美托洛尔缓释片对老年高血压伴心力衰竭患者的临床疗效分析

目的探讨美托洛尔缓释片治疗老年高血压伴心力衰竭患者的疗效。方法依据治疗方法不同将73例老年原发性高血压伴心力衰竭患者分为治疗组36例和对照组37例,对照组给予左旋氨氯地平治疗,治疗组在对照组基础上加用美托洛尔缓释片,3个月后观察临床疗效。结果两组疗效比较差异无统计学意义(P>0.05),治疗组VEGF和hs-CRP降低幅度均优于对照组,差异有统计学意义(P<0.05)。结论美托洛尔缓释片能够降低老年高血压伴心力衰竭患者的VEGF和hs-CRP指数,临床疗效显著,值得临床广泛应用。     

硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压的临床观察

目的:观察硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压的临床疗效和安全性。方法:92例老年冠心病合并高血压患者按随机数字表法均分为对照组和研究组。对照组患者口服氢氯噻嗪25 mg,qd+尼群地平10 mg,qd+硝酸异山梨酯5 mg,tid;研究组患者口服硝苯地平缓释片20 mg,qd+依那普利初始5 mg,bid,2周后增加到10 mg,bid。两组患者疗程均为8周。观察两组患者的临床疗效,治疗前后舒张压(DBP)、收缩压(SBP),缺血事件发生率及不良反应发生情况。结果:治疗后两组患者总有效率及不良反应发生率比较,差异均无统计学意义(P>0.05)。治疗前两组患者DBP、SBP比较,差异均无统计学意义(P>0.05);而治疗后两组患者DBP、SBP均显著低于同组治疗前,且研究组显著低于对照组,差异均有统计学意义(P<0.05)。研究组患者缺血事件发生率显著低于对照组,两组比较差异有统计学意义(P<0.05)。结论:硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压疗效显著,安全性较好。     

奥美沙坦对老年高血压伴阵发性房颤复发率的影响

目的:探讨奥美沙坦对老年高血压伴阵发性房颤(PAF)患者血浆氨基末端脑利钠肽前体(NT-pro BNP)水平、高敏C反应蛋白(hs-CRP)及左房内径(LAD)的影响。方法:选取老年高血压伴阵发性房颤患者188例,按照随机数字表法分为对照组和观察组,各94例。两组患者均口服胺碘酮常规治疗,观察组在常规治疗组的基础上给予奥美沙坦酯片治疗,两组患者治疗周期为12个月。比较两组患者治疗前(T0)及治疗后1个月(T1)、3个月(T2)、6个月(T3)、12个月(T4)的NT-pro BNP水平、hs-CRP及LAD的变化情况以及两组患者的房颤(AF)复发率,分析房颤复发的相关因素。结果:观察组NT-pro BNP及hs-CRP在T3~T4低于对照组,差异有统计学意义(P<0.05);观察组的LAD改善情况亦优于对照组,差异有统计学意义(P<0.05);观察组治疗后NT-pro BNP及hs-CRP下降幅度及下降率高于对照组,差异有统计学意义(P<0.05);观察组在T3~T4的房颤复发率低于对照组,差异有统计学意义(P<0.05);多元逐步回归分析显示:NT-pro BNP和hs-CRP与LAD呈现正相关,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,NT-pro BNP水平、hs-CRP、LAD与患者房颤复发呈正相关;NT-pro BNP降幅及hs-CRP降幅与患者房颤复发率呈负相关。结论:血浆NT-pro BNP和hs-CRP水平与老年高血压伴PAF患者LAD以及房颤复发密切相关,奥美沙坦可降低血浆NT-pro BNP及hs-CRP水平,减轻炎症反应及改善左房重构,从而降低患者的房颤复发率。     

贝那普利联合美托洛尔治疗老年原发性高血压伴心力衰竭的疗效分析

目的:观察贝那普利联合美托洛尔治疗老年原发性高血压伴心力衰竭的疗效和安全性。方法:回顾性分析100例老年原发性高血压伴心力衰竭患者资料,按用药方案的不同分为对照组(50例)和观察组(50例)。在常规治疗的基础上,对照组患者给予盐酸贝那普利片10 mg,口服,每日1次;观察组患者在对照组治疗的基础上给予酒石酸美托洛尔片初始剂量6.25 mg,口服,每日2次,后视患者病情,增加至50~100 mg,口服,每日2次。治疗6个月后观察两组患者的临床疗效,治疗前后收缩压(SBP)、舒张压(DBP)、肱-踝脉搏波传导速度(ba PWV)、静息心率、左室射血分数(LVEF)、每搏输出量(SV)及不良反应发生情况。结果:观察组患者总有效率(88.0%)显著高于对照组(62.0%),差异有统计学意义(P<0.05)。治疗前,两组患者SBP、DBP、ba PWV、静息心率、LVEF、SV比较,差异均无统计学意义(P>0.05)。治疗后,两组患者SBP、DBP、ba PWV均显著低于同组治疗前,且观察组显著低于对照组;两组患者LVEF、SV均显著高于同组治疗前,且观察组显著高于对照组;观察组患者静息心率显著低于同组治疗前及对照组,差异均有统计学意义(P<0.05);但对照组治疗前后静息心率比较,差异无统计学意义(P>0.05)。两组患者治疗期间均未见明显不良反应发生。结论:在常规治疗的基础上,贝那普利联合美托洛尔治疗老年原发性高血压伴心力衰竭的疗效显著,可改善患者心功能及血压,且安全性较好。     

