硝苯地平控释片联合厄贝沙坦片治疗原发性高血压疗效观察

目的探讨在原发性高血压治疗中应用硝苯地平控释片联合厄贝沙坦片的效果。方法选取原发性高血压患者120例,采用随机数字表法分为对照组和观察组,各60例。对照组给予常规治疗(卡托普利片联合硝苯地平控释片),观察组给予硝苯地平控释片联合厄贝沙坦片治疗,记录治疗前后两组患者的收缩压和舒张压,比较两组患者的治疗效果。结果治疗后,观察组患者血压改善情况显著高于对照组,差异具有统计学意义(P0.05);观察组治疗效果显著高于对照组,差异有统计学意义(P0.05)。结论在原发性高血压治疗中应用硝苯地平控释片联合厄贝沙坦片有效控制患者血压状况,提高疗效,值得临床推广应用。     

硝苯地平联合厄贝沙坦片治疗原发性高血压的临床观察

目的对硝苯地平联合厄贝沙坦片治疗原发性高血压的疗效进行观察研究。方法选取我院原发性高血压患者80例作为本次研究对象,随机分为对照组与观察组,各40例。对照组患者接受硝苯地平联合卡托普利片进行治疗,给予观察组硝苯地平联合厄贝沙坦片进行治疗,观察分析两组的疗效与不良反应。结果观察组的总有效率95.00%高于对照组77.50%,差异有统计学意义(P0.05)。结论硝苯地平联合厄贝沙坦片治疗原发性高血压的疗效显著,具有在临床推广与应用的价值。     

厄贝沙坦联合阿托伐他汀对原发性高血压患者左室肥厚的疗效观察

目的对厄贝沙坦联合阿托伐他汀对原发性高血压患者左心室肥厚的临床疗效进行研究探讨。方法随机抽取本院2012年3月~2013年6月接诊的98例原发性高血压患者左心室肥厚患者作为研究对象,将其随机分为观察组和对照组,每组各49例,对照组患者采用厄贝沙坦进行治疗,观察组患者在厄贝沙坦的基础上加用阿托伐他汀,观察两组患者治疗前后平均舒张压、收缩压、左心室质量指数(LVMI)、室间隔厚度(IVST)、左室舒张内径(LVWD)以及左室后壁厚度(LVPW)变化的情况。结果治疗后,两组患者平均收缩压、舒张压均明显下降,与治疗前比较差异显著(P0.05),具有统计学意义;治疗后两组比较无显著性差异(P0.05);两组患者LVMI、IVST、Lewd、LVPW的指标均与治疗前比较差异显著(P0.05),具有统计学意义;观察组患者LVMI低于对照组,二者比较差异显著(P0.05)。结论厄贝沙坦联合阿托伐他汀治疗原发性高血压患者左心室肥厚疗效显著,值得应用。     

厄贝沙坦对老年原发性高血压患者降压和逆转左心室肥厚的作用

目的观察厄贝沙坦对老年原发性高血压患者降压和逆转左心室肥厚（LVH）的作用。方法对85例老年原发性高血压合并LVH患者采用厄贝沙坦治疗,观察治疗前后血压、心率及超声心动图的变化情况。结果与治疗前比较,治疗后收缩压、舒张压下降（P均〈0．05）;室间隔厚度、左心室后壁厚度、左心室舒张末期内径、左心室质量指数降低（P均〈0．05）,心率无明显变化（P〉0．05）。结论厄贝沙坦能逆转原发性高血压引起的LVH并改善左心室舒张功能,明显改善老年原发性高血压患者预后。     

厄贝沙坦联合阿托伐他汀治疗原发性高血压伴左心室肥厚的疗效观察

目的分析厄贝沙坦联合阿托伐他汀治疗原发性高血压伴左心室肥厚的效果。方法将2011年5月—2012年12月我院收治的42例原发性高血压伴左心室肥厚患者按照治疗方法分为两组,对照组采用厄贝沙坦治疗,观察组采用厄贝沙坦联合阿托伐他汀治疗。比较两组患者治疗前后血压和左心室质量指数变化。结果治疗后观察组患者收缩压和舒张压低于对照组,左心室质量指数优于对照组,差异有统计学意义(P<0.05)。结论厄贝沙坦联合阿托伐他汀治疗原发性高血压伴左心室肥厚降压效果明显,能显著改善患者的左心室功能,值得临床推广。     

