线索诱发海洛因依赖者渴求反应的性别差异

目的:分析线索暴露对戒断期男女海洛因依赖者心理渴求程度及相关指标影响的差异。方法:222名男性和98名女性戒断期海洛因依赖者暴露于相关环境线索,根据被试者的自我报告,采用Likert分级评价线索诱发的渴求程度,填写主观戒断反应问卷、毒品使用情况和一般社会学资料。采用独立样本t检验,比较线索暴露诱发男女被试者渴求反应的差异。结果:线索暴露后,女性被试者诱发的渴求分值和主观戒断反应分值均高于男性(P<0·05,P<0·01),心率和瞳孔变化女性高于男性(P<0·01)。结论:环境线索诱发戒断期海洛因依赖者的渴求反应存在性别差异,女性渴求反应明显高于男性。     

HANS治疗仪对男性戒断期酒依赖患者心理渴求的作用

目的:评价HANS治疗仪对男性酒依赖患者戒断期心理渴求的影响。方法:将92例符合ICD-10中酒依赖诊断标准的戒断期男性患者随机分成两组:HANS组(治疗组)45例,给予2/100 Hz经皮穴位电刺激(HANS);Mock-HANS组(对照组)47例,给予模拟经皮穴位电刺激(Mock-HANS),为期15 d。比较两组酒精心理渴求评分(视觉模拟标尺,VAS)、谷氨酰转肽酶(GGT)和心率及血压变化。结果:(1)HANS组心理渴求分值(VAS)在治疗后d10(0.98±s 0.85 vs.1.6±s 1.35,P<0.05)和d15差异有显著性(0.67±s 0.76 vs.1.6±s 1.35,P<0.001),Mock-HANS组的下降差异无显著性;在治疗15 d时HANS组较Mock-HANS组的VAS分值差异有极显著性(0.67±s0.76 vs.1.84±s 0.87,P<0.001);(2)HANS组的GGT在治疗后下降差异有显著性(88.5±s 70.0 vs.198.1±s83.2,P<0.05),同时也低于Mock-HANS组的治疗后GGT的平均值(88.5±s 70.0 vs.144.0±s 85.2,P<0.05);(3)经治疗15 d后HANS组的收缩压和舒张压较治疗前下降明显(103.9±s 6.1 vs.126.7±s 14.1;68.7±s 6.0 vs.81.6±s 8.6,P均<0.05),而Mock-HANS组差异无显著性;(4)HANS组的心率在治疗15 d后下降差异有显著(70.5±s 2.8 vs.83.6±s 4.4,P<0.05),Mock-HANS组治疗后的心率变化差异无显著性。结獉论獉:HANS治疗仪能减轻戒断期酒依赖者的心理渴求程度,辅助改善血中GGT指标,降低酒依赖患者的心率、血压,对酒依赖患者的戒断期有一定的辅助治疗作用。     

环境线索暴露对海洛因戒断者焦虑和抑郁状态及心理渴求的影响

目的:研究环境线索对海洛因戒断者心理渴求及焦虑和抑郁症状的影响。方法:选取70例处于戒断60-90d的海洛因依赖者及28例健康志愿者暴露于海洛因相关环境线索中,测量暴露前后视觉模拟尺记录的渴求程度,以及心率、汉密尔顿焦虑和抑郁量表评分,并完成自编海洛因依赖受试者基本情况登记表等社会学资料。采用配对t检验统计暴露前后的渴求程度、心率及焦虑和抑郁评分。结果:暴露后海洛因戒断者的心理渴求和心率明显高于暴露前,差别具有显著性统计学意义(P<0.01)。焦虑和抑郁评分在暴露后明显降低,差异有显著性(P<0.01)。结论:环境线索可以使戒断期海洛因依赖者心理渴求和心率明显增加,但同时可以缓解焦虑和抑郁情绪。     

海洛因依赖者在环境线索诱发时HPA轴功能的变化

目的:了解海洛因依赖者下丘脑-垂体-肾上腺轴(HPA)系统的功能状态及环境线索诱发心理渴求时的促肾上腺皮质激素(ACTH)与血浆中皮质醇(cortisol,CORT)水平的变化特点。方法:比较19例脱毒后期海洛因依赖者与21正常对照者血清ACTH和CORT水平,分析19例海洛因依赖者环境线索诱发前后的心理渴求程度、血压、心率、瞳孔直径等生理指标、ACTH和CORT水平的变化特点。结果:戒断后期海洛因依赖者血清ACTH呈现高于正常对照组的趋势(t=1·663,P=0·104),CORT水平显著高于对照组(t=3·142,P=0·003);环境线索可诱发海洛因依赖者出现心理渴求,引其心律加快、血压上升、瞳孔变大,但血清ACTH和CORT水平改变不明显(P>0·05)。结论:戒断后期海洛因依赖者HPA系统功能升高,环境线索可诱发海洛因依赖者产生心理渴求和某些生理指标改变,提示降低海洛因依赖者对环境线索的敏感性及调整HPA功能可能有助于降低心理渴求及预防复吸。     

