左右臂血压差异的探讨

目的探讨左右臂血压的差异。方法入选健康体检者11 693例。应用日本Colin公司生产的动脉硬化检测仪,同时测量仰卧位左右臂血压。结果 （1）男性组的收缩压、舒张压、平均动脉压为左臂高于右臂,脉压为右臂高于左臂（P〈0.05）。按年龄分组后,各组收缩压差异无统计学意义（P〉0.05）。（2）女性组的收缩压、舒张压、脉压为右臂高于左臂（P〈0.01）。按年龄分组后,舒张压在60岁以前差异无统计学意义（P〉0.05）,在60岁以后差异有统计学意义（P〈0.01）。（3）总体组受男女性别血压差异的影响,统计结果无临床意义。结论左右臂血压的差异依性别而异。     

高血压病患者血压各参数与其并发脑卒中的关系

目的探讨高血压病患者血压各参数与其发生脑卒中的关系。方法回顾性分析798例高血压病患者。年龄45．65岁,其中单纯高血压病患者400例,高血压并发脑卒中者398例,分析两组患者的血压各参数关系,探讨收缩压、舒张压、平均血压、脉压与高血压并发脑卒中的相关性。结果收缩压、平均血压、脉压：脑卒中组与单纯高血压组比较有显著性差异（P〈0．05,P〈0．01）;舒张压：脑卒中组与单纯高血压组比较无显著性差异（P〉0．05）。结论中老年高血压病患者,收缩压、平均血压、脉压与脑卒中的发生有显著相关性,舒张压与脑卒中的发生无显著相关性。     

高血压患者十年脑卒中风险概率分析

目的分析徐州市中心医院高血压患者十年脑卒中发病风险概率。方法收集2011年11月至2012年4月徐州市中心医院1861例心内科门诊及住院高血压患者的病例资料,排除既往有脑卒中病史及现在新发脑卒中者。将就诊时陛别、年龄、血压水平以及合并糖尿病、心血管疾病、房颤等指标,按照弗雷明汉风险评分（Framingham risk score,FRS）,计算得出十年脑卒中风险概率,并对上述指标进行相关分析。结果①1861例高血压患者中男性967例,女性894例,平均年龄（60．78±12．79）岁,平均收缩压（143．12±16．31）mmHg,平均舒张压（81．37±12．56）mmHg。十年脑卒中风险概率评估发现低危者为27．35％,中危者为21．60％,其中高危者为51．05％,所占比率最高（P〈0．05）。②年龄〈54岁时高血压发病率男性较女性高（P〈0．05）,女性血压轻度升高者较男性比率高（P〈0．05）。随着年龄的增长,无论男女十年脑卒中风险概率均持续升高。男性高危者（64．53％）居多,而在女性人群中低危者（43．85％）比率最高。71岁之前男性十年脑卒中发生风险高于女性,但是71岁后两者之间无明显差异。③高血压患者脑卒中一级预防相关危险因素糖尿病、心血管疾病、房颤、左心室肥厚的患病率随着年龄的增加呈现增加的趋势。结论在脑卒中的一级预防中,综合评估并干预各种危险因素,采取积极有针对性的预防卒中策略,其中控制高血压是预防脑卒中的关键。     

425例高血压脑出血患者血压变化分析

目的 探讨广州市高血压脑出血患者发病及血压变化情况与高血压家族史、性别、年龄、病程等因素之间的关系.方法 回顾性分析广州市南方医院高血压脑出血425例临床资料,对其在不同家族史、性别、年龄、病程的发病情况及其与血压之间的关系进行分析.结果 青年组、中年组及老年组高血压脑出血男女发病比例分别为1.08∶1;2.04∶1;1.87∶1.男性有高血压家族史者明显高于无家族史者,女性有无高血压家族史对发病无明显影响.青年组男性收缩压及舒张压均明显高于女性;中年组及老年组收缩压及舒张压在两性间比较差异无统计学意义.所有患者收缩压及舒张压的分布情况均为急性期大于亚急性期大于恢复期.结论 高血压应区分年龄、性别、病程给予不同防治策略,最大限度降低脑出血的发生.     

