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1.
高血压病患者的运动血压及影响因素   总被引:2,自引:2,他引:2  
目的研究高血压病患者的运动血压及影响因素.方法监测327例1、2级高血压患者及64例正常者在活动平板运动试验中的血压反应,分析可能对其有影响的因素偶测血压、性别、年龄、体质指数、血脂、病程、吸烟、饮酒及家族史等.结果活动平板运动试验中高血压患者及正常者随运动量增加血压反应增高,高血压患者运动中、最大运动量及恢复期的血压反应均显著高于正常组,2级高血压组显著高于1级高血压组,运动中最高血压正常组为154±15 mmHg/81±10 mmHg, 1级高血压组为193±14 mmHg/96±7 mmHg, 2级高血压组为204±13 mmHg/102±7 mmHg.以运动高血压为标准,正常组有运动高血压4.68% , 1级高血压组有41.27% , 2级高血压组有75.76% , 各组间均有显著性差异.多元逐步回归分析显示运动中最高收缩压与偶测SBP、胆固醇、高密度脂蛋白、偶测DBP、低密度脂蛋白、体质指数、年龄、饮酒、性别有关;运动中最高舒张压与偶测SBP、胆固醇、偶测DBP、年龄、性别、饮酒、体质指数有关.结论各级高血压患者的运动血压反应具有统计学意义,运动血压除与偶测血压密切相关外,其他相关因素与高血压发病的危险因素相似,本研究所得血压反应值可为其在临床的应用提供参照依据.  相似文献   

2.
目的 探讨住院2型糖尿病(T2DM)患者血压控制的影响因素。方法 169例合并高血压的T2DM患者给予降压等综合治疗,以出院时血压130/80mmHg为界限分为达标组(n=97)及未达标组(n=72),比较两组入院时临床及实验室指标,并通过回归分析观察各种因素对出院时平均动脉压(MAP)水平的影响。结果 全组T2DM入院时收缩压(SBP)为143±15 mmHg,舒张压(DBP)为 78±8 mmHg,控制达标率仅17.8%;出院时血压达标率57.4%,降压药物种类平均增加0.8种。未达标组患者入院时SBP(151±15 vs. 137±12 mmHg, P=0.000)、DBP(80±9 vs. 77±7 mmHg, P=0.000)均高于达标组,且总胆固醇(TC)及24h尿白蛋白排泄率(UAE)显著升高。回归分析显示MAP与入院时SBP、DBP、TC及高血压病程显著正相关,与年龄负相关;MAP与UAE显著正相关(r=0.303, P=0.000)。合并糖尿病肾病(DN)患者随UAE增多而SBP显著升高,大量蛋白尿者需要多种降压药物联合且血压难以控制。结论 T2DM患者门诊血压控制达标率低;住院T2DM患者血压控制受入院时血压水平、高血压病程、高胆固醇血症、高UAE等因素影响;UAE增加可能是合并DN患者血压难以控制的直接原因。  相似文献   

3.
目的探讨广东佛山市普君街道办事处老年高血压患病率情况.方法按统一方法对佛山市禅城区普君街道办事处60岁以上常住居民3382人进行现场问卷调查,同时测量人体基本参数如血压、身高、体重等,并进行餐后2小时血糖测定,以及空腹血糖、血脂常规、血尿酸等测定.结果高血压粗患病率40.0%,标化率为40.0%,较佛山1993年(51.5%)明显下降.单纯收缩期高血压(ISH)粗患病率21.3%,标化率为22.1%.女性患病率高于男性.新检出高血压患者占高血压病患者总数的40.1%,ISH占高血压病患者总数的53.9%,随年龄增长高血压患病率增高.老年人群平均收缩压(SBP)为126±17 mmHg、舒张压(DBP)为77±8 mmHg、脉压(PP)为49±11 mmHg.高血压组的年龄、血压、体重、体重指数、餐后2小时血糖、空腹血糖、尿酸及血脂(总胆固醇、甘油三酯)与非高血压组比较有差异,(P<0.01~0.05).结论高血压与多种危险因素有密切相关,佛山市老年人高血压患病率高,应当重视开展高血压的社区防治.  相似文献   

4.
中年血压正常者和高血压患者血清总胆固醇水平是发生心血管疾病,特别是冠心病的主要危险因素,但老年患者任何一种心血管疾病的死亡原因都不是单一的。本文用随机双盲法研究老年高血压患者血清总胆固醇水平是否与预后不良有关。患者和方法:老年高血压患者822例,女性占70%,年龄72±8岁,坐位血压24.2±2.3/13.4±0.9kPa,体重67±12kg,血清总胆固醇6.36±1.34mmd/1,心血管并发症36%;早期平均胆固醇水平女性高于男性(6.46对6.07mmol/L,P<  相似文献   

