慢性非传染性疾病流行病学调查

慢性非传染性疾病流行病学调查徐遵海１石强序２聂宝兴３胡升安４刘世琛５姜在彪６为了解我县慢性非传染性疾病的流行情况及发展趋势，制定防治措施。我们于１９９５年对１９９４年全县人口进行了慢性非传染性疾病流行病学抽样调查。资料与方法１．调查人数：按全县总人数...     

延安市甲状腺疾病的流行病学调查

目的：了解延安市甲状腺疾病流行病学特点。方法：采用整群随机抽样的方法随机抽取2012年3月—2012年9月延安市社区和乡镇6层样本,调查对象为18岁以上常住（≥5年）人口2970人,采用高频超声进行甲状腺检查,对总人群、性别、年龄等数据进行统计学分析。结果：高频超声检出甲状腺异常的总阳性率31.58%（男性28.24%,女性33.70%）;甲状腺局灶性结节粗患病率27.68%（男性25.37%,女性29.14%）,标化患病率26.89%（男性23.71%,女性29.32%）,男女患病率差异有统计学意义（P〈0.05）;甲状腺结节患病率随年龄增长有增加趋势（P〈0.05）。甲状腺弥漫性病变粗患病率3.91%（男性2.87%,女性4.56%）,标化患病率为3.67%（男性2.71%,女性3.91%）,男女患病率差异有统计学意义（P〈0.05）,甲状腺弥漫性病变患病率随年龄增长无增加趋势（P〉0.05）,其患病率主要集中在30~50岁,且女性发病率明显高于男性（P〈0.05）。结论：延安市甲状腺疾病的患病率较高,采用高频超声进行甲状腺疾病的筛查有重要意义。     

仙居县高血压流行病学调查

仙居县高血压流行病学调查浙江省仙居县人民医院预防保健科（３１７３００）陈泰来为了解我县高血压流行趋势，为高血压防治提供依据，于１９９１年９月至１９９５年１０月共检查８４８４人。现将结果报告如下。在调查的８４８４人中，患高血压４１４人，患病率４．８８％...     

妊娠期高血压疾病155例临床分析

目的探讨妊娠期高血压疾病的相关高危因素及并发症的关系。方法回顾性分析住院分娩的155例妊娠期高血压疾病产妇的资料,通过询问病史、查阅病历,对不同类别妊娠期高血压疾病的分娩方式、围生儿并发症的发病率及死亡率、终止妊娠方式等进行比较分析。结果妊振期高血压疾病不同时期并发症发生严重程度明显不同。155例妊娠期高血压疾病中无死亡病例,其中行剖宫产134例,占86.5%;阴道分娩21例,占13.5%。两者比较,有显著性差异(P<0.01),具有统计学意义。妊娠期高血压组的胎儿发育受限、胎儿窘迫、新生儿窒息、早产及围生儿死亡的比率明显低于轻度组子痫前期,轻度组子痫前期又明显低于重度子痫前期组(P<0.01),提示重度子痫前期围生儿发病率及死亡率高。结论加强重度妊娠高血压疾病的观察,及时发现子痫及并发症的先兆,并合理处理是有效降低孕产妇及围生儿病死率的关键。     

吸烟与呼吸系统疾病关系的流行病学调查

我们为了解部队离退休干部吸烟与疾病的关系，特选择了在膳食习惯、生活条件和所处环境都相同的26个部队干休所的离退休老干部长达8个月的同群队列流行病学调查，发现本地区离退休老干部的吸烟率为68.15%（1750/2568），结果表明吸烟组的慢支炎、肺气肿、肺心病、肺癌的患病率明显高于不吸烟组，P＜0.005 RR2。同时显示随着吸烟等级的增加，这些疾病的患病率显著上升，P＜0.005，RR2。     

