老年人阻塞性睡眠呼吸暂停低通气综合征患者血清同型半胱氨酸的水平

阻塞性睡眠呼吸低通气综合征(OSAHS)是一种具有潜在危险性的睡眠呼吸障碍性疾病,且在老年人发病率高,由于其夜间反复的发生呼吸暂停和(或)低通气事件,造成各系统脏器功能的改变,尤其与老年人心脑血管疾病关系密切.国内外的研究表明,OSAHS是诱发老年人发生高血压、冠心病、脑血管病等多种疾病的独立危险因素.同型半胱氨酸(Hcy)是一种含硫氨基酸,为蛋氨酸代谢过程中的一个重要的中间产物,众多资料表明,高同型半胱氨酸血症是心脑血管疾病和外周血管疾病发病的独立危险因子.两者同作为心血管疾病研究领域的两大热点问题均与老年心脑血管疾病的发生密切相关.本研究旨在探讨老年OSAHS患者血清Hcy水平,以利于临床对于减低老年OSAHS患者心脑血管疾病的发生具有重要意义.     

慢性阻塞性肺疾病与支气管哮喘并存的诊治问题

COPD和支气管哮喘(简称哮喘)是两种不同的疾病,两者的不同之处也显而易见:一种是发生在成年人、与吸烟和中性粒细胞相关的疾病,最佳治疗方法是使用支气管舒张剂和去除危险因素;一种是儿童时期起源、与变态反应和嗜酸粒细胞相关的疾病,最佳治疗方法是针对气道炎症用药.     

阻塞性睡眠呼吸暂停低通气综合征患者高血压发生机制

阻塞性睡眠呼吸暂停低通气综合征是一种常见的睡眠呼吸疾病,具有发病率高,并发症多,危害性大的特点。众多研究已表明睡眠呼吸暂停低通气综合征是高血压发病的独立危险因素,然而其确切机制并不十分清楚,可能是多种因素协同作用的结果。     

经鼻持续气道内正压通气治疗阻塞性睡眠呼吸暂停低通气综合征进展

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种发病率较高并具有一定潜在危险的疾病,经鼻持续气道内正压通气(nCPAP)目前已成为治疗中、重度OSAHS患者的首选措施。本文介绍了应用nCPAP的治疗机制、对各器官的治疗作用、压力水平的调节、影响其成功的因素、以及经鼻面罩正压机械通气治疗OSAHS新模式和治疗的副作用等进行了综述。     

慢性阻塞性肺疾病气道基因表达与肺癌的易感性关系

COPD和肺癌均是全球高发病率、高病死率的疾病，临床上COPD合并肺癌的病例较为常见，长期以来人们将其作为两个独立的疾病分别进行了广泛研究，但目前两者相关的危险因素及潜在关联的发病机制已引起国内外临床医师及研究者的关注。研究也表明两者共同存在一些环境因素、遗传因素、异常的免疫炎症反应，影响COPD和肺癌的发生发展，本文就COPD气道基因表达与肺癌易感性的关系作一综述，以了解这两种疾病在分子水平的联系。     

趋化因子Fractalkine受体CX3CR1基因多态性与动脉粥样硬化

动脉粥样硬化是一种多因素共同作用的疾病,炎症被认为是动脉粥样硬化疾病的独立危险因素,CX3C是一类独特的趋化因子,其受体CX3CR1的基因多态性与动脉粥样硬化的关系也日见报道,然而两者是否有必然联系,目前尚未知晓。本文就趋化因子受体CX3CR1的结构、生物学特性及与动脉粥样硬化之间关系做一综述。     

阻塞性睡眠呼吸暂停低通气综合征与心脑血管疾病的关系

<正>阻塞性睡眠呼吸暂停低通气综合征(OSAHS)已为比较常见的疾病,研究显示OSAHS是多种全身疾病的独立危险因素,是对人类健康有影响的疾病之一,是心脑血管疾病的独立危险因子。     

阻塞性睡眠呼吸暂停低通气综合征与胰岛素抵抗研究进展

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnoea-hypopnoea syndrome,OSAHS)有较高的代谢性疾病并发症.胰岛素抵抗(insulin resistance,IR)与十余种代谢疾病有关,也是导致这些疾病的主要因素.两者在临床上有较高的并存率.以下就OSAHS与IR相关性作一综述.     

