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1.
目的研究血管紧张素转换酶(ACE)基因I/D多态性和醛固酮合成酶(CYP11B2)基因-344T/C多态性与氢氯噻嗪降压疗效的关系。方法829例高血压病(EH)患者同时服用氢氯噻嗪12·5mg(1次/d),6周后资料完整的785例患者按不同ACE基因型和CYP11B2基因型分组,比较不同基因型和不同基因型组合间血压下降值有无差别。结果服用氢氯噻嗪6周后,ACE基因II、ID、DD型患者收缩压分别下降(5·1±14·8)mmHg(1mmHg=0·133kPa)、(4·8±16·3)mmHg和(9·4±15·7)mmHg,DD型患者下降值大于II、ID型患者,组间比较差异有统计学意义(P<0·00);CYP11B2基因TT、TC、CC型患者收缩压下降值分别为(5·8±16·2)mmHg、(5·5±14·9)mmHg和(7·6±16·1)mmHg,组间比较差异无统计学意义。DD+CC基因型患者收缩压下降值为(10·6±12·3)mmHg,高于其他基因型组合患者,但差异无统计学意义(P>0·05)。多因素分析结果表明DD基因型和治疗前醛固酮浓度是影响患者坐位收缩压下降的主要因素。结论ACE基因的DD型与氢氯噻嗪的降压疗效相关,CYP11B2基因CC型、DD+CC型患者对氢氯噻嗪的降压反应可能优于其他基因组合患者。  相似文献   

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目的研究血管紧张素转换酶(ACE)基因I/D多态性和α-adducin基因G614T多态性与氢氯噻嗪降压疗效的关系.方法829例原发性高血压患者同时服用氢氯噻嗪12.5mg,1次/d,6周后资料完整的754例患者按不同ACE基因型和α-adducin基因型分组,比较不同基因型组和组合基因型组血压下降值.结果服用氢氯噻嗪6周后,DD基因型患者收缩压下降值大于II、ID型患者,差异有统计学意义(P<0.05).TT基因型患者收缩压下降值大于GG、GT型患者,差异有统计学意义(P<0.01);TT、GT基因型患者舒张压下降值大于GG基因型患者,差异有统计学意义(P<0.01);多因素分析结果表明DD基因型、TT基因型、DD+TT组合基因型、治疗前醛固酮(Ald)水平是影响患者收缩压下降的主要因素.结论ACE基因I/D多态性、α-adducin基因G614T多态性均与氢氯噻嗪的降压疗效相关;DD+TT组合基因型对HCTZ的降压反应可能优于其他组合基因型.  相似文献   

3.
目的 研究血管紧张素转换酶(ACE)基因I/D多态性和α-adducin基因G614T多态性与氢氯噻嗪降压疗效的关系。方法 829例原发性高血压患者同时服用氢氯噻嗪12.5mg,1次/d,6周后资料完整的754例患者按不同ACE基因型和α-adducin基因型分组,比较不同基因型组和组合基因型组血压下降值。结果 服用氢氯噻嗪6周后,DD基因型患者收缩压下降值大于II、ID型患者,差异有统计学意义(P<0.05)。TT基因型患者收缩压下降值大于GG、GT型患者,差异有统计学意义(P<0.01);TT、GT基因型患者舒张压下降值大于GG基因型患者,差异有统计学意义(P<0.01);多因素分析结果表明:DD基因型、TT基因型、DD TT组合基因型、治疗前醛固酮(Ald)水平是影响患者收缩压下降的主要因素。结论 ACE基因I/D多态性、α-adducin基因G614T多态性均与氢氯噻嗪的降压疗效相关;DD TT组合基因型对HCTZ的降压反应可能优于其他组合基因型。  相似文献   

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目的 探讨血管紧张素转换酶(ACE)基因I/D与血管紧张素Ⅱ-1型受体(AT1R)基因A1166C多态性与氢氯噻嗪(HCTZ)降压疗效的关系.方法 原发性高血压患者服用HCTZ 6周后,按不同ACE基因型和AT1R基因型分组,比较不同基因型组合患者的血压下降值.结果 ACE基因DD、ID、II基因型患者收缩压均下降,DD基因型患者收缩压下降值显著大于ID、II型患者(P<0.05);AT1R基因AC(CC)和AA基因型患者收缩压下降值组间比较无显著差异(P>0.05);DD AC(CC)基因型组合患者收缩压亦下降,与其他基因型组合患者比较无显著差异(P>0.05).多因素分析结果表明,治疗前醛固酮浓度和DD基因型是影响患者收缩压下降的主要因素.结论 ACE基因的DD基因型与HCTZ的降压疗效相关;AT1R基因AC(CC)、DD AC(CC)型组合患者对HCTZ的降压反应可能优于其他基因型组合患者.  相似文献   