社区人群高血压管理及其效果分析

目的 探讨社区高血压人群管理及其效果。方法 对干预社区35岁以上人群进行高血压普查，然后对检出的确诊高血压和临界高血压患者进行为期3年的综合干预管理。结果 3年确诊高血压管理率平均为81．5％，血压达160／95mmHg以下的控制率为45．8％；3年临界高血压管理率平均为90．3％，160／95mmHg以下的控制率为75．7％；管理率随被管理对象的年龄增大而升高，但是，控制率以45岁年龄组最高，以后随年龄增高而下降。确诊高血压随访组的平均收缩压(MSBP)3年内下降了13．6mmHg，平均每年下降4．6mmHg；平均舒张压(MDBP)3年内下降了7．2mmHg，平均每年下降2．4mmHg;高血压随访组3年内心脑血管病发病率下降了46．7％，死亡率下降52．2％。结论 社区高血压人群管理是降低心脑血管病的发生和死亡的重要途径，而且是切实有效的。     

探讨高血压病患者血压各参数与其并发脑卒中的关系研究

目的探讨高血压病患者血压各参数与其并发脑卒中的关系。方法回顾性分析798例高血压病患者,年龄45～65岁,其中单纯高血压病患者400例,高血压并发脑卒中者398例,分析两组患者的血压各参数关系,探讨收缩压、舒张压、平均血压、脉压与高血压并发脑卒中的相关性。结果收缩压;平均血压;脉压:脑卒中组与单纯高血压组比较有显著性差异(P<0.05;P<0.01);舒张压:脑卒中组与单纯高血压组比较无显著性差异(P>0.05)。结论中老年高血压病患者,收缩压、平均血压、脉压与脑卒中的发生有显著相关性,舒张压与脑卒中的发生无显著相关性。     

左旋氨氯地平联合阿托伐他汀治疗高血压并高血脂疗效观察

1资料与方法
　　1.1一般资料研究对象为我院2010-04-2012-04收治的75例高血压患者，诊断标准依据中国高血压防治指南：收缩压≥140 mmHg和（或）舒张压≥90 mmHg ；均伴高血脂。男52例，女23例；年龄60～81岁，平均68岁。均未服用过或接受降血脂治疗，均非因糖尿病、心血管系统疾病等引起的高血脂症。2组年龄、血脂水平等无明显差异（P＞0.05），具有可比性。     

抗高血压药物治疗的适应证及药物应用原则

高血压的定义是人为制定的，人群中血压的分布由低到高呈渐次递增偏态曲线。当某人测得的血压读数处于对心血管有明显危险水平之上（在此水平患病死率即增加50％）便可定义为高血压。目前，我国采用国际上统一诊断标准：未服用抗高血压药物的情况下，收缩压≥140mmHg和（或）舒张压≥90mmHg即可诊断为高血压。     

抗焦虑治疗高血压并焦虑患者的疗效分析

目的 探讨抗焦虑治疗对的初诊高血压合并焦虑障碍患者血压达标率的影响。方法 左旋氨氯地平单药未达标的初诊高血压患者,经汉密顿焦虑量表诊断焦虑者共72例,随机分为A组加用替米沙坦,B组加用帕罗西汀,治疗8周,观察血压及达标率。结果 A组平均收缩压为(165.3±9.4)mmHg,平均舒张压为(99.1±5.7)mmHg,治疗8周后分别为(145.6±8.7)mmHg和(90.3±4.8)mmHg(P均<0.01);B组平均收缩压为(166.2±10.1)mmHg,平均舒张压为(99.6±5.9)mmHg,治疗8周后分别为(139.6±9.1)mmHg和(88.3±6.7)mmHg(P均<0.01);A、B组的血压控制达标率分别为68.26%和为79.39%(P<0.05)。结论 抗焦虑治疗可改善初诊高血压合并焦虑患者的血压达标率。     

