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1.
动态血压评价福辛普利治疗老年收缩期高血压的临床疗效 总被引:1,自引:0,他引:1
目的评价福辛普利治疗老年收缩期高血压(ISH)的临床疗效及其安全性。方法56例轻、中度高血压患者服用福辛普利5~20mg,1/d,疗程6周,采用随测血压(CBP)和24h动态血压监测(ABPM)。结果总有效率为91.1%。谷峰比率:收缩压(SBP)为73.5%,舒张压(DBP)为52.8%。治疗后,24h平均SBP(24hS)、最低SBP(MinS)、最高SBP(MaxS)、白昼平均SBP(dS)、夜间平均SBP(nS)和血压负荷值(S>140)均呈显著性下降(P<0.01);24h平均DBP(24hD)、最高DBP(MaxD)和夜间平均DBP(nD)亦有明显下降(P<0.05)。不良反应的发生率为23.3%。结论福辛普利是治疗ISH的安全、有效、耐受良好的药物 相似文献
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高血压患者左室肥厚及主动脉根内径与动态血压的关系 总被引:2,自引:1,他引:2
目的探讨ABP与左室后壁厚度(LVPWT),室间膈厚度(IVST)及主动脉内径(AOD)之间的联系。方法对88例原发性高血压患者应用超声心动图及动态血压计同时测定其LVPWT、IVST、AOD及动态血压各参数值。结果左室肥厚(LVPWT或/和IVS)者50例,主动脉根扩张者60例。相关分析显示LVPWT、LVST及AOD、动态血压各参数平均值呈显著正相关(P<0.05),其中与24h平均收缩压、最高收缩压及夜间平均收缩压相关最密切(P<0.01),此外LVPWT,IVST及AOD与24h最高收缩压与最低收缩压之差(ΔABPs)及24h最高舒张压与最低舒张压之差(ΔABPs)亦呈正相关(P<0.05),其中与ΔABPs相比更密切(P<0.01)。结论血压波动性是左室肥厚及主动脉根内径的影响因素。 相似文献
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目的观察地尔硫缓释剂对高血压合并冠心病患者疗效。方法29例高血压合并冠心病患者口服地尔硫缓释剂90mg,2/d,用药4周,应用24h动态血压和动态心电图观察用药前后血压和缺血性ST段的变化。结果用药后24h收缩压(SBP)从145±9降至127±12mmHg,舒张压(DBP)从106±11降至82±15mmHg(P<0.05);SBP负荷由64±9%降至38±9%(P<0.01),DBP负荷由54±14%降至29±10%(P<0.01)。心肌缺血发作频率从4.3±2.0降至2.3±1.0/24h,缺血总时间(min/24h)从16.9±3.9降至9.4±2.9,最大ST段下移由1.4±0.5mm降为0.8±0.3mm(P<0.01)。结论地尔硫缓释剂能显著改善高血压合并冠心病患者的心肌缺血和降低患者血压。 相似文献
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用动态血压监测的方法评价塞利洛尔的降压疗效 总被引:1,自引:0,他引:1
目的用24h动态血压监测的方法评价塞利洛尔降压疗效及作用持续时间。方法符合入选条件的轻中度高血压病患者32例,平均48.6±7.8岁。服安慰剂2周后,每天服用塞利洛尔100~300mg共6周,治疗前后分别监测24h动态血压。结果治疗后24h、白天、夜间的SBP和DBP均有明显下降(P<0.01);血压负荷值亦明显减小(P<0.01);SBP及DBP谷峰比值均>50%。心率无明显变化(P>0.05)。结论:塞利洛尔的降压作用能持续24h以上,且安全有效。 相似文献
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高血压伴颈动脉粥样硬化患者动态血压监测的意义 总被引:4,自引:0,他引:4
对108例原发性高血压患者应用彩色超声心动图检查颈动脉形态,并结合24小时动态血压监测(ABPM),观察颈动脉粥样硬化(CAS)与动态血压的关系。结果显示:CAS组夜间收缩压和舒张压负荷值明显高于颈动脉正常组(P值均<0.01);日间收缩压和舒张压负荷值及24小时平均收缩压和舒张压两组比较亦有显著性差异(P值均<0.05);CAS组的血压昼夜节律紊乱检出率(62.5%)显著高于颈动脉正常组(37.5%)(P<0.01);两组偶测血压相近(P值均>0.05)。表明CAS与动态血压均值、血压负荷值及血压昼夜节律紊乱密切相关,其中以夜间血压负荷的持续时间及昼夜节律消失的关系为明显,提示在高血压患者预测高血压性脑血管损害方面,动态血压优于偶测血压。 相似文献
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红细胞钠-锂逆向转运活性与糖尿病肾病关系的研究 总被引:2,自引:0,他引:2
目的 探讨红细胞钠锂逆向转运( S L C) 活性在糖尿病肾病( D N) 发病中的作用及其对 D N 的预测价值。方法 采用 Zerbini 最新提出的600 m mol/ L 法,测定正常对照24 例、原发性高血压26 例及2 型糖尿病85 例 S L C 活性。糖尿病组按尿白蛋白/ 肌酐比值分为正常、微量和大量白蛋白尿组。结果 原发性高血压组( P< 0 .001) 和糖尿病组( P< 0 .001) S L C 活性明显高于正常对照组,微量白蛋白尿组( P< 0 .01) 和大量白蛋白尿组( P< 0 .005) S L C 活性明显高于正常白蛋白尿组。多元线性逐步回归分析显示 S L C 活性、病程、平均血压、甘油三酯为尿白蛋白/ 肌酐比值升高的独立危险因素。结论 S L C 活性增高是糖尿病肾病发生的主要危险因素之一,可作为糖尿病肾病的易感指标,有一定的预测价值,但缺乏特异性和敏感性。 相似文献
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血管紧张素转换酶抑制剂对早期糖尿病性肾病的防治作用 总被引:7,自引:0,他引:7