阻塞性睡眠呼吸暂停低通气综合征与多器官疾病的关系

阻塞性睡眠呼吸暂停低通气综合征（obstruvtive sleep apnea hypopnea syndrome,OSAHS）是指睡眠时上气道塌陷阻塞引起的睡眠呼吸暂停和通气不足,伴有打鼾、睡眠结构紊乱,频发血氧饱和度下降,白天嗜睡等症状,是一种发病率高、严重影响生活并危及生命的疾病,是高血压、冠状动脉粥样硬化性心脏病（冠心病）、肺源性心脏病（肺心病）和脑卒中等心脑血管疾病的独立危险因素。     

呼吸机相关性肺炎的相关危险因素分析

目的 探讨呼吸机相关性肺炎的危险因素.方法 将134例机械通气治疗患者分为发生呼吸机相关性肺炎（病例组：51例）,和未发生（对照组：83例）,并进行单因素和多因素分析其发病相关危险因素.结果 在呼吸机相关性肺炎相关的危险因素中,年龄、机械通气时间、侵入性操作、气管切开、留置胃管、昏迷和药物使用情况（使用制酸剂）方面的差异具有统计学意义（P＜0.05）;而与性别、血糖无关（P＞0.05）.结论 通过研究呼吸机相关性肺炎的相关危险因素,可用于临床预防和治疗该疾病,具有一定的临床意义.     

Genetic determinants of diabetes and atherosclerosis

Common risk factors for type 2 diabetes and cardiovascular disease are suspected because of the higher than expected prevalence of cardiovascular disease in individuals with newly diagnosed type 2 diabetes and in nondiabetic individuals with impaired glucose tolerance. Some of these risk factors may be genetic in origin. The risk of diabetes and cardiovascular disease may be linked through common pathways, including insulin resistance and/or inflammation. In this review, we describe the rationale for proposing these as common mechanisms affecting both diabetes and cardiovascular risk, and we then summarize the available evidence suggesting that common genes within these pathways have pleiotropic effects influencing susceptibility to both diseases.     

Nutraceuticals and Prevention of Atherosclerosis: Focus on ω‐3 Polyunsaturated Fatty Acids and Mediterranean Diet Polyphenols

Nutraceuticals are potentially healthful foods that play a role in maintaining human well being, enhancing health and preventing, or even treating, specific diseases. More than for any other diseases, cardiovascular diseases occur in association with risk factors that are amenable to prevention or treatment by nutraceutical interventions. Several ingredients marketed for use in dietary supplements address such risk factors. The ability of nutraceuticals to favorably influence cardiovascular risk factors and atherosclerotic vascular disease should be recognized as an enormous opportunity for the prevention or treatment of this common condition. In this review, we attempt at summarizing some of the recent research findings on ω‐3‐polyunsaturated fatty acids and antioxidant polyphenols that have beneficial cardiovascular effects to update the practicing clinicians on the potential benefits of nutraceuticals in this area.     

我国类风湿关节炎胃肠道和心血管危险因素调查:ATTENTION-1调查研究报告(二)

目的调查我国类风湿关节炎患者使用非甾体消炎药(non-steroidal anti-inflammatory drugs,NSAIDs)时出现胃肠道危险因素的发生情况和对服用NSAIDs胃肠道危险因素的认知情况,以及使用NSAIDs后心血管风险的发生情况。方法全国多中心横断面非干预现场问卷调查研究,全国共有28家医院2646例RA患者参与问卷调查。结果参加调查的RA患者主要受累关节为手和腕关节。高剂量NSAIDs使用史、吸烟、使用糖皮质激素、高龄是最常见的胃肠道高危因素。52.46%的RA患者存在1个或2个危险因素,38.02%的RA患者存在3个以上危险因素。RA患者中,知晓导致服NSAIDs时胃肠道风险增加的危险因素依次是酗酒、消化道溃疡史和高龄。在使用糖皮质激素的RA患者中,25.52%的患者知晓服用高剂量糖皮质激素药物会导致胃肠道风险增加。心血管风险因素依次是高血压、高血脂和糖尿病。结论高剂量NSAIDs使用史、吸烟是最常见的胃肠道高危因素,38.02%RA患者存在3个以上的危险因素。高血压是心血管最常见的风险因素。对NSAIDs应均衡胃肠道风险和心血管风险后选用。     

COPD and lung cancer: epidemiological and biological links

Lung cancer and chronic obstructive lung disease (COPD) are two common fatal diseases. Apart from their common link to tobacco, these two diseases are usually considered to be the result of separate distinct mechanisms. In the past 15 years, numerous studies have produced arguments in favour of a relationship between these two pathologies that goes beyond a simple addition of risk factors. At the epidemiological level, there are data that demonstrate an increased incidence of bronchial carcinoma in patients with COPD. The links between these two pathologies are still unexplained but there are numerous arguments supporting a common physiopathology. Common genetic and epigenetic abnormalities, mechanical factors and signalisation pathways have been quoted. COPD and lung cancer appear to be two diseases possessing a genetic basis that creates a predisposition to environmental or toxic assaults, resulting in a different clinical manifestation in each disease. Consequently, improvements in the management of these two diseases will involve a more intensive investigation of their physiopathology, and require a closer collaboration between research centres and clinical units.     