心电监护下线索诱发海洛因渴求程度及心率、血压的变化

目的:心电监护下评价海洛因相关环境诱发心理渴求程度及心率、血压的变化。方法:对143名自愿戒毒人员,放松训练后给予心电监护,询问渴求分值,记录当时心率、血压数值作为基线值。然后暴露于吸毒相关环境,询问诱发后渴求分值,并记录诱发后心率、血压作为诱发数值。利用配对t检验方法分析暴露前后上述心理及生理指标的变化。结果:暴露前后,海洛因依赖者的心理渴求程度、心率、血压均有显著性差异(P<0.05)。结论:海洛因依赖者在相关线索环境下能够诱发出明显的心理渴求,并引起心率、血压等相应生理指标的改变,在此基础上两者相互作用,大大增加复吸的可能性。     

东莨菪碱脱毒治疗对海洛因依赖者血清瘦素水平、营养状态的影响

目的:观察东莨菪碱脱毒治疗对海洛因依赖者的营养状态与血清瘦素水平的影响。方法:用ELISA方法检测血清瘦素水平,采用三头肌皮皱厚度等指标评价营养状态。结果:海洛因依赖组的三头肌皮皱厚度(脱毒前9.99mm±s0.91mm;脱毒后9.96mm±s1.04mm)比正常对照组明显减少(10.89mm±s0.79mm,P<0.05)。脱毒治疗6d后,海洛因依赖组的血清瘦素水平(脱毒后,1.70ng·ml~(-1)±s0.92ng·ml~(-1))明显下降(脱毒前,4.22ng·ml~(-1)±S2.58ng·ml~(-1),P<0.01)。结论:用东莨菪碱脱毒治疗可降低海洛因依赖者的血清瘦素水平。     

海洛因依赖者对吸毒相关汉字线索的注意偏向

目的:利用情绪Stroop任务测量海洛因依赖者是否存在对吸毒相关汉字线索的注意偏向。方法:男性海洛因依赖者(研究组)与健康志愿者(对照组)各15例,采用NeuroSCAN工作站STIM2编程,记录并比较研究组和对照组对3类汉字(包括海洛因毒品相关类、中性、音乐类、)的反应时(reaction time,RT)及正确率。结果:两组对3类汉字线索的反应正确率之间无差异;与对照组相比,研究组对毒品相关汉字的反应时明显延长(789.23 ms±s102.53 ms vs 701.27 ms±s69.48 ms,P<0.05);而对音乐汉字的反应时显著缩短(630.52 ms±s84.33 vs 739.65ms±s92.28 ms,P<0.01)。重复测量的方差分析发现,存在刺激类别的主效应(F(2,28)=8.94,P<0.01)以及组别和刺激类别的交互效应(F(2,28)=9.58,P<0.01),研究组对海洛因相关汉字的反应时间与吸毒时间呈正相关(r=0.563,P<0.05)。结论:海洛因依赖者对吸毒相关的汉字线索存在着注意偏向。     

