to each high blood pressure.It is as well valid to can’t bear to be subjected to diuretic and the b Zu Zhi a sufferer.
But the recent years research put forward query to sufferer’s safety of the treatment high blood pressure of the calcium Jie anti-.Furberge[8] etc.s collected 16 random second class preventions that the nitric benzene Mao Dings used for a coronary to experiment and draw up evaluation the nitric benzene Mao Ding to influence to the death rate of quantity effect relation, result express, the short effect nitric benzene Mao Ding makes the death rate of coronary go up.(present amount of dependence)Use a 30-50 mgs, 60 mgs and 80 mg sufferer to everyday, the total death rate dangerous degree distinguishes to 1.06(95% can believe to limit to 0.81-1.27), 1.18(95% can believe to limit to 0.93-1.50), and 2.83.(95% can believe to limit to 1.35-5.93) Pahor[9] etc. the research be as a result also very alike.This research emphasizes the death of patient who analyze various medicine treatment high blood pressure dangerous, result the Wei pull a Pa rice in the treatment don’t suffer from the Chong guts the mental exertion crock up the patient, various the death rate that the reason cause the unlike b Zu Zhi be good, ground the Er sulphur Zhuo risk increase Gao but don’t show, the risk of the nitric benzene Mao Ding then obviously increases Gao.
The nitric benzene Mao Ding causes death rate to increase a high mechanism still incompletely clearly, probably stimulate with the sympathetic nerves of the calcium Zu Zhi glint, increment myocardial oxygen consumption, with the result that heart Lyu disorder;The negative change dint function;The sufferer’s hat vein which extend an afferent function to make a serious coronary of the calcium Zu Zhi provides blood reposition of redundant personnel to smaller hat vein side to pay circulation blood vessel and go to make the partial myocardial lack blood;Anti- blood platelets come together, increment surgical operation the patient bleed dangerous etc. relevant.
Short effect nitric benzene Mao this kind of side effect of Ding can push and other growth effect nitric benzene of the type calcium Jie anti- Mao Dings, only large, the prospect research then can confirm.Still can’t descend a hard conclusion currently.But it warns a clinical doctor, should still diuretic sufferer with the b Zu Zhi(or), there is usage calcium the Jie anti-\ACEI when the other anti- high blood pressure medicine advertise for, should choose to the most suitable and proper medicine of patient’s individual.
On the Zong say, there has been clinical hint using a short effect in the cardiovascular disease currently, the generation calcium Jie anti- disease sufferer with cardiovascular rightness bad influence after prepare.Therefore suggest that the clinical doctor cures mental exertion to crock up\angina pectoris and high blood pressure sufferer, should choose feat medicine according to the individual difference of condition, and avoid using a short effect over a long period of time, the generation calcium Jie anti
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