高血压合并2型糖尿病患者动态血压状况

目的：探讨高血压合并2型糖尿病患者24小时血压变化状况,指导临床用药。方法：采用MOBIL-O-Graph动态血压监测仪监测40例原发性高血压病（EH组）和38例原发性高血压病合并2型糖尿病（DM组）患者24小时血压,比较24hSBP、24hDBP、dSBP、dDBP、nSBP、nDBP、血压负荷值、血压昼夜节律。结果：24hSBP、24hDBP、dSBP、dDBP、白天血压负荷值无差异（P〉0.05）,nSBP、nDBP、夜间血压负荷及血压昼夜节律存在差异（P〈0.05）。结论：高血压合并2型糖尿病患者夜间血压升高,夜间负荷值升高,血压昼夜节律发生改变。     

温州市绝经后妇女血脂变化

抽样调查温州市女５５岁男６０岁以上人群的血脂，以了解温州市绝经后妇女的血脂变化特点。结果如下：（１）绝经后妇女血总胆固醇（ＴＣ０、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）水平及混合笥高脂血症、高ＴＣ血症、主同ＬＤＬ－Ｃ血症明显高于同龄男性。（２）绝经后妇女血ＴＣ、ＬＤＬ－Ｃ主混合性高脂血症、高ＴＣ血症高ＬＤＬ－Ｃ血症患病主顷６０￣岁组明显高于餐经期组（５５－岁组），提示温州市绝经后妇女存在着明显的血脂代谢     

福辛普利改善原发性高血压并糖耐量减低患者血压、血糖及血管功能的研究

目的：探讨福辛普利对原发性高血压并糖耐量减低患者血压、血糖及血管功能的影响。方法：选择本院2012年4月-2013年7月收治的原发性高血压并糖耐量减低患者48例,全部患者均给予福辛普利治疗,5 mg/次,1次/d,疗程为6个月,治疗前后检测患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、内皮素（ET）、收缩压（SBP）、舒张压（DBP）、空腹胰岛素（FINS）以及胰岛素抵抗指数（HOMA-IR）,并测定治疗前后脉搏波传导速度（baPWV）变化情况。结果：治疗后患者SBP、DBP、2 h PG、FINS、HOMA-IR、ET、baPWV均明显低于治疗前,前后比较差异均有统计学意义（P〈0.05）,治疗前后FPG比较差异无统计学意义（P〈0.05）。结论：福辛普利治疗原发性高血压合并糖耐量减低患者效果良好,可在降低血压的同时,减轻胰岛素抵抗,改善血管内皮功能及大动脉弹性及顺应性,值得应用。     

Correlates of Physical Activity in Pregnancy among Latina Women

Objectives: National data indicate that Latina women are less active than non-Latina white women and are at higher risk of gestational diabetes and subsequent type 2 diabetes. Physical activity may reduce risk of maternal disorders of pregnancy, but sparse data exists on the correlates of physical activity in pregnant Latina women. Methods: We conducted a prospective cohort study from 2000 to 2004 among healthy Latina prenatal care patients in a public clinic and midwifery practice. Physical activity was assessed using a modified version of the Kaiser Physical Activity Survey (KPAS) in early and mid pregnancy. Results: A total of 1,231 women (predominantly of Puerto Rican heritage) met the eligibility criteria and were enrolled. Participation in household/caregiving, occupational, sports/exercise, and active living decreased from prepregnancy to pregnancy. Overall, women who were more active prior to pregnancy were more likely to have high levels of participation in every domain of pregnancy activity. Women with the highest level of participation in occupational activity during pregnancy (defined as the highest quartile of activity, compared with the lower three quartiles) were more likely to be older, college-educated, have higher income, and have fewer children. Women with the highest level of household/caregiving activity were more likely to be older, have more children, be U.S. born, and prefer Spanish while women with the highest levels of sports/exercise during pregnancy were less likely to prefer Spanish. Conclusions: These findings suggest that sociodemographic, acculturation, health, and behavioral correlates of physical activity vary by domain among Latina women. Programs aimed at promoting physical activity during pregnancy in this high risk ethnic group should recognize these differences.     

