自发性高血压大鼠心肌乳酸盐转运障碍

目的在离体心脏灌流模型及分离的心肌肌膜囊泡上，比较自发性高血压大鼠（ＳＨＲ）和对照（Ｗｉｓｔａｒ－ＫｙｏｔｏＷＫＹ）大鼠心肌Ｌ－１４Ｃ－乳酸盐的摄入，及心肌肌膜囊泡（ＳＬＶ）对乳酸盐转运的特征。方法应用１４Ｃ标记的乳酸盐，测定ＳＨＲ和ＷＫＹ大鼠心肌ＳＬＶ的乳酸盐的转运。结果ＳＨＲ心肌摄取乳酸盐的能力较ＷＫＹ大鼠明显降低（４．２１±０．３１ｖｓ５．７２±０．３３ｎｍｏｌ／ｍｇＷＷ／２ｍｉｎ，Ｐ＜０．０１），ＳＬＶ的乳酸盐跨膜转运呈时间－浓度依赖性，ＳＨＲ较ＷＫＹ大鼠ＳＬＶ乳酸盐最大转运速率降低３６％（Ｐ＜０．０１），心肌乳酸盐的摄入和ＳＬＶ的转运速率与心肌肥大程度呈负相关（ｒ＝－０．６７，Ｐ＜０．０５，ｒ＝－０．７３，Ｐ＜０．０５）。结论ＳＨＲ大鼠存在心肌乳酸转运障碍     

高血压左心室肥厚与心肌原癌基因c-fos的表达

目的研究细胞核内原癌基因ｃ－ｆｏｓ在高血压左室肥厚（ＬＶＨ）发生、发展过程中的作用。方法采用两种高血压模型即自发性高血压大鼠（ＳＨＲ）和两肾一夹型（２Ｋ１Ｃ）肾血管性高血压大鼠，观察在高血压所致ＬＶＨ的不同阶段，收缩压（ＳＢＰ）、左室重／体重比（ＬＶＷ／ＢＷ）及左心室ｃ－ｆｏｓ基因表达水平的变化。结果ＳＨＲ在８～１０周龄时已有明显的高血压和ＬＶＨ，其ＳＢＰ与ＬＶＷ／ＢＷ均显著高于对照的ＷＫＹ大鼠，左心室ｃ－ｆｏｓ基因表达水平与ＷＫＹ大鼠相比，差异无显著性，但二者均较高。２０～２２周龄与４０～４２周龄时，ＳＨＲ的ＳＢＰ、ＬＶＷ／ＢＷ及左室ｃ－ｆｏｓ基因表达水平明显高于对照组ＷＫＹ大鼠。２Ｋ１Ｃ大鼠左肾动脉缩窄１周后就有明显的ＬＶＨ，其ＬＶＷ／ＢＷ较假手术组大鼠显著升高（２．９０±０．１３ｖｓ２．５７±０．１５，Ｐ＜０．０５），同时伴左室ｃ－ｆｏｓ基因的高表达，至术后３周、１０周仍保持较高水平。钙拮抗剂尼群地平和血管紧张素ＡＴ１受体拮抗剂ｌｏｓａｒｔａｎ治疗１０周后均可使２Ｋ１Ｃ大鼠左室ｃ－ｆｏｓ基因表达水平降低。结论心肌原癌基因ｃ－ｆｏｓ的高表达可能参与高血压ＬＶＨ的发生、发展过程。     

高血压大鼠心脏肌凝蛋白重链mRNA表达和卡托普利的作用

目的：观察自发性高血压大鼠（ＳＨＲ）心肌肥厚时心脏α和β－肌凝蛋白重链（α－ＭＨＣ和β－ＭＨＣ）ｍＲＮＡ表达和卡托普利的保护作用。方法：１５周龄雄性ＳＨＲ口服卡托普利（１００ｍｇｋｇ－１／ｄ）１２周（ＣＡＰ组），同样年龄性别的ＳＨＲ（ＳＨＲ组）和Ｗｉｓｔａｒ－ｋｙｏｔｏ大鼠（ＷＫＹ组）不给药，在同样条件下喂养同样时间，通过称重法计算左室重量指数（ＬＶＩ），使用测微技术测量心肌细胞横径（ＴＤＭ），采用Ｎｏｒｔｈｅｒｎ印迹技术检测左室α和β－ＭＨＣｍＲＮＡ水平。结果：（１）ＳＨＲ组ＬＶＩ和ＴＤＭ显著高于ＷＫＹ组；ＣＡＰ组上述指标显著低于ＳＨＲ组，而与ＷＫＹ组无显著差异；（２）ＳＨＲ组α－ＭＨＣｍＲＮＡ表达明显受抑，β－ＭＨＣｍＲＮＡ表达明显增加；卡托普利抑制α－ＭＨＣｍＲＮＡ水平降低，但不影响β－ＭＨＣｍＲＮＡ水平。结论：高血压肥厚心肌ＭＨＣ基因出现了异常表达，卡托普利可以防止这种现象的发生。     