为探讨血管紧张素转换酶抑制剂(ACEI)对早期糖尿病性肾病的长期治疗作用,将46例新诊断的血压正常、24小时尿白蛋白排泄<30mg的非胰岛素依赖型糖尿病(NIDDM)患者随机分为两组。A组服ACEI培哚普利(perindopril),2mg/d,B组为对照组。对两组患者的收缩压、舒张压、平均血压、肾小球滤过率、肾有效血浆流量、滤过分数、尿白蛋白排泄率(UAER)、胰岛素敏感指数(SI)及血脂进行为期约2年的观察。结果表明,A组用ACEI治疗2年后,NIDDM者肾小球高滤过状态得以改善(P<0.05),UAER明显减少(P<0.05),SI降低,血压稳定;而非ACEI治疗的B组,肾功能指标有恶化趋势,并且血压明显增高,SI改善不明显。两组的血脂在治疗前后变化均不明显(P>0.05)。提示小剂量培哚普利长期治疗,对早期糖尿病性肾病具有保护其肾功能的作用,并可改善胰岛素抵抗,减少动脉粥样硬化的危险因素 相似文献
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老年高血压病患者血压节律与靶器官损害的相关性 总被引:5,自引:1,他引:5
目的探讨老年高血压病患者血压节律变化与心、脑、肾等靶器官损害的相关性。方法观察高血压病血压节律正常(杓型组)和异常(非杓型组)2组老年患者各38例的临床资料。结果组间在体重指数、偶测血压、白昼平均收缩压等无显著差异(P>0.05);非杓型组24h平均收缩压和舒张压、白昼平均舒张压、夜间平均收缩压和舒张压、收缩压和舒张压负荷值较杓型组升高(P<0.05~0.01);左室重量和左室重量指数显著增加(P<0.05,0.01);无症状腔隙性脑梗塞的个数及发病率均高于后者(P均<0.05);无痛性心肌缺血次数增多,总持续时间延长(P<0.01,0.05);尿蛋白检出率亦高于后者(P<0.01)。结论血压昼夜节律消失较节律正常的高血压病患者有更显著的靶器官损害。 相似文献
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The immunoneuroendocrine role of melatonin 总被引:19,自引:0,他引:19
Georges J. M. Maestroni 《Journal of pineal research》1993,14(1):1-10
Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ. 相似文献
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Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland 总被引:2,自引:0,他引:2
Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland. 相似文献
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Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage. 相似文献
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Martinez-Cecilia D Arjona-Sanchez A Gomez-Alvarez M Torres-Tordera E Luque-Molina A Valenti-Azcarate V Briceno-Delgado J Padillo FJ Lopez-Cillero P Rufian-Pena S 《World journal of gastroenterology : WJG》2008,14(12):1949-1951
Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs. 相似文献
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H.P.J.M. Noteborn P.P. van Balen A.A. van der Gugten I.C. Hart I. Ebels C.A. Salemink 《Journal of pineal research》1993,14(1):11-22
Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the Mr range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [125I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (Ka of 4.7 ± 0.2 × 109 M-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of Mr 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL. 相似文献
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Gary S. Goldberg B.A. Bruce A. Orkin M.D. Lee E. Smith M.D. 《Diseases of the colon and rectum》1994,37(5):439-443
PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae
(16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum
was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy. 相似文献