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目的:探讨血管紧张素转化酶(ACE)基因I/D多态性与奥美沙坦酯降压疗效的关系。方法:高血压患者服用奥美沙坦酯8周,在观察降压疗效的同时,用PCR—RFLP方法对患者血白细胞基因组DNA多态性位点ACEI/D基因型进行检测;按不同ACE基因型进行分组,比较不同基因型患者的血压下降值、降压总有效率的差异。结果:ACE基因ID+DD基因型和II基因型患者使用奥美沙坦酯8周后收缩压下降幅度分别为16.23±6.51mmHg(2.164±0.868kPa,1kPa=7.5mmHg)、5.10±8.66mmHg,降压总有效率分别为81.25%、33.34%,组间比较有统计学差异(P〈0.05);舒张压下降幅度分别为13.34±7.25mmHg、6.21±5.29mmHg,组间比较无统计学差异(P〉0.05)。结论:ACE基因ID+DD基因型高血压患者对奥美沙坦酯降压治疗较敏感。  相似文献   

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醛固酮合成酶基因多态性对氢氯噻嗪降压疗效的影响   总被引:1,自引:1,他引:0  
采用PCR技术检测734例同时服用氢氯噻嗪患者醛固酮合成酶(CYP11B2)基因型,比较不同基因型间的降压疗效。结果TT、TC、CC基因型间舒张压及平均动脉压下降值差异均无统计学意义(P均〉0.05),但CC基因型患者收缩压下降值大于其他两型。提示高血压病患者不同CYP基因型对氢氯噻嗪的降压疗效存在一定影响。  相似文献   

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目的为了探讨血管紧张素转化酶(ACE)基因多态性与高血压左室肥厚(LVH)的关系.方法利用外周血白细胞抽提基因组DNA、体外PCR基因扩增的方法检测68例高血压LVH患者ACE基因第16内含子、长度为287 bp的片段插入/缺失(I/D)多态性,并将患者分为DD、ID、II三种基因型.观测给予口服氯沙坦(50 mg~100 mg/d、部分病例加用氢氯噻嗪12.5 mg~25 mg/d)20周前后患者坐位收缩压(SBP)、舒张压(DBP)、超声心动图左房内径(LAD)、舒张末期室间隔厚度(IVST)、左室后壁厚度(PWT)、左室舒张末期内径(LVDd)及左室重量指数(LVMI)的变化.结果 (1) 68例高血压LVH患者中,ACE基因DD型17例(25%)、ID型22例(32%)、II型29例(43%),D和I等位基因频率分别为0.41和0.59.(2) 所有患者口服氯沙坦20周后,SBP、DBP明显下降;但其它观测指标却因基因型不同而呈现不同的变化.LVMI的下降幅度,DD型为7.4%,ID型为5.2%,II型为2.3%,DD型与ID型、II型相比,有显著性差异.结论 (1) ACE基因I/D多态性可能与高血压LVH有关,ACE基因DD型可能是高血压LVH的独立危险因子.(2) 氯沙坦可以显著降低高血压LVH患者的血压、逆转LVH,且以ACE基因DD型效果较好(与ID型、II型相比).  相似文献   

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目的 为了探讨血管紧张素转化酶(ACE)基因多态性与高血压左室肥厚(LVH)的关系。方法 利用外周血白细胞抽提基因组DNA、体外PCR基因扩增的方法检测68例高血压LVH患者ACE基因第16内含子、长度为287bp的片段插入/缺失(I/D)多态性,并将患者分为DD、ID、II三种基因型。观测给予口服氯沙坦(50mg~100mg/d、部分病例加用氢氯噻嗪12.5mg~25mg/d)20周前后患者坐位收缩压(SBP)、舒张压(DBP)、超声心动图左房内径(LAD)、舒张末期室间隔厚度(IVST)、左室后壁厚度(PWT)、左室舒张末期内径(LVDd)及左室重量指数(LVMI)的变化。结果 (1)68例高血压LVH患者中,ACE基因DD型17例(25%)、ID型22例(32%)、II型29例(43%),D和I等位基因频率分别为0.41和0.59。(2)所有患者口服氯沙坦20周后,SBP、DBP明显下降;但其它观测指标却因基因型不同而呈现不同的变化。LVMI的下降幅度,DD型为7.4%,ID型为5.2%,II型为2.3%,DD型与ID型、II型相比,有显著性差异。结论 (1)ACE基因I/D多态性可能与高血压LVH有关,ACE基因DD型可能是高血压LVH的独立危险因子。(2)氯沙坦可以显著降低高血压LVH患者的血压、逆转LVH,且以ACE基因DD型效果较好(与ID型、II型相比)。  相似文献   