亚低温疗法辅助颅内血肿清除术治疗脑出血对患者血清炎性因子水平及预后的影响

脑出血是非外伤性脑实质内血管破裂引起的出血,占全部脑卒中的20％～30％,主要与高血脂、糖尿病、高血压、血管的老化、吸烟等密切相关［1］。脑出血主要治疗手段是开颅手术清除血肿［2］。研究发现,亚低温辅助治疗对脑出血患者术后整体预后有益。
　　1资料与方法
　　1.1一般资料选择2011‐03—2012‐12我院收治的80例脑出血患者为研究对象,随机分为观察组和对照组各40例,观察组男25例,女15例;年龄48～76岁,平均（56.7±1.2）岁;明确高血压史4～8 a ,平均（5.6±2.1）a;12例患者合并糖尿病;收缩压（179.5±15.6）mmHg ,舒张压（107.6±3.9） mmHg ;出血量30～60 mL ,平均（45.2±3.9）mL ;头颅CT显示均为基底节区出血、中线移位5 mm以上、对侧侧脑室受压明显。对照组男23例,女17例;年龄48～72岁,平均（55.7±1.8）岁;明确高血压史4～10 a ,平均（5.5±2.15）a;15例患者合并糖尿病;收缩压（180.5±13.3）mmHg ,舒张压（109.6±2.5）mmHg ;出血量30～60 mL ,平均（46.2±1.9） mL ;头颅CT显示均为基底节区出血、中线移位5 mm以上、对侧侧脑室受压明显。2组患者基本资料差异无统计学意义（P＞0.05）,具有可比性。     

Suicide and religiosity—Masaryk’s theory revisited

BACKGROUND: The relationship between suicide rates and the religious climate of a community is a matter of controversy. Rising suicide rates have been attributed in part to a decline in religious observance, but contradictory evidence has also been adduced. METHODS: We compared national suicide rates, classified according to gender, age, and urban-rural location,with the results of a national survey on religious belief and practice conducted during the same year. The survey consisted of four questions dealing with different dimensions of religiosity, some of which might be considered as internal and central, others more external and social. RESULTS: Suicide rates were higher for males than for females, and for younger than for older age groups. Religiosity was, in contrast, higher among females and in rural areas. Suicides were more frequent in rural areas, which also had greater religiosity. External, social dimensions of religiosity differed more than core beliefs. CONCLUSIONS: There is evidence of an inverse relationship between religiosity and suicide when age and gender are considered, but not according to location. Possible reasons for this are discussed.     

上海市虹口区社区老年人轻度认知功能障碍的危险因素调查研究

目的 调查上海市虹口区社区居家模式老年人群轻度认知功能障碍（MCI）患者的危险因素。方法分为两步,第一步采用整群分层抽样的方法随机选取上海市虹口区4个街道社区,采用AD8简体中文版对社区卫生服务中心年度体检的≥65岁健康体检老年人进行评测,AD8≥2分为有认知功能障碍;第二步为完成第一步的认知功能障碍受试者,完成一般资料调查表、MMSE、MoCA等量表评测,进行临床诊断,以临床诊断的MCI患者作为研究对象,共163例,并随机选取健康照料者及体检健康人群127例作为健康对照组;采用Logistic回归分析筛查MCI患者的危险因素;组间比较采用秩和检验或t检验,计数资料采用卡方检验。结果第一步共8549名社区老年人完成评估;第二步有163例诊断为MCI,单因素logistic回归分析可见性别、年龄、教育年限、年收入、社会活动、锻炼、睡眠障碍与MCI的发生有关(P<0.05);多因素logistic回归分析表明女性、高龄、教育程度低、低年收入、缺少社会活动、缺少锻炼、睡眠障碍为虹口区社区居家模式MCI患者的高危因素。结论上海市虹口区社区老年人认知功能障碍的发病率较高,女性、高龄、教育程度低、低年收入、缺少社会活动、缺少锻炼、睡眠障碍是轻度认知功能障碍的主要危险因素。     

上海城乡帕金森病患病率研究

目的 :明确我国老年人口中帕金森病的患病率以及观察帕金森病的动态变化。方法 :抽样方法采用分层多级整群抽样方法确定调查对象。抽样结果为 2 2个居委会和 14个村委会的 5 5岁和以上的居民 170 18。调查采用二阶段法。采用统一调查表和标准化调查用语 ,按名单入户调查。结果 :实查 16 0 30人 ,拒查等失访 988人 ,实查率 94.2 % ,总的粗患病率为 0 .99% ,6 0岁或以上、 6 5岁或以上 PD患病率分别为 1.13%和 1.42 % ,其中男性患病率为 0 .86 % ,女性患病率为 1.1% ,城市患病率为 1.1% ,农村患病率为 0 .76 %。 PD患病率随年龄的增长而增加 ,到 85岁下降。男女有相似的趋势。帕金森病综合征以血管性的帕金森综合征最多。结论 :上海帕金森病患病率高于以往的调查 ,和 10年前相比有上升趋势     

Association of depression with Alzheimer's disease and vascular dementia in an elderly Arab population of Wadi-Ara, Israel