2/100Hz经皮穴位电刺激对社区戒毒康复中阿片成瘾者的作用

目的:评价2/100 Hz经皮穴位电刺激对社区戒毒康复的阿片成瘾者的作用。方法:154例阿片成瘾患者被随机分成两组:HANS组(治疗组)78例,给予2/100 Hz经皮穴位电刺激(HANS);Mock-HANS组(对照组)76例,给予模拟经皮穴位电刺激(Mock-HANS),为期12月。比较两组治疗保持率、尿检阳性率、稽延性戒断症状评分和阿片渴求评分。结果:(1)在第9月末,Mock-HANS组和HANS组的治疗保持率分别为0%和48.7%;在第12月末HANS组的治疗保持率仍为43.6%(P<0.001)。(2)Mock-HANS组和HANS组12个月总的尿检阳性率分别为78.3%和51.2%(P<0.001);比较两组各月的尿检阳性率,除第1、3月外,在其他各月HANS组尿检阳性率均低于Mock-HANS组(P<0.05,P<0.001)。(3)Mock-HANS组的稽延性戒断症状评分在治疗前、后分别为14.7±s3.2和13.6±s2.7;HANS组的稽延性戒断症状评分在治疗前、后分别为15.7±s4.3和11.5±s3.1。HANS组的稽延性戒断症状评分较Mock-HANS组显著降低(P<0.001)。(4)Mock-HANS组的阿片渴求评分在治疗前、后分别为39.1±s12.6和37.8±s10.4;HANS组的阿片渴求度评分在治疗前、后分别为38.1±s10.2和28.5±s7.3。HANS组的阿片渴求评分较Mock-HANS组有显著降低(P<0.001)。结论:2/100 Hz经皮穴位电刺激能够缓解患者的稽延性戒断症状和阿片渴求,降低阿片成瘾患者的尿检阳性率,有利于患者在社区中坚持治疗和康复。     

经皮穴位电刺激联合地西泮治疗酒精戒断综合征的疗效观察

目的:观察地西泮联合2/100Hz经皮穴位电刺激与单用地西泮治疗汉族男性酒精戒断综合征的临床疗效差别。方法:40例汉族男性酒依赖患者随机分为研究组(n=20,地西泮口服5mg,bid联合2/100Hz经皮穴位电刺激治疗)和对照组(n=20,单用地西泮口服10mg,bid治疗),并于戒断后12h、24h、48h、72h、d4、d5、d6、d7,采用酒精戒断量表评估其戒断症状;采用渴求视表于戒断后12h、d4、d7评估其心理渴求。结果:(1)治疗48h后,研究组酒精戒断量表总分开始低于对照组(31.65±s2.52比36.05±s2.70),两组比较差异有显著性(P<0.01)。治疗终结时酒精戒断量表总分研究组为10.00±s0.00分,戒断症状全部消失;对照组为11.55±s1.19分,戒断症状基本消除,两组比较差异有显著性(P<0.01)。(2)酒精戒断量表因子:恶心呕吐24h评分,研究组6.40±s0.94分,对照组7.25±s0.91分,两组比较差异有显著性(P<0.01);震颤、出汗、焦虑、激越,于治疗的48h或72h,两组差异出现显著性(P<0.05或P<0.01)。(3)渴求视表评分在d4、d7研究组显著低于对照组(5.25±s1.55比7.55±s1.23;0.95±s1.23比4.45±s1.15),两组比较差异有显著性(P<0.01)。结论:2/100Hz经皮穴位电刺激联合地西泮能有效地控制酒依赖患者的戒断症状,同时对患者的心理渴求也具有很好的疗效。     

海洛因依赖者脱毒后稽延性戒断症状与渴求的关系

目的··:探讨海洛因依赖者脱毒后造成复吸的重要因素。方法··:采用海洛因稽延性戒断症状自评量表对封闭式戒毒病房的151例海洛因依赖者进行调查,了解稽延性戒断症状与渴求等因素的关系。结果··:稽延性戒断症状与渴求、脱毒时间及吸毒方式有密切关系,与渴求关系最密切的是稽延性戒断症状的睡眠障碍及焦虑项目。结论··:稽延性戒断症状与渴求紧密相关。     

Cue-induced craving and physiological reactions in recently and long-abstinent heroin-dependent patients

Objective

To understand the different patterns of cue-induced craving and physiological reactions among recently abstinent and long-abstinent heroin-dependent patients.

Method

26 healthy adult controls (HC), 29 long-abstinent (more than 1 year, LA), and 26 recently abstinent (less than 1 month, RA) heroin-dependent individuals were exposed to heroin-related and neutral video cues, one video per session, on different days in random order. Self-reported heroin craving by a 10-point visual analog scale (VAS), physiological reactions [skin conductance (SC), muscle electromyography (MEG), skin temperature (TEMP)] and cardiovascular arousal [heart rates (HR), systolic blood pressure (HBP) and diastolic blood pressure (LBP)] were assessed at baseline and after exposure.

Results

Both heroin-abstinent groups showed increased heroin craving, SC, MEG, HR, SBP and LBP after exposure to heroin-related video, compared to the control group and compared to exposure to the neutral video. Except the RA group showed more HR changes, changes of heroin craving, SC, MEG, HR, SBP and LBP after exposure to the heroin cue video were not different between the LA and RA groups.

Conclusions

Abstinent heroin-dependent patients had elevated craving and physiological reactions after exposure to videos containing heroin-related cues and the cue induced responses still occurred in long-abstinent patients. This phenomenon should be addressed in treatment and recovery services for heroin dependence.     