卡托普利治疗对SHR大鼠遗传血压,左心室肥厚及心肌胶原的影响

目的探讨卡托普利对自发性高血压大鼠（ＳＨＲ）的血压及左心室肥厚的影响。方法选用一组ＳＨＲ（Ｆ０），从交配之日起每天给卡托普利（２０ｍｇ／ｋｇ），其子代（Ｆ１）持续治疗到１６周时分为２组。第一组Ｆ１ａ在交配时继续用药治疗；第二组Ｆ１ｂ交配时停药。第二代两组小鼠（Ｆ２）出生后，Ｆ２ａ继续用药治疗到１６周停药；Ｆ２ｂ不用药治疗。分别观察其血压，左心室重量（ＬＶＭ），左心室重量与体重比（ＬＶＭ／ＢＷ）及测定左心室羟脯氨酸浓度和计算机图像分析心肌胶原的含量。结果发现在停药前动物血压处于较低的水平，但明显高于ＷＫＹ；而停药后血压明显回升到接近ＳＨＲ的水平。Ｆ２ａ表现基本一致；而Ｆ２ｂ的血压与对照组ＳＨＲ一样，明显高于Ｆ２ａ组。心肌内羟脯氨酸浓度及胶原含量，在Ｆ２ａ明显较ＳＨＲ和Ｆ２ｂ低，接近ＷＫＹ水平。结论卡托普利治疗并不能防止ＳＨＲ的高血压的遗传发展，但可以减低左心室肥厚，且主要是由于用药降低了心肌中胶原的含量     

依那普利逆转高血压性心血管改变的实验研究

目的：探讨依那普利逆转高血压性心血管改变的机理。方法：给１０周龄的自发性高血压大鼠（ＳＨＲ）饮水中加入依那普利１０周,观察ＳＨＲ的收缩压（ＳＢＰ）、左心室肥厚和肠系膜小动脉的组织结构改变。结果：（１）收缩压：２０ 周龄时,ＳＨＲ 治疗组（ＳＨＲｅｎ）的ＳＢＰ：１２０ ±１２ ｍ ｍ Ｈｇ,较对照组ＳＨＲ（ＳＨＲｃ）的血压（１９６±１３ｍ ｍ Ｈｇ）显著回降（Ｐ＜ ０．０５）;（２）ＬＶＨ的指标变化：１）左心室胶原含量：ＳＨＲｅｎ 为４．０６±０．０４ ｍ ｇ 和ＳＨＲｃ（５．８４±０．０３ｍ ｇ）比较明显下降（Ｐ＜ ０．０５）;（２）左心室重／体重之比率（ＬＶ／ＢＷ）：ＳＨＲｅｎ 组为２．２２±０．０２ 比ＳＨＲｃ组（３．３２±０．０４）显著降低（Ｐ＜ ０．０５）;（３）ＳＨＲｅｎ 肠系膜小动脉的病理性组织结构改变,基本恢复正常。结论：依那普利能逆转ＳＨＲ的高血压、左心室肥厚和肠系膜小动脉的病理性改变     

不同龄SHR心肌细胞内Ca~（2＋）及心肌组织NE含量的变化

采用荧光探针结合计算机图像处理技术测定幼年、成年、老年ＳＨＲ心肌单细胞内游离Ｃａ~（２＋）浓度，采用高压液相色谱法测定幼年、成年、老年ＳＨＫ心肌去甲肾上腺素（ＮＥ）含量。结果显示随着年龄增加，ＳＨＲ心肌细胞内游离Ｃａ~（２＋）增加，而心肌组织ＮＥ含量下降。与老年ＷＫＹ大鼠比较，老年ＳＨＲ心肌细胞内Ｃａ（２＋）含量较高（Ｐ＜０．０１），而其心肌组织ＮＥ含量却较少（Ｐ＜０．０５）。本研究提示心肌组织ＮＥ与ＳＨＲ的血压升高及心肌细胞内游离Ｃａ~（２＋）增多无直接关系。＊Ｐ＜０．０１，ａ．ｖｓ．ＳＨＲ２ｍ，ｂ．ｖｓＳＨＲ６ｍ，ｃ．ｖｓ．ＳＨＲ１２ｍ３不同年龄阶段ＳＨＲ心肌组织ＮＥ含量ＳＨＲ的年龄越大，其心肌组织ＮＥ的含量越少，各年龄组之间均有显著差异（Ｐ＜０．０１）。与老年ＷＫＹ大鼠比较．老年ＳＨＲ是心肌组织ＮＥ含量明显降低（Ｐ＜０．０５）（Ｆｉｇ３）。Ｆｉｇ３ＮＥｃｏｎｔｅｎｔｓｉｎｃａｒｄｉａｃｔｉｓｓｕｅｓＩｎＳＨＲｓｏｆｖａｒｉｏｕｓａｇｅｓａｎｄｅｌｄｅｒＷＫＹｒａｔｓ：Ｐ＜０．０５．＊：Ｐ＜０．０１，ａ．ｖｓ．ＳＨＲ２ｍ，ｂ．ｖｓＳＨＲ６ｍ．ｃ．ｖｓＳＨＲ１２ｍ．ＤＩＳＣＵＳＳＩＯＮＦｕｒａ－２能选择性地     