厄贝沙坦治疗高血压伴心力衰竭的疗效及其对血清hs-CRP和BNP水平的影响

目的：探讨厄贝沙坦治疗高血压伴心力衰竭的疗效及其对血清hs-CRP和BNP水平的影响。方法：将我院收治的96例高血压伴心力衰竭患者随机分为两组。对照组采取常规内科治疗措施,试验组在对照组基础上加用厄贝沙坦治疗。比较两组临床疗效及hs-CRP、BNP水平。结果：试验组心力衰竭总有效率为95.8%,显著高于对照组的79.2%,差异有统计学意义（P<0.05）;治疗后试验组hs-CRP、BNP水平降低,显著低于对照组,差异有统计学意义（P＜0.05）。结论：厄贝沙坦治疗高血压伴心力衰竭的效果显著,具有较高的临床有效率,有效降低患者hs-CRP、BNP水平,提高生存质量,值得临床选择。     

缬沙坦治疗老年高血压伴糖耐量异常患者的疗效

目的对缬沙坦治疗老年高血压伴糖耐量异常患者的疗效进行分析探讨。方法将我院74例老年高血压伴糖耐量异常患者随机分为对照组和观察组。对照组37例患者以苯磺酸左旋氨氯地平治疗,观察组37例患者以缬沙坦治疗,对比两组患者的治疗效果。结果两组患者治疗后的白昼DBP及SBP、夜间DBP及SBP均得到明显降低,但观察组与对照组无显著性差异(P>0.05)。对照组患者治疗前后FINS、2h PG、ISI及2h INS无显著性差异(P>0.05),观察组患者治疗后上述指标均得到明显降低,P<0.05,差异具有统计学意义,且明显低于对照组,P<0.05,差异具有统计学意义。观察组不良反应发生率为8.11%,对照组不良反应发生率为10.81%,两组患者的不良反应发生率无显著性差异(P>0.05)。结论对老年高血压伴糖耐量异常患者采用缬沙坦治疗,可有效缓解患者临床症状,提高治疗效果,在临床上值得推广应用。     

老年慢性心力衰竭给予琥珀酸美托洛尔缓释片+氯沙坦钾片治疗的临床分析

目的:探究琥珀酸美托洛尔缓释片+氯沙坦钾片治疗老年慢性心力衰竭的临床效果。方法:选取我院心内科收治的老年慢性心力衰竭患者98例,随机分为对照组和观察组,分别给予氯沙坦钾片疗法和琥珀酸美托洛尔缓释片联合氯沙坦钾片疗法进行治疗,对比分析两组患者的心功能指标和不良反应发生率。结果:观察组HR、BNP水平均小于对照组,其LVEF大于对照组,差异有统计学意义(P0.05);两组不良反应发生率差异无统计学意义(P0.05)。结论:琥珀酸美托洛尔缓释片+氯沙坦钾片治疗老年慢性心力衰竭效果显著,能够改善患者心功能,对其病情恢复具有很大的临床意义。     

氨氯地平与缬沙坦联用对老年原发性高血压伴糖尿病患者抗高血压的疗效评价

目的:评价氨氯地平与缬沙坦联用治疗对老年原发性高血压伴糖尿病患者抗高血压的临床疗效。方法:选取2015年2月—2017年1月间治疗的老年原发性高血压伴糖尿病患者103例临床资料,依据治疗方法不同将其分为对照组51例予以氨氯地平治疗,治疗组52例在对照组基础上加用缬沙坦治疗,比较两组患者治疗后的总有效率以及治疗前及治疗3月后舒张压(DBP)、收缩压(SBP)的变化情况。结果:治疗组治疗3月后DBP、SBP低于对照组(P<0.05),总有效率高于对照组(P<0.05)。结论:对老年原发高血压伴糖尿病患者予以氨氯地平与缬沙坦联用治疗效果较显著,可有效改善其血压水平。     