7－氯苄基四氢巴马汀对豚鼠乳头肌迟后去极，触发活动及猫心单相动作电位的影响

７一氯苄基四氢巴马汀对豚鼠乳头肌迟后去极，触发活动及猫心单相动作电位的影响夏国瑾，曾维忠，姚伟星，戴水平，江明性，黄文龙，黄忱亚，彭司勋（同济医科大学药理学教研室，武汉４３００３０；中国药科大学药物化学研究室，南京２１０００９）７－氯苄基四氢巴马汀（...     

海洛因依赖患者与健康对照组的脑CT研究

目的:探讨海洛因依赖患者脑CT的形态学改变。方法:39例海洛因依赖患者与20例健康对照组行头部CT扫描,测量侧脑室前角尖间最大宽度等7项相关指标(D1-D7),用SAS9.1统计软件处理。结果:海洛因依赖者两侧脑室前角最大宽度为7.67mm±s1.63mm,额叶脑沟最大宽度为3.08mm±s0.61mm,两侧脑室体中间部最大距离为34.91mm±s3.69mm,与正常对照组(6.41mm±s1.15mm/1.91mm±s0.65mm/31.70mm±s5.33mm)比较差异有显著性(P值均<0.01)。结论:海洛因依赖患者侧脑室增大,存在额叶皮层萎缩现象。     

Diurnal variation in cue-induced responses among protracted abstinent heroin users

Objectives

The physiological and psychological responses to drug cue exposure have been assessed in substance abusers. However, there is no study to demonstrate whether the responses to drug cue exposure are diurnal dependence. The present study was to examine whether there was a variation in drug-related cue reactivity across the diurnal cycle among recently abstinent opiate addicts.

Methods

Four groups of 20 abstinent heroin dependent patients (n = 80) were exposed to both neutral and drug-related videos at four separate times during the day: 8:00, 12:00, 16:00, and 20:00 h. Physiological and psychological responses, including heart rate, blood pressure, heroin craving, and subjective anxiety were assessed before and after each cue exposure.

Results

Drug cue significantly increased craving ratings compared to neutral cues across all the four separate times of day. Drug cue-induced craving was greater in the morning (8:00 am) than noon (12:00 pm), but was similar to evening assessments (8 pm). Drug cues also significantly increased anxiety, which positively correlated with cue-induced craving. Drug cues increased heart rate, systolic and diastolic blood pressures, which were not correlated with cue-induced craving or anxiety. However, no time effects were found on the three physiological measures.

Conclusions

Cue-induced craving could be profoundly affected by the time points of cue exposure, using cue-reactivity paradigm. The relative sensitivity of morning and evening assessments of drug craving suggests a need for replication and further research on mechanisms contributing to these diurnal variations.     

药物相关环境线索对戒断不同时间海洛因依赖者冲动性选择的影响

目的:药物依赖者的典型特征是反复发作的强迫性觅药和摄药。戒断后数月乃至数年,虽然躯体症状已经消失,但当再次接触与药物相关的环境时,仍然表现为对行为的选择和控制能力下降,在行为上显得冲动而不考虑后果,最终导致不断地觅药和摄药。药物相关环境线索暴露能引起药物依赖者的渴求增加而导致复吸已经被多数研究者证实,但是药物相关环境线索暴露对戒断不同时间海洛因依赖者冲动性选择的影响尚无相关的研究。本研究从认知行为学的角度研究药物相关的环境线索对戒断不同时间海洛因依赖者冲动性选择的影响。方法:本研究采用冲动性选择的实验室评价方法IGT(IowaGamblingTask)对药物相关的环境线索暴露前后海洛因依赖者的冲动性选择进行评估。选择年龄在20-45a之间,选择戒断时间30d、3m、12m、24m,符合DSM-Ⅳ阿片类药物依赖诊断标准的男性受试者签定知情同意书;然后进行基本人口学资料的采集以及焦虑量表(HAMA)、抑郁自评量表(BDI)、Barratt冲动量表(BIS)等量表的评分,并且同时进行注意力、工作记忆(workingmemory)的测试;在给予海洛因相关环境线索以及自然场景前后进行生命体征(心率、血压)的监测和分化情绪量表评分,以及心理渴求评分以确定所给干预的有效性;在海洛因相关环境线索和自然场景前后分别用IGT对其冲动性选择进行评价。结果:本研究发现,给予有效的海洛因相关环境线索暴露之后,短期戒断和长期戒断的海洛因依赖者的冲动性选择增加,与干预之前有显著性差异。结论:本研究提示药物相关的环境线索暴露强化海洛因依赖者的冲动性选择,为解决药物依赖者强迫用药和复吸问题奠定了基础,但对于药物相关线索暴露后冲动行为增加的神经机制需要进一步的研究。     