昆明市城乡居民劳动强度与高血压患病关系研究

目的探讨城乡居民劳动强度与高血压的关系,为高血压防治提供基础数据。方法于2008年1—4月采用多阶段随机抽样方法,抽取昆明市20岁及以上常住城乡居民5191人,进行问卷调查、人体测量及生化指标检测和劳动强度分级。结果调查对象中轻体力劳动、中等体力劳动和重体力劳动的高血压患病率分别为33．8％、24．9％和18．1％,糖尿病患病率分别为8．1％、4．5％和1．9％,各劳动强度级别患病率两两比较,差异均有统计学意义（P〈0．05）;收缩压、舒张压、体质指数（BMI）、腰围、空腹血糖（FPG）、餐后2h口服75g葡萄糖耐量实验（2h-OGTT）、高血压患病率均随劳动强度的增加而下降,且各劳动强度级别均数两两比较,差别均有统计学意义（P〈0．05）。多因素Logistic回归分析,在调整了年龄、性别、肥胖等多种混杂因素之后,中等体力劳动组和重体力劳动组高血压的OR值分别为0．74（95％CI：0．43～1．31）、0．58（95％CI：0．36～0．93）,趋势分析P=0．03。结论体力劳动强度对高血压的患病率有保护作用,经常性的适度体力劳动有助于降低居民高血压患病风险。     

瑜伽锻炼对绝经女性雌激素、血脂及免疫指标的影响

目的探讨瑜伽锻炼对绝经女性雌激素、血脂及免疫指标的影响。方法对20名绝经女性进行5个月的瑜伽锻炼,测试锻炼前后受试对象血清雌二醇(E2)、睾酮(T)、孕酮(P)等雌激素指标,甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等血脂指标及免疫机能指标(IgA、IgM、IgG)。结果经5个月瑜伽锻炼后,E2、P较锻炼前提高(P<0.01),T水平下降(P<0.01);TG、TC和LDL-C较锻炼前降低(P<0.01),HDL-C较锻炼前提高(P<0.01);IgA、IgM和IgG较锻炼前提高(P<0.05或P<0.01)。结论瑜伽锻炼对绝经女性雌激素、血脂及免疫机能有积极的影响。     

Physical Activity Pattern of Prepubescent Filipino School Children During School Days

Background:  Little is known about pre-pubescent Filipino children's involvement in moderate-to-vigorous physical activity (MVPA). There are international guidelines regarding required levels of MVPA for healthy children.
Methods:  This study describes participation of 11- to 12-year-olds in randomly selected public and private schools in San Juan, Metromanila, in MVPA and sports during a school day. The Filipino-modified Physical Activity Questionnaire for Older Children (F_PAQ_C) was administered in English and Filipino. Additional data was collected on sex, age, type of school, and amount of time spent using television and computers. Children's self-assessment of physical activities (1 question in the F_PAQ_C) was correlated with their cumulative F_PAQ_C score.
Results:  Three hundred eighty subjects (167 boys, 213 girls) participated. Participation in MVPA varied between sex and age groups, from 56.1% to 65.0%. Fewer than 10% of participants were very active. The children were more active during physical education classes than at recess or lunch, after class, or in the evening. Walking for exercise, jumping, jogging and running, free play, and dance were most common. Boys, younger children, and private school students most commonly engaged in MVPA. Self-assessed physical activity had modest correlation ( r ²= 0.21) with cumulative F_PAQ_C score, after adjusting for sex, age, and school type.
Conclusion:  Most children were not physically active during the school day, except in physical education classes. To reduce the gap between recommended and current activity levels, more opportunities should be provided for preteen Filipino children to engage in MVPA during and after school.     

不同剂量辛伐他汀对老年高血压合并高脂血症患者血压、血脂水平的影响

目的探讨不同剂量辛伐他汀治疗老年高血压合并高脂血症患者的临床效果。方法 60例老年高血压合并高脂血症患者随机分为两组各30例。在常规治疗基础上,对照组给予常规剂量(20 mg/d)辛伐他汀治疗,观察组给予高剂量(40 mg/d)辛伐他汀治疗。比较两组的临床疗效,血压、血脂指标,以及不良反应。结果观察组的总有效率显著高于对照组(P<0.05)。治疗后,观察组的舒张压、收缩压、TC、TG、LDL-C、HDL-C水平均显著优于对照组(P<0.05)。两组的不良反应发生率无统计学差异(P>0.05)。结论高剂量辛伐他汀治疗老年高血压合并高脂血症患者的临床效果显著,可有效降低血压、血脂。     

提高血压测量的准确度

目的 提高血压测量的准确度,确保医疗安全.方法 建立计量爱心QC小组进行现状调查,找出血压测量不准确的原因,并制定对策.结果 血压计的误差缩小到2mmHg.结论 计量爱心QC小组活动提高了血压测量准确度,增强了医护人员的服务意识.     