参附注射液用于抢救急危重症患者的临床疗效的观察

目的：观察参附注射液用于抢救急危重症患者的临床疗效。方法：按照数字随机分组法,将收治的92例急性左心衰竭患者均分为治疗组和对照组,两组患者均给予常规综合治疗,其中治疗组患者在此基础上加用参附注射液治疗,比较两组患者临床疗效、治疗前后血流动力学、心衰评分、中医证候评分、血浆BNP水平和心功能分级变化情况。结果：治疗组患者治疗的总有效率明显高于对照组（P〈0.05）;两组患者治疗后HR、SBP及DBP均明显下降,与治疗前比较其差异有统计学意义（P〈0.05）;治疗组治疗后HR、SBP及DBP均明显低于对照组,差异均具有显著性（P〈0.05）;两组患者治疗后心衰评分和中医临床症状评分均明显降低,与治疗前比较差异均具有显著性（P〈0.05）;治疗组治疗后心衰评分和中医临床症状评分均明显低于对照组,经比较其差异有统计学意义（P〈0.05）;两组患者治疗后血浆BNP水平值和心功能分级值均明显下降,与治疗前比较其差异有统计学意义（P〈0.05）;治疗组治疗后血浆BNP水平及心功能分级值的改善情况均明显优于对照组（P〈0.05）。结论：在常规综合治疗基础上加用参附注射液能够显著改善左心衰患者的临床症状、血流动力学及血浆BNP水平值,临床疗效较为确切。     

氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床价值分析

目的：探讨氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床疗效。方法100例高血压合并冠心病患者随机分为对照组与观察组,每组50例。分别给予硝苯地平控释片与氨氯地平阿托伐他汀钙片进行治疗,比较两组治疗前后舒张压(DBP)、收缩压(SBP)变化情况及心绞痛改善情况。结果①两组患者治疗后DBP及SBP水平较治疗前均显著降低,且观察组治疗前后SBP及DBP水平变化程度显著大于对照组,差异具有统计学意义(P<0.05);②观察组患者心绞痛改善效果显著优于对照组,差异具有统计学意义(P<0.05)。结论与常规药物硝苯地平控释片相比,氨氯地平阿托伐他汀钙片治疗高血压合并冠心病具有更高的临床价值。     

586例肿瘤患者贫血发生率调查

目的 分析各系统肿瘤患者中贫血的发生率和程度.方法 对在我院肿瘤内科住院的586例患者的临床资料进行回顾性分析.结果 肿瘤患者贫血的发生率达45.73%,其中Ⅰ、Ⅱ度为68.28%,Ⅲ、Ⅳ为度31.72%.血液系统肿瘤贫血的发生率最高,为58.67%,泌尿生殖系统为50.00%,消化道肿瘤为46.91%,乳腺癌为41.94%,肺癌为24.59%,其他肿瘤为44.78%.66.42%肿瘤患者有贫血症状,13.06%采取治疗措施,出院有贫血诊断仅为1.12%.结论 肿瘤患者贫血发生率高,漏诊率高,治疗率低,应引起医师的高度重视.     

Therapy with macrolides in patients with cystic fibrosis

Cystic fibrosis affects 1/2500 individuals and is the most common lethal autosomal recessive disease in people of northern European descent. It is characterized by chronic infections with mucoid Pseudomonas aeruginosa and progressive deterioration of respiratory function. Much research has focused on the inflammatory component of the disease. Macrolide antibiotics are postulated to suppress inflammatory mediators and interfere with biofilm formation produced by P. aeruginosa. In vitro studies show promising results, and a limited number of human studies reported improvements in respiratory function with the drugs. Macrolide antibiotics are generally safe and well tolerated and may prove to be effective in patients with cystic fibrosis.     

Cardiovascular drug therapy in patients with hepatic diseases and patients with congestive heart failure

Hepatic impairment can alter the pharmacokinetic profiles of cardiovascular drugs, which can lead to unwanted toxicity. In the presence of cirrhosis, portosystemic shunting occurs and cytochrome P450 activity is reduced. Impaired oxygen uptake caused by changes in the liver's sinusoids, as proposed by the oxygen limitation theory, may also explain the alteration of drug metabolism seen in cirrhosis. With congestive heart failure, sinusoidal congestion and hypoperfusion of the liver are seen. Similar to cirrhosis, the common pathway for hepatic damage in congestive heart failure seems to be liver hypoxia, which may explain the disease's effect on drug metabolism. Since routine hepatic function tests do not always relate to the liver's ability to eliminate drugs, existing guidelines for dosing cardiovascular drugs in patients with hepatic impairment are limited. This article provides guidance for dosing cardiovascular drugs in cirrhotic and heart failure patients based on available research data. Altered drug metabolism, especially in congestive heart failure, tends to be overlooked or not realized in clinical practice. Therefore, further research is needed in congestive heart failure to better elucidate safe prescribing patterns.     