短期氟伐他汀治疗对自发性高血压大鼠阻力血管肥厚的影响

目的探讨氟伐他汀（一种ＨＭＧ－ＣｏＡ还原酶抑制剂）对自发性高血压大鼠阻力血管结构和血压进程的影响。方法１４只８周龄雄性ＳＨＲ大鼠，氟伐他汀２０ｍｇｋｇ－１ｄ－１灌胃，作为治疗组（ＳＨＲｆｌｕ），同周龄、同性别给于安慰剂的ＳＨＲ和ＷＫＹ大鼠作对照组。用计算机图象分析计算血管壁腔比，以观察三组大鼠肠系膜动脉三级分支及主动脉结构变化。结果８周后，氟伐他汀治疗组（ＳＨＲｆｌｕ）收缩压比对照组（ＳＨＲ）平均下降了２１ｍｍＨｇ（１９１±１３ｍｍＨｇｖｓ２１２±８ｍｍＨｇ，Ｐ＜０．０５）。ＳＨＲｆｌｕ肠系膜动脉三级分支比ＳＨＲ的血管壁薄，管腔大，血管的壁腔比显著小于未治疗的ＳＨＲ（Ｐ＜０．０５）。结论短期氟伐他汀治疗，抑制了ＳＨＲ大鼠血压发展过程中伴随的血管壁肥厚现象，延缓了ＳＨＲ大鼠高血压的进程。     

自发性高血压大鼠降钙素基因相关肽水平观察

目的探讨降钙素基因相关肽（ＣＧＲＰ）在高血压的发生、发展中的病理生理意义。方法采用放射免疫分析法测定常压大鼠（ＷＫＹ）和自发性高血压大鼠（ＳＨＲ）血浆、脑脊液、脑及主动脉血管中ＣＧＲＰ含量。结果ＳＨＲ血浆ＣＧＲＰ水平（３５．５±７．２５ｎｇ／Ｌ）较ＷＫＹ大鼠（４９．６±１０．３ｎｇ／Ｌ）显著降低（Ｐ＜０．０１）；脑脊液中含量分别为４８．７±９．４与５０．３±１０．５ｎｇ／Ｌ，两者差异无显著性（Ｐ＞０．０５）；ＳＨＲ脑、主动脉血管组织ＣＧＲＰ含量分别为１０３．０±１７．４，６９．３±１９．３ｎｇ／ｇ，较ＷＫＹ大鼠（６２．３±１５．８，３１．３±２４．４ｎｇ／ｇ）显著升高（Ｐ＜０．００１；Ｐ＜０．００５）。结论ＳＨＲ体内ＣＧＲＰ水平的变化可能与高血压的发生、发展有关     

高血压左心室肥厚与心有原癌基因c—fos的表达

研究细胞核内原癌基因ｃ－ｆｏｓ在高血压左室肥厚（ＬＶＨ）发生、发展过程中的作用。方法 采用两种高血压模型即自发性高血压大鼠（ＳＨＲ）和两肾一夹型（２Ｋ１Ｃ）肾血管性高血压大鼠，观察在高血压所致ＬＶＨ的不同阶段，收缩压（ＳＢＰ）、左室重／体重比（ＬＶＷ／ＢＷ）及左心室ｃ－ｆｏｓ基因表达水平的变化。结果 ＳＨＲ在８－１０周龄时已有明显的高血压和ＬＶＨ，其ＳＢＰ与ＬＶＷ／ＢＷ均显著高于对照的ＷＫＹ大鼠，     

血管平滑肌细胞的一氧化氮活性及精氨酸加压素对其调节与高血 …

以培养的自发性高血压大鼠（ＳＨＲ）和正常对照大鼠（ＷＫＹ）血管平滑肌细胞（ＶＳＭＣ）为模型，动态观察了精氨酸加压素（ＡＶＰ）的对动脉ＶＳＭＣ的一氧化氮合酶（ＮＯＳ）活性，一氧化氮（ＮＯ）合成的影响。结果表明：ＳＨＲ动脉ＶＳＭＣ的ＮＯＳ活性，ＮＯ含量明显低于ＷＫＹ（Ｐ〈０．０５）；ＡＶＰ对ＳＨＲ动脉ＶＳＭＣ的ＮＯＳ活性，ＮＯ合 有显著促进效应，同一浓度ＡＶＰ作用下ＳＨＲ及ＷＫＹ动脉，ＶＳＭＣ，ＷＫＹ     

胰岛素瘤的解剖分布特点分析

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。     

Pathogenesis of carcinoma of the papilla of Vater

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.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

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.     

Demonstration of the mechanism of action of biguanides

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.     

血吸虫童虫生长发育及其机制的研究进展

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。     

124例耐多药结核分枝杆菌基因突变特征分析

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。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

氯硝柳胺悬浮剂的毒性评价

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。     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。