厄贝沙坦联合螺内酯在慢性心力衰竭中的应用效果

目的 研究厄贝沙坦联合螺内酯在慢性心力衰竭中的应用效果及对病人心功能的影响.方法 选择慢性心力衰竭病人60例,按随机数字表法均分为观察组、对照组.对照组采用常规治疗,观察组加用厄贝沙坦联合螺内酯治疗.观察两组临床疗效,心功能指标,血压、心率,血清B型脑钠肽(BNP)及高敏C-反应蛋白(hs-CRP)水平.结果 治疗后,观察组(86.67%)总有效率与对照组(63.33%)比较,差异有统计学意义(P<0.05);两组病人心功能指标较治疗前改善,但观察组改善更明显,左室舒张末期内径(LVDd)[(52.33±4.92) mm vs (59.46±5.57) mm]、左室收缩末期内径(LVSd)[(40.24±4.13) mm vs (46.95±4.87) mm]、左室射血分数(LVEF)[(48.62%±7.13%) vs (42.41%±6.65%)],差异有统计学意义(P<0.05);两组病人血压、心率较治疗前下降,但观察组下降更明显[舒张压(75.36±3.54) mmHg vs (85.47±4.09) mmHg,收缩压(130.65±8.74) mmHg vs (139.22±9.35) mmHg,心率(76.72±10.56)次/分钟 vs (82.59±11.34)次/分钟],差异有统计学意义(P<0.05);两组BNP、hs-CRP水平较治疗前下降,但观察组下降更明显[BNP(1.71±0.34) μg·L-1 vs (2.48±0.57) μg·L-1,hs-CRP(6.26±1.03) μg·L-1 vs (8.79±1.12) μg·L-1],差异有统计学意义(P<0.05).结论 厄贝沙坦与螺内酯联合治疗慢性心力衰竭应用疗效确切,能有效改善病人心功能,延缓病情的发展.     

孕鼠大量酒精摄入对子代胰岛素敏感性及脂肪源性细胞因子的影响

目的观察孕期大量摄入酒精对子代成年期胰岛素敏感性影响并探讨其影响机制。方法6只SD孕鼠随机分为对照组和酒精组,酒精组以酒精灌胃(4g·kg-1·d-1)至分娩前。第16周龄子代鼠进行静脉葡萄糖耐量试验(IVGTT),RT-PCR检测脂肪组织瘦素、抵抗素及脂联素mRNA表达水平,放射免疫方法测血清瘦素、抵抗素及脂联素含量。结果出生时,酒精组新生鼠体重低于对照组(5.7g±0.1gvs6.9g±0.1g,P<0.01);16wk龄时,与对照组比较,酒精组子代16wk龄时,血糖曲线下面积增加(P<0.05)、8min时葡萄糖刺激的胰岛素分泌增加(P<0.01)、胰岛素敏感指数(SI)及葡萄糖耐量指数(KG)降低(P<0.01);脂肪组织中抵抗素mRNA表达及血清抵抗素水平增加(P<0.05),而脂肪组织中瘦素、脂联素mRNA表达及血清瘦素和脂联素水平均无变化。结论孕期大量饮酒可引起后代宫内发育迟缓,并导致其成年期发生胰岛素抵抗,其机制部分与脂肪组织抵抗素表达增加有关。     

Abnormal pain response in pain-sensitive opiate addicts after prolonged abstinence predicts increased drug craving