原发性高血压患者血压昼夜节律及血压变异性与血液粘度的关系

目的探讨高血压病患者血压昼夜节律及血压变异性与血液粘度之间的关系。方法对64例原发性高血压病(EH)患者血压变异性与血液粘度之间的关系进行观察；按血压昼夜节律分为血压节律消失组与血压节律正常组，观察两组血液粘度。结果两组间血液粘度有显著差异(P＜0.05)；收缩压变异性、平均动脉压变异性与血液粘度呈正相关(P＜0.05)。结论高血压病患者血压昼夜节律消失及血压变异性增高者血液粘度增加。     

国际体力活动问卷中体力活动水平的计算方法

介绍国际体力活动问卷（IPAQ）长卷和短卷的结构、数据清理原则、体力活动水平计算方法和分组标准。通过实例分析,示范IPAQ长卷的具体计算过程。     

老年人高血压病与高血压合并糖尿病动态血压的研究

目的探讨老年人糖尿病对高血压患者动态血压(ABP)的影响及变化特点。方法对100例高血压病和1100例高血压合并糖尿病患者进行动态血压监测,对两组患者的ABP进行进行对比分析。结果两组患者ABP参数比较,合并糖尿病的高血压患者24小时平均血压、日间平均血压、夜间平均血压的总体水平高于高血压组(P<0.05)。结论对老年高血压合并糖尿病患者,降低血压和降低血糖对糖尿病病人的血压和微血管并发症的防治同等重要。     

Intra-Individual Variation and Estimates of Usual Physical Activity

PURPOSE: The magnitude of intra-individual variation, as determined by three methods of physical activity (PA) assessment, was estimated to determine the optimal number of repeated measures needed to reliably measure an individual's usual PA habits.

METHODS: Data were obtained from 77 healthy adults enrolled in the Survey of Activity, Fitness, and Exercise (SAFE). PA was measured by: 1) Caltrac accelerometers worn 48-hours every 26 days for one year; 2) concurrent 48-hour PA records (PARs); and 3) a corresponding series of four-week PA histories (FWH). Repeated measures regression analyses were used to analyze the data.

RESULTS: PA tended to be slightly higher in the summer months as compared with the winter months, but this seasonality explained little of the intra-individual variation. The intra-individual standard deviation (SD) estimated for the FWH (180 MET-min^d−1 ) was 39% of the mean annual MET-min^d−1, as compared with the Caltrac (163 MET-min^d−1 or 9%) and PAR (259 MET-min^d−1 or 11% ). Given the intra-individual variation, three repeated observations of the FWH, six Caltrac, or nine PAR over the course of the year were needed to achieve 80% reliability in estimation of mean annual PA.

CONCLUSIONS: Intra-individual variation in PA is substantial and must be accounted for in estimates of usual PA.     

糖尿病合并高血压患者动态血压心电二合一监测的临床意义

目的分析动态血压心电二合一监测在糖尿病合并高血压患者病情观察中的意义。方法收集糖尿病合并高血压患者50例为观察组,单纯高血压患者50例为对照组。观察组中无靶器官损害为A组,有靶器官损害者为B组。动态监测患者的血压、心电。结果与对照组相比,观察组的24hSBP、 dSBP、 nSBP、 nDBP、 SDNN、 SDANN、 SDNN Index、 PNN50、 r MSSD均更高(P <0.05)。与A组相比, B组的24hSBP、 dSBP、 nSBP更高, 24hDBP、 dDBP均更低(P <0.05);与A组相比, B组心率变异各指标均更低(P <0.05)。结论动态血压心电二合一监测能准确评估糖尿病合并高血压患者的病情,为治疗提供指导。     