5.
目的:研究高血压人群中发现的肾上腺醛固酮瘤切除手术前安体舒通治疗围手术期降压的临床疗效。方法:回顾34例肾上腺醛固酮瘤临床资料,分析术前安体舒通试验性治疗效果围手术期血压变化。结果:安体舒通治疗有效组(18例)比无效组(16例)围手术期收缩压和舒张压都显著下降[收缩压:(125.7±7.0)mmHgvs(140.9±15.6)mmHg,舒张压:(75.8±7.0)mmHgvs(86.2±8.9)mmHg,P<0.01]。与安体舒通试验性治疗前的血压相比,安体舒通治疗有效组围手术期收缩压和舒张压都显著下降[收缩压:(144.7±7.5)mmHgvs(125.7±7.0)mmHg,P<0.01,舒张压:(93.6±6.9)mmHgvs(75.8±7.0)mmHg,P<0.01],而无效组则均无统计学差异[收缩压:(144.6±11.3)mmHgvs(140.9±15.6)mmHg,(91.2±10.4)mmHgvs(86.2±8.9)mmHg,P<0.05]。将围手术期血压变化与安体舒通治疗效果进行偏相关分析,控制所有与安体舒通治疗相关和影响围手术期血压的因素,安体舒通试验治疗收缩压和舒张压改变分别与围手术期血压改善呈正相关(r=0.434,P=0.03;r=0.716,P=0.001)。结论:在高血压人群中筛选的肾上腺醛固酮瘤,术前安体舒通治疗(抗醛固酮治疗)的有效性与围手术期血压改善呈正相关。  相似文献   

6.
目的探讨Tv1>Tv5、v6与高血压的相关性.方法对正常健康体检心电图无其它异常仅有Tv1>Tv5,v6者分为≥50岁(A组)及<50岁(B组)两组,记录血压情况,作13年随访.结果Tv1>Tv5、v6高血压发生率占41%,均见于A组.高血压发病时间1~30(11.1±9.4)年.最高血压收缩压140~220(170±26)mmHg;舒张压80~130(101±14)mmHg.随访发现,高血压发生率提高到74.3%.A组高血压发生率达到96%;B组高血压发生率仅为20%,差异显著(P<0.01).结论Tv1>Tv5、v6与高血压呈密切的相关性,并随年龄增大高血压发病率增高.  相似文献   

7.
胰岛素抵抗而非高胰岛素血症与高血压相关   总被引:12,自引:1,他引:11  
目的探讨胰岛素抵抗(IR)与高血压的关系.方法872例受试者根据收缩压(SBP)、舒张压(DBP)水平各分成6组.SBP1<120mmHg(1mmHg=0.133kPa);SBP2120~129mmHg;SBP3130~139mmHg;SBP4140~159mmHg;SBP5160~179mmHg;SBP6≥180mmHg.DBP1<80mmHg;DBP280~84mmHg;DBP385~89mmHg;DBP490~99mmHg;DBP5100~109mmHg;DBP6≥110mmHg.结果(1)单因素方差分析表明,不同血压水平的HOMA胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(IAI)、空腹血糖、餐后血糖、体重指数(BMI)、腰臀比值(WHR)、甘油三酯、胆固醇和年龄差异有显著性(P<0.05),但不同血压水平的空腹胰岛素(FINS)、餐后胰岛素(PINS)差异无显著性.双因素方差分析表明,BMI对血压有明显影响,但FINS和PINS对血压无明显影响.(2)Pearson相关分析表明,SBP、DBP与BMI、WHR、PINS、空腹血糖、餐后血糖、胆固醇、甘油三酯、HOMA-IR和年龄等多变量正相关.但控制BMI的影响后,偏相关分析表明,SBP、DBP与PINS无相关性.(3)以平均血压(MBP)与HOMA-IR、IAI、BMI、WHR、FINS、PINS、空腹血糖、餐后血糖、甘油三酯、胆固醇、年龄作回归分析,能进入该方程的变量为年龄和BMI.回归方程为MBP=49.062+0.475×年龄+0.947×BMI.结论(1)影响血压的因素众多,主要取决于年龄和BMI.(2)IR较高胰岛素血症与高血压的关系更加密切,高胰岛素血症可能不是致高血压的独立危险因素.  相似文献   

8.
江苏金坛农村心血管病危险因素的趋势   总被引:1,自引:0,他引:1  
目的了解近15年金坛农村心血管病危险因素的变化趋势。 方法分别于1984年、1992年和1998年随机抽取35~59岁者做心血管病危险因素调查(实际调查人数男女分别为974/1147、491/616、496/636人)。 结果从1984年到1998年,男女血压分别从119/74mmHg(1mmHg=0.133kPa)、119/73mmHg增加到126/80mmHg、125/77mmHg;血清总胆固醇从3.15mmol/L、3.20mmol/L增加到4.86mmol/L、4.76mmol/L;男女高血压患病率从13.9%、12.7%增加到24.7%、19.2%;男性饮酒率从43.1%增加到63.8%;1998年糖尿病患病粗率男女分别为8.1%、9.3%。 结论金坛农村主要心血管病危险因素呈上升趋势,应加以干预。  相似文献   