OBJECTIVES: Because dementia and depression share common risk factors, we investigated risk factors for depression in Arab subjects with Alzheimer's disease (AD) and vascular dementia (VaD). METHODS: In a cross-sectional population-based study, we conducted a door-to-door survey of all adults over age 60 in an Arab community of rural Israel. We conducted interviews, gave questionnaires, and collected DNA blood specimens for determination of ApoE genotype. RESULTS: Of the 823 individuals in this naturalistic sample, 168 had dementia of Alzheimer's type (DAT) and 49 had VaD. Vascular risk factors, including the ApoE-epsilon4 allele, were more prevalent among VaD than DAT subjects. Depressive symptoms were present in 57% of DAT patients and 86% of VaD patients. Depressed DAT individuals had a greater history of ischemic cardiovascular or cerebrovascular (CV/CBV) disease than non-depressed DAT subjects, but depressed DAT subjects were less likely to have the ApoE-epsilon4 allele. Within the VaD group, there was no difference in the distribution of cardiovascular risk factors in individuals with and without depressive symptoms, and ApoE-epsilon4 was more prevalent among subjects with depressive symptoms. CONCLUSIONS: Depressive symptomatology is prevalent among subjects with dementias in this Arab community. History of CV/CBV is associated with the presence of depressive symptoms in DAT. Further studies are needed to clarify the role of ApoE in depression onset in different ethnic groups with DAT.     

社区糖尿病患者痴呆患病率调查

目的 调查社区糖尿病患者痴呆患病率,计算年龄别、性别患病率,并与非糖尿病组相比较.方法 对上海市某社区50岁以上常住居民中糖尿病患者及与其年龄、性别相匹配1:1对照的非糖尿病患者进行调查.运用问卷采集人口学及病史资料,MMSE筛查认知功能.对于文盲≤19分、小学≤21分、初中及以上文化程度≤24分者,进一步给予成套神经心理学量表检查,依据DSM-Ⅳ诊断痴呆.结果 糖尿病患者中痴呆患病率[4.75%(23/484),95%CI:3.03%～7.04%]高于非糖尿病患者[2.24%(11/490),95%CI:1.13%～3.98% X~2=4.54,P=0.03].糖尿病组60～69、70～79和80岁以上各年龄段的痴呆患病率分别为1.94%(2/103)、4.43%(9/203)和14.12%(12/85)(趋势X~2=18.04,P<0.01);非糖尿病组相应年龄段痴呆患病率分别为1.43%(2/140)、2.86%(6/210)和5.00%(3/60,趋势X~2=4.58,P:0.03).糖尿病组女性和男性痴呆患病率分别为6.55%(19/290)和2.06%(4/194,X~2=5.18,P=0.02);非糖尿病组女性和男性痴呆患病率分别为3.01%(9/299)和1.05%(2/191).结论 糖尿病患者中痴呆患病率显著高于非糖尿病患者,2组痴呆患病率均随年龄增大而升高,并且女性痴呆患病率高于男性.     

Comparison of characteristics between geriatric and younger subjects with schizophrenia in community

Relatively little is known about the different characteristics of non-institutionalized geriatric and younger subjects with schizophrenia. This study compared demographic and clinical characteristics of all the geriatric, middle-age and young subjects with schizophrenia living in a Chinese rural community. Geriatric (age >/= 65 years) (N = 51), middle-age (age 41-64 years) (N = 263) and young subjects with schizophrenia (age 15-40 years) (N = 196) in a rural community were assessed with the Present State Examination and Social Disability Screening Schedule. Age at first onset was significantly older in geriatric male and female groups. While there were no significant differences of negative symptoms among the three groups, the rates of lifetime nuclear syndrome were significantly lower in geriatric subjects compared to the other two groups. Geriatric subjects were less likely to have been hospitalized (9.8%) than middle-age (19.0%) and younger subjects (24.8%). Although the duration of illness was significantly longer in geriatric subjects than in the other two groups, the clinical outcome was significantly better in the geriatric group and social functioning scores were similar among the three groups. Geriatric subjects were more likely to be female, with longer duration of illness, fewer "core" symptoms, relatively stable social functioning and clinical outcome. The pathogenesis and psychopathology of geriatric subjects may be different compared to younger subjects with schizophrenia.     