60例肥胖儿童血糖,胰岛素与高血压的关系

目的了解儿童血糖、血胰岛素与高血压的关系。方法对肥胖儿童及正常对照儿童各６０例进行空腹血糖（ＧＳ）、胰岛素（ＩＳ）及高密度脂蛋白（ＨＤＬ）测定，其中各３０例做葡萄糖耐量试验。结果两组儿童空腹ＧＳ、ＨＤＬ及糖负荷后ＧＳ差异无显著性。肥胖组的空腹ＩＳ、糖负荷后ＩＳ、胰岛素曲线下面积及曲线下面积的ＩＳ／ＧＳ均高于对照组，肥胖组有４３例（７１．７％）血压增高。结论肥胖儿童存在高胰岛素血症及胰岛素抵抗。肥胖与高血压关系密切。     

144名初中学生血压与尿钠、钾排出量的关系

本文通过收集三个全夜尿,对父母为高血压的子女其血压水平与盐摄入之间的关系进行了研究。使用逐步回归分析,结果显示,这些学生的血压(收缩压和舒张压)与尿钠/钾排泄量显著相关,提示这些学生的血压与钠、钾电解质摄入有一定联系。     

温州市中老年人血脂抽样调查及与高血压、超重关系

目的 研究调查中老年人的血脂情况及与血压、体重的关系。方法 抽样调查温州市女55岁,男60岁以上共1371人的血脂、血压及体重。结果（1）女性除75－79岁年龄段外其余总胆固醇（TC）平均水平均超过5．20mmol/L,女性TC,低密度脂蛋白胆固醇（LDL－C）水平超过男性。（2）女性高胆固醇血压,混合性高脂血症及高低密度脂蛋白血症高于男性;高甘油三酯血症,低高密度脂蛋白血症则低于男性。（3）男性血脂高低与血压高否无关,女性高血压者,TG、TC水平增高（4）无论男女,超重均使TG升高和高密度脂蛋白胆固醇（HDL－C）下降。结论 随着生活条件的改善,温州市已成为潜在的心血管事件的高危地区。     

Difference in Blood Pressure Readings with Mercury and Automated Devices: Impact on Hypertension Prevalence Estimates in Dar es Salaam, Tanzania

Objectives

(1) To compare blood pressure (BP) readings with an automated arm cuff oscillometric device (AutoBP) to readings with a mercury sphygmomanometer (HgBP) and (2) to evaluate the impact on the prevalence of hypertension (HBP) in a population-based survey.

Methods

(1) In a convenience sample (“Comparison Study”), we measured?BP with both AutoBP (Visomat® OZ2) and?HgBP and we modeled BP difference (ΔBP = HgBP?AutoBP) with multiple regression analysis. (2) Using ΔBP, we calculated HgBP in a survey previously conducted in Dar es Salaam (“Population Survey”) in which BP was measured with the automatic device Visomat® OZ2 and we compared the prevalence of HBP (≥140/90 mmHg or treatment).

Results

In the Comparison Study (404 subjects aged 25–64), systolic/diastolic BP was higher by 4.4/4.7 mmHg (SE: 0.4/0.3) with HgBP than AutoBP. The prevalence of HBP was 42% with HgBP and 36% with AutoBP (relative difference of 14%). ΔBP was associated with age, BP and arm circumference. In the Population Survey (9.254 subjects aged 25–64), the prevalence of HBP was 17% with calculated HgBP and 14% with AutoBP (relative difference of 20%).

Conclusion

A small systematic bias in BP readings between two different devices had large impact on hypertension prevalence estimates. This suggests that automated devices used in epidemiological studies should be validated with particular care.     

老年高血压患者血尿酸检测结果的临床意义探讨

目的探讨高尿酸血症与老年高血压及并发症的关系以及血UA检测结果的临床意义。方法采用尿酸酶法检测血UA。结果老年高血压组与老年健康人对照组血UA水平比较差异有显著性(P<0.01),有无并发症老年高血压患者血UA水平差异显著(P<0.01)。结论高尿酸血症与老年高血压患者的发病有密切关联,血UA的测定对老年高血压患者并发症有预测判断价值。