Oxmetidine (SK&F 92994): pharmacokinetic study in patients with in patients with liver cirrhosis

The pharmacokinetics of oxmetidine (SK&F 92994) were investigated in nine cirrhotic patients and compared with ten control subjects with gastroduodenal ulcers, but without any symptoms of hepatic pathology. On two separate occasions each patient received 200 mg oxmetidine as a single oral dose and 100 mg as a single intravenous dose. In the cirrhotics, the bioavailability of the oral dose and the plasma elimination half-life after both oral and intravenous administration were significantly higher than in the controls. Moreover, a positive correlation was found between the plasma elimination half-lives and the biochemical parameters of cholestasis. Such findings indicate that in severe liver disease and in cholestasis the accumulation of oxmetidine in the circulation may limit the use of this drug.     

慢性乙肝及肝硬化患者血清自身抗体结果分析

目的 探讨慢性乙肝及肝硬化患者血清中自身抗体的变化情况。方法 收集了慢性乙肝患者120例、肝硬化43例，血清标本测定抗核抗体（AVA）和可提取性核抗原（ENA）抗体。结果 慢性乙肝和肝硬化ANA的检出率分剐为9．1％和18．6％，均明显高于正常对照组的1．1％（P〈0．05）。两组病例间也有显著差异（P〈0．05）。抗ENA抗体阳性率分别为4．1％和7．0％，阳性主要有SS-A、Sm、Scl-70、Go-1、dsDNA等多种类型。结论 慢性乙肝及肝硬化患者血清自身抗体显著高于正常人。     

糖尿病相关皮肤病变

由于血糖长期慢性升高而导致的各种急慢性并发症是糖尿病患者寿命缩短、生活质量下降的重要原因。糖尿病引起的皮肤病变虽不像心、脑、肾、眼病那样直接危害生命，但也给患者带来很多痛苦，如处理不好也会导致严重后果。     

甲状腺功能亢进患者的心电图改变分析

目的 分析甲状腺功能亢进(甲亢)患者心电图改变.方法 选取155例甲亢患者为甲亢组,对该组患者进行通常规心电图、24 h动态心电图检查,结果与155名健康体检者(对照组)同样项目检查进行比较分析.结果 甲亢患者心电图改变呈多样性形式,心律失常多见,占67.7%(105/155),以房性早搏、心房颤动、窦性心动过速、ST-T改变为主,与对照组比较差异有统计学意义(21.3%比2.5%;16.8%比1.3%;21.3%比5.2%;20.0%比3.2%;P<0.05).结论 甲亢患者心电图改变以心律失常、ST-T改变为主.

Abstract：

Objective To investigate the electrocardiogram changes in patients with hyperthyroidism.Methods Recordings of routine electrocardiogram and 24-hour Holter ECG were obtained from 155 patients with hyperthyroidism and 155 healthy volunteers,and analyzed.Results Patients with hyperthyroidism had various changes noted in their ECGs,and 105 patients(67.7%)had arhythmia,most were atrial premature beats,atrial fibrillation,sinus tachyeardia and ST-T deviation.The changes were significantly difierent from that of healthy controls(21.3%vs 2.5%;16.8%vs 1.3%;21.3%vs 5.2%;20.0%vs 3.2%;P<0.05).Conclusion The most common ECG changes noted in patients with hyperthyroidism are arhythmia and ST-T alteration.     

Suanzaorentang in cardiac patients with anxiety

Summary In 60 patients with cardiac symptoms and anxiety, the anxiolytic effect of the ancient Chinese remedy Suanzaorentang has been studied. It was a promising anxiolytic remedy, without apparent adverse effects on the cardiovascular system, and appearing not to interact with other drugs.     

Antiphospholipid antibodies in patients with cancer

Antiphospholipid antibodies are generally associated with Antiphospholipid Syndrome, which can occur as a primary disorder or may be secondary to connective tissue disease or tumour. The presence of antiphospholipid antibodies in patients with tumour disease is responsible for thrombotic complications. In a population of 53 tumor patients with positive carcinoembryonic antigen CEA, carbohydrate antigen CA19.9, CA125 and CA15.3 markers, IgM and IgG anticardiolipin and antiphosphatidylinositol were detected by solid-phase immunoassays. Our results show that moderate or high levels of antiphospholipid antibodies are present in a great number of patients with CEA and CA19.9 markers, suggesting a specific association with gastroenteric tumors. By testing for antiphosphatidylinositol antibodies, many patients not evidenced by the standard anticardiolipin assay were found to be antiphospholipid-positive. The analysis of antiphosphatidylinositol antibodies as a diagnostic tool in gastroenteric cancer to highlight patients with the risk of thromboembolic complications is discussed.