西藏拉萨市堆龙德庆县45岁以上农牧民高血压流行病学调查分析

目的分析西藏拉萨市堆龙德庆县45岁以上农牧民高血压患病情况及对高血压的知晓、治疗及控制情况。方法对当地农牧民1 350人进行性别、年龄、身高、体质量、血压、心率、肝肾功能、心电图、B超、胸透及尿常规等检测,以问卷调查形式了解高血压患者对高血压的知晓、治疗及控制情况。结果高血压患病率为45.77%,知晓率为26.21%,治疗率为22.29%,控制率为2.75%。高血压知晓率和治疗率均随年龄增长而升高(P<0.05),但控制率无明显变化(P>0.05);女性知晓率和治疗率均高于男性(P<0.05),男女性间控制率差异无统计学意义(P>0.05)。影响高血压知晓率和治疗率的主要因素是年龄、高血压家族史、体质量指数、性别。结论该地区45岁以上农牧民高血压患病率较高,知晓率低,治疗率及控制率更低;45岁以上农牧民高血压防治形势严峻,应引起有关部门的高度重视。     

妊娠期高血压疾病孕妇的麻醉

<正>妊娠期高血压疾病(hypertesive disorders of pregacy,HDP)是妊娠与血压升高并存的一组疾病,发生率5%～10%^[1-2],是孕妇和围产儿死亡的主要原因之一^[3],严重影响母婴健康^[4]。妊娠期高血压疾病的麻醉管理有其特点,本文将此领域进展阐述如下。     

妊娠期高血压疾病子痫前期对胎儿的影响

目的研究妊娠期高血压疾病子痫前期对胎儿的影响。方法 2007年至2009年安阳市妇幼保健院共有90例妊娠高血压综合征子痫前期患者,轻度妊娠期高血压疾病子痫前期（A组）45例,重度妊娠期高血压疾病子痫前期（B组）45例,妊娠期无各类疾病包括高血压病的患者50例（C组）。三组之间的年龄、病程比较差异无统计学意义（P〉0.05）。观察妊娠期高血压子痫前期的轻度、重度以及无高血压病孕妇生产胎儿的结果,观察期为1.5年。结果轻度妊娠期高血压疾病子痫前期（A组）、重度妊娠期高血压疾病子痫前期（B组）以及妊娠期无各类疾病包括高血压病的孕妇（C组）间比较差异有统计学意义（P〈0.05）。妊娠期高血压对胎儿有一定的影响,会影响新生儿的体质量,增加早产率和死亡率。结论在我们的临床工作中要对妊娠期高血压疾病的危害有认识并且时刻警惕,及时进行有效地救治。     

开封市汴南街社区高血压流行病学调查

目的：了解开封市某社区人群高血压发病及控制状况，为高血压病三级预防工作打下基础。方法：于1998年6月对宋门办事处汴南街社区3502名居民做健康体检，对八类慢性疾病进行建立档案，分类管理。其中重点对15岁以上的2862位进行血压状况调查，有高血压的患者填调查表调查服药及控制状况，并予分析、跟踪记录。结果：汴南街社区人群高血压患病率为20.3％，知晓率40．0％，规律用药率4．0％，控制率13．0％，具有发病率高，合并症高，知晓率低，服药率低，控制率低的特征。结论：该社区高血压患者具有典型的一高三低特征，因此高血压的防治应以社区为基本单位，进行综合干预，这是控制高血压发生、发展的关键。     

马里锡加索大区医院儿科疾病流行病学调查及分析

马里是浙江省医疗队援非的主要国家，虽说已经有36年援助的光荣历史，但缺乏对儿科疾病的总体评价，作者作为2003至2005年援马里的第18批医疗队成员，为了解马里儿科疾病流行病学动态以供后来者参考，对工作整整2年时问的锡加索医院儿科疾病与马方同仁一道进行回顾性调查，现将结果报告如下。     

Factors associated with pregnancy-induced hypertension

This article reports the results of a correlational study that explored the association between the three factors of pregravid weight, prenatal weight gain at 28 weeks and maternal age, and the subsequent development of pregnancy-induced hypertension (PIH). A significant relationship between low maternal age and PIH development was found. Further data analysis showed that PIH occurred significantly more often when the second trimester mean arterial pressure (MAP) did not drop to a level lower than the first trimester MAP. Clinically, emphasis should be placed on early detection of women at high risk for PIH development. Analysis of the MAP changes could prove to be a low-cost, effective and low-risk predictive test for PIH development.     

On the alert for pregnancy-induced hypertension

Increasing the skills of maternal-child home care nurses can identify early incidences of pregnancy-induced hypertension (PIH) for medical intervention, resulting in the prevention of hospitalization and decrease of potential complications. This article describes one agency's approach to teaching staff these important skills.     