9.
α-内收蛋白基因多态性与氢氯噻嗪降压疗效的相关性研究   总被引:8,自引:0,他引:8  
Wu SL  Li DQ  Li HF  Yu Q  Li Y  Zhao HY 《中华心血管病杂志》2005,33(10):880-884
目的探讨原发性高血压患者α-内收蛋白基因多态性与氢氯噻嗪降压疗效的相关性。方法829例原发性高血压患者同时服用氢氯噻嗪12.5mg,每日1次,共6周,用PCR—RFLP方法检测α-内收蛋白基因第10外显子G614T单核苷酸多态性(SNP)。资料完整的754例原发性高血压患者按'IT、GT、GG三种基因型分组,比较不同基因型患者的降压疗效。结果含T等位基因患者的△舒张压(DBP)、A平均动脉压(MAP)值大于GG基因型患者的ADBP、AMAP值,差异有统计学意义(P〈0.05);TT基因型患者的△收缩压(SBP)、AMAP值大于GT、GG基因型患者的ASBP、AMAP值,差异有统计学意义(P〈0.05);TT基因型患者的降压有效率高于GT、GG基因型患者的降压有效率,差异有统计学意义(P〈0.05)。多元逐步回归分析显示:TT基因型、治疗前SBP水平是影响收缩压下降值的主要因素。结论α-内收蛋白基因多态性与氢氯噻嗪的降压疗效相关,TT基因型患者的降压疗效最显著。  相似文献   

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目的研究原发性高血压(EH)患者血管紧张素转换酶(ACE)基因I/D、醛固酮合酶(CYP11B2)基因344T/C和α内收蛋白(αadducin)基因G614T不同基因多态性组合与氢氯噻嗪(HCTZ)降压疗效的关系。方法829例EH患者同时服用HCTZ12.5mg,1次/d,共6周。资料完整的716例患者按ACE、CYP11B2及αadducin不同基因多态性组合,比较不同基因多态性组合患者的降压疗效。结果27种不同多态性组合中,ACEID CYPTT αadducinTG多态性组合在患者中分布频率最高(ACEDD CYPTC αadducinTT)基因多态性组合的患者收缩压下降值最大(17.7±30.5)mmHg,显著高于其它基因多态性组合(P<0.05);多元逐步回归分析提示:ACE基因DD型、αadducin基因TT型、ACEDD CYP11B2TC αadducinTT基因多态性组合等是影响患者收缩压下降值的主要因素。结论不同ACE基因I/D、CYP11B2基因344T/C、αadducin基因G614T多态性组合患者对氢氯噻嗪的降压疗效存在差异;ACEDD CYP11B2TC αadducinTT基因多态性组合对HCTZ的降压疗效优于其他基因多态性组合的患者。  相似文献   

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Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.  相似文献   

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目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。  相似文献   

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The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.  相似文献   

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Pylorus preservation has been advocated to decrease the morbidity associated with the classical or standard pancreaticoduodenectomy. The proposed advantages are decreased incidence of peptic ulceration, dumping syndrome, and nutritional problems. However, after an initial period of enthusiasm for the procedure, it is now being found that marginal ulceration at the duodenojejunal anastomosis is encountered with increasing frequency. Delay in gastric emptying occurs frequently, with an overall incidence of 30%. With the availability of better pancreatic enzyme supplements, the current incidence of nutritional problems and weight loss after the standard Whipple procedure is unknown. Whether there is a difference in long-term survival after the two procedures performed for adenocarcinoma of the head of the pancreas is still debatable. A controlled trial is needed to answer many of these questions, and pylorus-preserving pancreaticoduodenectomy should be used cautiously until further data become available.  相似文献   

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The relation between the mesorectal vessels and the mesorectal fascia needs to be clarified, as a total mesorectal excision (TME) probably derives its advantage from the fact that the visceral or mesorectal fascia can be regarded as a “tumor-tight packaging” and does not contain anatomically preformed perforations. The purpose of this investigation was to study both rectal arterial supply and vascular distribution pattern within the mesorectum. The arterial supply to the rectum was studied with the injection technique in 12 porcine and 28 human TME specimens. We stain-marked 12 porcine and 15 human specimens. Thirteen human specimens were angiographed after filling their arterial bed with a radio-opaque substance. The superior rectal artery is the main rectal artery. Terminal branches extend downwards and forward around the rectum to the level of the levator and muscle. The superior rectal artery and vein were found to be enclosed in a fibrous sheath. The main mesorectal vessels do not penetrate the mesorectal fascia. This study supports the hypothesis of bilateral somatic and one central visceral compartment in the pelvis and implies the absolute necessity of tumor removal within an intact mesorectal fascia. Received: 15 August 2000 / Accepted in revised form: 1 October 2000  相似文献   

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