无症状性脑梗死认知功能障碍的分析

目的深入地探讨无症状性脑梗死与认知功能障碍的关系。方法在性别、年龄、血糖、肾功能、血脂、血压、EKG表现、有无颈动脉斑块、MMSE评分值和MoCA值的高低方面,运用SPSS 13.0统计软件对上海地区44例高血压患者进行统计。结果 26例SCI合并高血压患者与18例无SCI的高血压患者之间有无颈动脉斑块的差异有统计学意义(P0.05),其余各项指标的差异无统计学意义(P0.05)。同时发现两组之间MOCA评分值和间隔9个月的两次MMSE评分差值均存在显著差异(P0.05)。另外多元逐步Logistic回归分析提示,血尿素氮值的大小和有无颈动脉斑块对SCI发生的风险有显著影响;SCI与随访9个月后测定的MMSE评分值和MOCA评分值的高低有明显关系。结论 SCI可引起认知功能障碍,特别是在随访后更加明显。     

社区中、老年人群高血压前期对颈动脉粥样硬化斑块形成的影响

目的 探讨社区中、老年人群高血压前期与颈动脉粥样硬化斑块形成的关系.方法 分别对942名46～75岁广州社区居民进行问卷调查、体格检查、血生化检验和双侧颈动脉超声检查,根据JNC-7的血压分类标准,比较正常血压(normotension,NT)、高血压前期(prehypertension,Pre-HT)和高血压(hypertension,HT)3亚组人群颈动脉粥样硬化斑块形成的差异.结果 Pre-HT和HT均与高龄、男性、肥胖、血脂异常、吸烟的危险因素相关.控制相关危险因素后,Pre-HT颈动脉粥样硬化斑块形成是NT的2.37倍(95%CI:1.42～3.95,P<0.01),Pre-HT与HT之间颈动脉粥样硬化斑块形成的差异不明显(P>0.05).与HT相比,Pre-HT颈动脉粥样硬化斑块以低回声斑块较多.结论 高血压前期与颈动脉粥样硬化斑块形成风险增高相关,处于高血压前期的中、老年人群已存在较明显的靶器官损害--颈动脉粥样硬化斑块形成.     

An exploration of perceptions of possible depression prevention services for caregivers of elderly or chronically ill adults in rural Georgia

Caregiving for elderly or chronically ill adults can be stressful, contributing to a high rate of depression in caregivers. Rural caregivers are at particularly high risk due to reduced access to mental health care services. This study explored the acceptability among rural caregivers of introducing a program to prevent or alleviate depression. Focus groups with caregivers and community members were conducted in four rural counties of Georgia. Caregivers reported high levels of stress and depression and recommended the following interventions: support groups, respite care, a centralized source of information, training for caregivers and other community members, financial support, and a telephone hotline. There were more commonalities than differences across the locations, but some programmatic preferences and acceptability varied.     

Socio-demographic variation of dementia subtypes in china: Methodology and results of a prevalence study in Beijing, Chengdu, Shanghai, and Xian

OBJECTIVE: To characterize sociodemographic variations in the prevalence of AD and VaD in China. METHODS: Data were collected in a 1997-1998, cross-sectional, door-to-door prevalence survey of 34,807 community residents ages > or =55 years in Beijing, Shanghai, Chengdu and Xian. Initial diagnoses of AD and VaD were assessed by clinicians using standardized protocols, according to the NINCDS-ADRDA and NINDS-AIREN criteria; diagnoses were confirmed after 6 months by repeating neuropsychological evaluations. Prevalence odds ratios were estimated in logistic models adjusting for survey design, age, and other sociodemographic factors. RESULTS: We identified 732 prevalent cases of AD and 295 cases of VaD. Adjusting for all sociodemographic factors concurrently, prevalence odds of AD and VaD were higher in northern versus southern China. Age trends for AD appeared different in western and eastern China. AD also showed an age-adjusted elevation among women and, in the fully adjusted model, a gender education interaction indicating a female preponderance in the highest education group. North-south variation for VaD was age-dependent. In the fully adjusted model, for AD, widowed had significantly higher prevalence odds; for VaD, widowed persons and minorities had significantly lower prevalence odds; professionals had statistically significant and borderline lower prevalence odds for both VaD and AD; sales-service occupations had significantly lower odds for AD only. CONCLUSION: We observed variations in prevalence for AD and VaD in different regions and demographic groups in China that persisted after controlling for potential confounding factors. Sociodemographic factors are probable surrogates for conditions such as lifestyle, environment, comorbidities, and life expectancy.