多囊卵巢综合征与心血管疾病的关系

多囊卵巢综合征(PCOS)是最常见的妇科内分泌疾病.近期研究显示,PCOS患者心血管疾病风险明显增加,而且患者在年轻时已存在动脉粥样硬化的早期病变.PCOS患者中存在的胰岛素抵抗、血脂代谢异常、高雄激素血症及肥胖等均会增加其心血管疾病风险.因此对PCOS患者存在的相关心血管疾病危险因素等进行早期评估,并予以相应治疗具有重要作用.     

Epidemiology and risk factors of cerebral ischemia and ischemic heart diseases: similarities and differences

Cerebral ischemia and ischemic heart diseases, common entities nowadays, are the main manifestation of circulatory diseases. Cardiovascular diseases, followed by stroke, represent the leading cause of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. However, each entity has its own particularities. Ischemic stroke shows a variety of pathogenic mechanisms not present in ischemic heart disease. An ischemic stroke increases the risk of suffering a coronary heart disease, and viceversa. The aim of this chapter is to review data on epidemiology, pathophisiology and risk factors for both entities, considering the differences and similarities that could be found in between them. We discuss traditional risk factors, obtained from epidemiological data, and also some novel ones, such as hyperhomocisteinemia or sleep apnea. We separate risk factors, as clasically, in two groups: nonmodifiables, which includes age, sex, or ethnicity, and modifiables, including hypertension, dyslipidemia or diabetis, in order to discuss the role of each factor in both ischemic events, ischemic stroke and coronary heart disease.     

缺血性卒中的药物预防治疗研究进展

目前脑血管疾病占我国死因的第一位,卒中是大多数发达国家的第三位死因,也是最常见的致死、长期致残和住院的原因之一。卒中有诸多的危险因素,但高血压、高胆固醇血症、心房颤动是导致卒中的独立危险因素,因而重视并对其进行积极的干预治疗对卒中的原发和继发性预防至关重要。大量的循证医学研究结果证实对具有诸多危险因素的高危病人,予以降压、降脂和抗血小板治疗以及对行为危险因素进行干预可明显降低卒中的发生率和死亡率。     

老年2型糖尿病患者合并心脑血管疾病的危险因素分析

目的　探讨老年 2型糖尿病 (diabetesmellitus ,DM)患者心脑血管病变的特点及相关危险因素。方法　通过回顾性分析方法 ,将 2 12例老年 2型DM患者分为心脑血管病变组 (病变组 )和无血管病变组 (无病变组 )各 10 6例。病变组含缺血性心脏病 (ischemicheartdisease ,IHD)患者组 72例和 (或 )脑血管病变 (cerebrovasculardisease,CVD)患者 5 0例。其中 ,两者并存者 16例。对两组间患者的临床数据进行比较及回归分析。结果　病变组的年龄、高血压患病比率、DM病程、尿微量白蛋白排泄率异常比无病变组明显增高 ;各亚组与无病变组的比较也有相似的趋势。回归分析显示 ,年龄、高血压是老年 2型DM患者总的心脑血管病变的独立危险因素 ,同时也分别是IHD和CVD的独立危险因素 ;另外 ,高甘油三酯血症与病变组和IHD分别独立相关 ;吸烟史是IHD的独立危险因素。结论　对于老年2型DM患者 ,除了年龄、高血压外 ,高甘油三酯血症是心脑血管病变的独立危险因子     

糖尿病和癌症共识报告——美国糖尿病协会、美国癌症学会公布

流行病学证据显示:癌症发生率和糖尿病、某些糖尿病风险因子以及糖尿病治疗有关.由美国糖尿病协会(ADA)和美国癌症学会(ACS)汇集的专家共识,回顾了科学研究现状.包括:(1)糖尿病和癌症发生及预后的关系.(2)糖尿病和癌症共同的危险因子.(3)在精尿病和癌症风险之间可能的生物学联系.(4)糖尿病的治疗是否影响癌症发生及预后.糖尿病和癌症都是常见病,严重影响着人类的健康.流行病学证据显示:糖尿病患者有发生多种癌症的较高风险;2型糖尿病(T2DM)和癌症有许多共同的危险因子.但目前T2DM和癌症之间的生物学联系尚未完全明了.而且,观察性研究的证据还显示:某些治疗高血糖的药物,增加或减少癌症发生的风险.鉴于此,ADA和ACS在2009年12月的研讨会上达成以下共识.     

Pregnancy and gallbladder disease

Gallbladder disease is a highly prevalent disease in western countries as a consequence of several genetic, biochemical, and environmental factors. Females are a high risk group, and pregnancy increases this risk considerably. In fact, gallbladder diseases are the second most common indication for nonobstetric surgical intervention in pregnancy. In this review, we discuss the most important aspects of gallbladder disease and pregnancy as part of the Symposium on Liver and Pregnancy, co-sponsored by the Mexican Association of Hepatology and the Mexican Association of Gynecologists and Obstetrics.