Serum digoxin-like substances in pregnancy-induced hypertension

1. Endogenous digoxin-like immunoreactivity (EDLI) was measured in the serum of 85 normotensive pregnant (NTP) women and 77 women with pregnancy-induced hypertension (PIH) by a radioimmunoassay (New England Nuclear). All women were in the third trimester. 2. EDLI, which was undetectable in serum from non-pregnant women, was present in NTP and PIH and was significantly higher in PIH. EDLI correlated with gestational age in NTP, but not in PIH. 3. Ouabain-sensitive Na+ transport was estimated in normal peripheral blood leucocytes after incubation with sera from 50 NTP and 42 PIH women. Significant inhibition of active Na+ transport occurred only with the serum of hypertensive patients without proteinuria. 4. EDLI did not correlate with the effect of the sera on active Na+ transport. The radioimmunoassay therefore provides a poor index of Na+ transport inhibitory activity in PIH.     

Plasma prolactin concentrations and pregnancy-induced hypertension

Human prolactin (PRL) has been related to various pathologic disorders known to be associated with osmoregulation and hypertension. In this study, we compared changes in plasma PRL concentrations in normal pregnant patients to those in patients with severe pregnancy-induced hypertension (PIH). Comparison of plasma PRL concentrations collected antepartum, at delivery, and 48 hours postpartum failed to distinguish women with PIH from those without. Only women with PIH, however, showed a significant rise in systemic PRL concentrations between admission to the study and delivery. Antepartum abnormalities in plasma PRL concentrations associated with PIH may not have been detected because of diurnal variations in PRL secretion.     

重度妊娠高血压综合征的护理对策

目的:总结重度妊娠高血压综合征的护理对策。方法:对67例妊娠高血压综合征患者进行回顾性分析,通过产前、产后护理,观察重度妊娠高血压综合征的病因、临床表现和预防处理,制定护理对策。结果:对重度妊娠高血压综合征患者按病情进行综合评估、加强孕期保健,对有自觉症状者,做到早发现、早处理,同时排除产后子痫的诱发因素,做好产妇的健康教育及心理护理,有效地促进了母婴健康。结论:加强孕期保健,做好孕妇的心理疏导,积极治疗和有效护理妊娠高血压综合征患者是降低孕产妇及围产儿死亡的重要环节。     

Abnormal membrane cation transport in pregnancy-induced hypertension

An abnormality of sodium handling has been suggested as one of the mechanisms responsible for the development of pregnancy-induced hypertension. We analysed the plasma and urinary concentrations, and the intraerythrocyte activities of Na and K, and the RBC membrane Na+/K+-ATPase activity of 77 hypertensive and 133 normal pregnant women. Umbilical cord blood of infants from 21 hypertensive and 28 control women was studied. The Na+/K+-ATPase activity was determined by measuring the inorganic phosphate released by incubation in a reaction medium in the presence and absence of K ions or ouabain. The intra-erythrocyte sodium and potassium activities were measured by ion-selective electrode analysis of the haemolysates, after washing the RBCs in 110 mmol/l MgCl2. We found a significant increase in intracellular sodium and a reduction in Na+/K+-ATPase activity in the hypertensive women in comparison with the control subjects during pregnancy. No difference was observed in early puerperium. Cord blood from infants of pregnancy-induced hypertensive women showed an increase in intracellular Na+ activity and a decrease in the erythrocyte membrane Na+/K+-ATPase activity in comparison with cord blood samples from control subjects. The observed abnormalities in the plasma membrane sodium transport may play a major role in the pathophysiology of pregnancy-induced hypertension.     

妊娠期高血压疾病性心脏病的诊断与处理

孕妇既往没有心脏病史，在妊娠期高血压疾病的基础上突然出现以心肌损害为特征的心力衰竭症候群，称为妊娠期高血压疾病性心脏病．约占妊娠合并心脏病的4．0％-5．7％，重度子痫前期中约有4％发生此病。因发病隐匿，病情危重，是妊娠期高血压疾病患者及胎儿死亡的主要原因之一，早期诊断、及时处理极为重要。本文就其诊断及处理论述如下。