9.
受试者有:A组43例原发性高血压(收缩压≥160mmHg和/或舒张压≥95mmHg),B组16例临界高血压,C组17例正常血压(≤140/90mmHg)。A组各例均无心力衰竭、肾功能衰竭或代谢疾病;试验前从未服用降压药物或者试验前至少2周降压药物已从体内清除;其中4例因高血压急症而入院。(A、B和C)三组的年龄(53±9、49±11和48±10岁)、性别(男性56.8%、50.0%和52.0%)和血清肌酐浓度(1.0±0.3、0.9±0.3和0.9±0.3mg/dl)均无显著差别。三组平均动脉压分别为127.0±18.2、109.6±3.7和94.1±7.1mmHg;血浆心钠素水平  相似文献   

10.
目的探讨新疆维吾尔族人群内皮型一氧化氮合酶基因(endothelialnitricoxidesynthasegene,eNOS)第7外显子894G→T多态性与原发性高血压(essentialhypertension,EH)之间的关系。方法应用多聚酶链反应、限制性片段长度多态性技术(PCR-RFLP)对新疆地区375例EH患者(EH组)及正常血压者414例(NT组)的eNOS第7外显子894位进行基因分型,并采用生化技术测定其空腹血糖、血浆胆固醇、甘油三酯、胆红素,测定体重指数等水平。结果(1)eNOS基因第7外显子894G→T多态性符合Hardy-Weinberg平衡;GG、GT、TT基因型频率在维吾尔族EH患者及正常人群中分布分别为56.5%、28.3%、15.2%和65.9%、22.5%、11.6%,T等位基因频率分别为29.33%和22.83%,该位点各基因型频率与等位基因频率在维吾尔族高血压组和正常对照组中差异有统计学意义(P<0.05,OR=2.97,95%可信区间1.393~6.358)。(2)在EH组中GT+TT基因型者的收缩压[(171.36±22.30)mmHg,1mmHg=0.133kPa]和舒张压[(103.63±13.22)mmHg]均显著高于GG基因型者[(158.07±20.85)mmHg和(89.90±10.39)mmHg],两组比较差异有统计学意义(P<0.01)。结论eNOS基因第7外显子894G→T变异可能是中国新疆维吾尔族人群EH的一种遗传易感性指标。  相似文献   

11.
Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.  相似文献   

12.
Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.  相似文献   

13.
目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤,因其临床表现多样,导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用,拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点,以期有助于提高影像学的诊断准确率和降低漏诊率,尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料,检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例,通过查阅病例的方法,提取出胰岛素瘤的大小和解剖分布等数据,进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例,其中,男45例、女71例,年龄13~76岁,平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布:头颈部46例(39.7%),单发45例、多发1例;体尾部68例(58.6%),单发65例、多发3例;全胰腺多发2例(1.7%)。病变大小特点:最大径0.4~3.4 cm,平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例,≤3 cm 15例,>3 cm 3例。年龄与肿瘤的大小相关,≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm,P<0.05。头颈部的肿瘤大于体尾部的肿瘤,头颈部肿瘤平均大小(1.66±0.63)cm,体尾部(1.42±0.52)cm,P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发;绝大多数单发,但可以全胰腺多发;多数小于1.5 cm,肿瘤的大小与患者年龄和肿瘤的解剖分布相关。  相似文献   

14.
氯硝柳胺悬浮剂的毒性评价   总被引:2,自引:2,他引:2  
目的评价氯硝柳胺悬浮剂的毒性,为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg,经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3,该药经口、经皮肤、经呼吸道毒性均属微毒类药物;兔眼用药后,观察期内无不良反应,对眼无刺激性;皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比,氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物,对鱼的毒性低于其乙醇胺盐可湿性粉剂,适合于现场应用。  相似文献   

15.
BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.  相似文献   

16.
研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P<0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P>0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。  相似文献   

17.
血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。  相似文献   

18.
目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。  相似文献   

19.
目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。  相似文献   

20.
Results of treatment of fistula-in-ano   总被引:4,自引:1,他引:3  
To evaluate the application of Parks' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9 percent, transsphincteric, 52.1 percent, suprasphincteric, 1.3 percent, extrasphincteric, 0. A horseshoe extension occurred in 8.8 percent of the fistulas and 3.8 percent did not exactly conform to the classification as they were either complex or combinations of more than one type of fistula. The sole immediate postoperative complication was bleeding, which occurred one week postoperatively and ceased spontaneously (0.7 percent). Alteration in continence occurred in 6 percent of patients with 2.6 percent experiencing temporary incontinence to flatus, 1.3 percent to liquid stool, and 0.7 percent to solid stool. Permanent loss of control for flatus occurred in one patient (0.7 percent) and for liquid stool in one patient (0.7 percent). No patients suffered loss of control for solid stool. Recurrence developed in 6.3 percent of patients, all between five and 25 months postoperatively. Classifcation was found to be a useful guide in the operative management of patients with fistula-in-ano. Read at the joint meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana, May 6 to 11, 1984.  相似文献   

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