Résumé
Objective To investigate the influence of mannitol and glycerin injection (containing 15％ mannitol and 15％ glycerin) on experimental intracranial hypertension.Methods Rabbits were randomly divided into eight groups (n =8 rabbits/group):normal control group,model control group,mannitol-glycerol injection groups (2.5 ml/kg group,5 ml/kg group,and 10 ml/kg group),compound mannitol injection fluid group,20％ mannitol group,and 10％ glycerol-sodium chloride injection group.The continuous intravenous infusion of nitroglycerin [0.04 mg/(kg · min),10 min] on rabbits was used to establish intracranial hypertension model except the normal control group of animals,and effect of mannitol glycerol injection on it with a single intravenous injection was observed.Serum renal function,electrolytes and other indicators were tested.Results Intravenous infusion of mannitol glycerol injection (2.5 ml/kg,5 ml/kg,and 10 ml/kg) could significantly reduce rabbit nitroglycerin-induced intracranial hypertension,and dosedependent,with increasing dose reducing intracranial pressure could enhance(P ＜ 0.05).Mannitol glycerol injection (5 ml/kg) produced the same intracranial pressure compared to 20％ mannitol and compound mannitol injection,and maintained a long-time role.Conclusions Mannitol glycerin injection can significantly reduce intracranial pressure.Its intensity is the same as 20％ mannitol and compound mannitol injection,and maintains a longer intracranial pressure without significant renal dysfunction and electrolyte distnrhances.
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Objective To compare the clinical effect of valsartan/amlodipine combination or irbesartan/hydrochlorothiazide(HCTZ)combination in very elderly hypertensives.Methods After a 4-week placebo period,94 hypertensives,aged 75-89 years were random given valsartan 160 mg/amlodipine 5 mg or irbesartan 300 mg/HCTZ 12.5 mg for 24 weeks according to a rospective study.After 4 weeks,amlodipine or HCTZ was doubled in non-responders.Patients were checked every 4 weeks.At each visit,sitting,lying and standing blood pressure(BP),systolic BP(SBP)and diastolic BP(DBP)were measured. At the end of placebo period and treatment period,electrolytes and uric acid were evaluated.Results Blood pressure was significantly decreased in both treatment groups,however,there was no statistical significance between two groups.BP changes from lying to standing position were significantly greater in the irbosartan/HCTZ group(-17.2/-9.1 mmHg)than that in the valsartan/amlodipine group(-10.1/-1.9 mmHg,t=2.14,P＜0.05 for SBP and t=3.11,P＜0.01 for DBP vs.irbesartan/HCTZ).Potassium significantly decreased and uric acid significantly increased(-0.4 mmol/L,t = 2.33,P＜ 0.05 and+29.7μ mol/L,t =2.54,P＜0.05 vs.baseline,respectively)only in the irbesartan/HCTZ group.Conclusions Both combinations had similarly effective in reducing clinical BP in very elderly hypertensives.However,valsartan/amlodipine offered some advantage and less pronounced BP orthostatic changes and absence of metabolic adverse effects.
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Objective To examine the barbiturate infusion for intractable intracranial hypertension and its effect on brain tissue oxygen ( PbtO2 ). Method 60 patients with intractable intracranial hypertension were divided into tow groups, experimental group and control group. PbtO2 and intracranial pressure (ICP) were continuous monitored. Follow-up was more than 3 months and the prognosis was compared between two groups. Results When pentobarbital administration began, the mean PbtO2 [ 72 h: (26. 7 ±6. 7)mmHg] at 24h, 48h and 72h in experimental group were significantly higher than that of control group [ 72 h: ( 21. 1 ± 7. 2) mmHg ] ( P < 0. 05 ). The mean ICP [ 5 d: (2. 48 ± 1.11 ) kPa ] in the third and fifth day of experimental group were lower than that of control group [ 5 d: (3. 12 ± 1.09 ) kPa ]. Prognosis of pentobarbital group was better than control group( P < 0. 05 ). Conclusions Pentobarbital can effectively reduce intracranial pressure in patients with refractory intracranial hypertension and improve brain tissue oxygen. PbtO2 is an ideal monitoring marker, and it can predict prognosis to a certain extent.