Rationale  Craving is a primary feature of opiate addiction and is clinically significant because of its potential to trigger opiate use and relapse. Opiate use can also produce abnormal pain perception. We predicted that for opiate addicts (OAs), there may be an association between these two major features of addiction (drug craving and abnormal pain responses). Objectives  To examine pain responses in abstinent opiate addicts in comparison with healthy controls using a cold-pressor test (CPT) and investigate the correlations of cue-induced drug craving with pain responses. Material and methods  Fifty-four abstinent OAs and 46 healthy subjects participated in the CPT, and the OAs were also exposed to heroin-related cues the day before the pain test. Outcome measures included pain-tolerance time, VAS ratings of pain intensity and distress, and (in the cue-exposure procedure) VAS ratings of heroin craving and anxiety. Results  In the CPT, abstinent addicts showed shorter pain-tolerance time (85.1 ± 14.1 s vs. 133.7 ± 16.7 s, p < 0.05) and higher ratings of pain distress (61 ± 3.2 vs. 45.6 ± 3.2, p < 0.01) compared to healthy controls. When we divided the addicts and controls into pain-sensitive (PS) and pain-tolerant (PT) groups by dichotomizing each group in terms of pain-tolerance time, we again found differences between the two PS groups (37.3 ± 3.5 s vs. 57.4 ± 5.1 s, p < 0.01 for pain-tolerance time; 66.7 ± 3.2 vs. 52.4 ± 3.3, p < 0.01 for distress ratings). For all participants, pain-tolerance time was negatively correlated with VAS ratings for pain intensity and distress. More importantly, the PS addicts reported greater cue-induced craving than the PT addicts (17.8 ± 2.2 vs. 4.5 ± 4.2, p < 0.05). For the addict group as a whole, pain distress (the affective aspect of pain) was positively correlated with intensity of cue-induced craving measured on a different day (r = 0.33, p = 0.01). Conclusions  A hyperalgesic state persists for at least 5 months in abstinent OAs and is predictive of cue-induced craving. Longitudinal research is needed to clarify the direction of causation between hyperalgesia and opiate addiction.     

冻干重组人脑利钠肽联合缬沙坦氢氯噻嗪在急诊急性心力衰竭伴高血压病人中的应用

目的 探讨冻干重组人脑利钠肽联合缬沙坦氢氯噻嗪在急诊急性心力衰竭(AHF)伴高血压病人中的应用.方法 选取2017年4月至2018年12月郑州大学附属洛阳中心医院收治的AHF伴高血压病人106例,以随机数字表法分为对照组和联合组各53例,对照组给予缬沙坦氢氯噻嗪+螺内酯治疗,联合组给予冻干重组人脑利钠肽+缬沙坦氢氯噻嗪+螺内酯治疗.对比两组治疗前及治疗2周后的血压、心率、心功能指标、心率变异性指标、血清肌钙蛋白T(TNT)、N末端B型脑钠肽前体(NT-proBNP)及胱抑素C(Cys-C)水平变化,对比临床疗效及治疗期间的不良反应.结果 治疗2周后,收缩压(SBP)[对照组(165.16±34.83)mmHg比(133.78±23.41)mmHg、联合组(166.23±35.37)mmHg比(124.32±22.57)mmHg]和舒张压(DBP)[对照组(108.76±22.75)mmHg比(87.57±12.89)mmHg、联合组(109.23±23.14)mmHg比(82.16±13.17)mmHg]均降低(P<0.05),联合组更低(P<0.05);治疗2周后,心脏指数(CI)[对照组(2.13±0.37)L·min-1·m-2比(3.32±0.53)L·min-1·m-2、联合组(2.15±0.24)L·min-1·m-2比(3.65±0.48)L·min-1·m-2]、心排血量(CO)[对照组(4.96±0.32)L/min比(5.23±0.85)L/min、联合组(4.95±0.36)L/min比(5.41±0.72)L/min]及左室射血分数(LVEF)[对照组(50.79±7.26)％比(55.37±7.18)％、联合组(51.03±6.83)％比(59.37±7.52)％]均显著高于治疗前(P<0.05),且联合组CI、LVEF均更高(P<0.05),两组病人心率(HR)[对照组(88.28±9.14)次/分比(77.83±6.51)次/分、联合组(87.94±8.86)次/分比(73.58±7.16)次/分]明显低于治疗前(P<0.05),联合组更低(P<0.05);治疗2周后,两组RR间期标准差(SDNN)、相邻RR间期差值均方根(RMSSD)及相邻RR之差>50 ms个数所占百分比(PNN50)均明显高于治疗前(P<0.05),联合组均更高(P<0.05);TNT、NT-proBNP及Cys-C水平均明显低于治疗前(P<0.05),联合组更低(P<0.05);两组临床疗效分布差异有统计学意义(P<0.05),联合组总有效率明显高于对照组(94.45％比77.36％,P<0.05);治疗期间两组病人不良反应发生率相近(P>0.05).结论 冻干重组人脑利钠肽联合缬沙坦氢氯噻嗪治疗可显著降低急诊AHF伴高血压病人血压、改善心功能及心率变异性,减慢心率,显著降低TNT、NT-proBNP及Cys-C水平,增强疗效且安全可靠.