硝苯地平联合厄贝沙坦治疗糖尿病合并高血压的疗效分析

目的探讨硝苯地平联合厄贝沙坦治疗糖尿病合并高血压患者的治疗效果。方法该院将收治的60例糖尿病合并高血压患者单双号编号分为对照组与观察组,对照组糖尿病合并高血压患者采用厄贝沙坦作为常规治疗方案,观察组糖尿病合并高血压患者在对照组基础上,采用硝苯地平作为治疗方案,观察两组患者的治疗效果。结果观察组患者总有效率、舒张压以及收缩压与对照组患者相比具有明显优势(P0.05)。结论采用硝苯地平联合厄贝沙坦治疗糖尿病合并高血压的效果显著,安全性高,值得在以后的临床治疗中运用推广。     

厄贝沙坦联合阿托伐他汀治疗原发性高血压左心室肥厚的疗效观察

目的 观察厄贝沙坦联合阿托伐他汀治疗原发性高血压左心室肥厚患者的临床效果.方法 选择我院2011-08-01-2013-03-01收治的原发性高血压左心室肥厚患者90例,按患者入院就诊顺序编号,将其随机分为对照组和观察组,对照组患者运用厄贝沙坦进行治疗,观察组患者运用厄贝沙坦联合阿托伐他汀进行治疗,对比两组患者的临床疗效、心脏功能及不良反应发生情况.结果 观察组患者的临床治疗总有效率为95.6%,高于对照组的84.4%,差异有统计学意义（P＜0.05）;治疗后观察组患者左室舒张末期内径（LVWd）及左心室质量指数（LVMI）低于对照组,差异有统计学意义（P＜0.05）;观察组患者不良反应发生率为2.2%,低于对照组的13.3%,差异有统计学意义（P＜0.05）.结论 厄贝沙坦联合阿托伐他汀治疗原发性高血压左心室肥厚疗效确切,且十分安全,值得推广.     

硝苯地平联合厄贝沙坦治疗糖尿病合并高血压的疗效

目的探讨硝苯地平联合厄贝沙坦治疗糖尿病合并高血压疗效。方法选取我院收治糖尿病合并高血压患者120例,随机分为观察组和对照组,每组60例。对照组口服硝苯地平治疗,观察组在其基础上给予厄贝沙坦联合治疗,比较两组患者的临床疗效治疗后血压、血糖水平。结果经治疗后观察组治疗总有效率高于对照组(P0.05),血压较对照组明显改善(P0.05)。两组患者治疗后空腹血糖和餐后2 h血糖水平比较,差异无统计学意义(P0.05)。治疗期间两组均未见明显不良反应。结论硝苯地平联合厄贝沙坦治疗糖尿病合并高血压临床疗效显著,安全性高。     

硝苯地平联合厄贝沙坦治疗糖尿病合并高血压的疗效

目的探讨硝苯地平联合厄贝沙坦治疗糖尿病合并高血压的疗效。方法 2013年3月--2013年3月选该院治疗糖尿病高血压患者144例为临床研究对象,患者随机分为观察组、对照组,每组72例。对照组患者采用硝苯地平治疗,观察组患者使用硝苯地平、厄贝沙坦治疗相结合。比较两组患者的治疗效果。结果患者有效率治疗观察组明显高于对照组,比较结果,差异有统计学意义(P0.05)。治疗前两组患者血压,差异无统计学意义(P0.05),治疗患者的血压观察组比对照组明显降低,差异有统计学意义(P0.05)。两组患者的血糖水平在治疗后均明显下降(P0.05),但组间比较差异无统计学意义(P0.05)。结论硝苯地平联合厄贝沙坦治疗糖尿病高血压的临床疗效好,值得推广。     

厄贝沙坦联合加味生脉散治疗慢性充血性心力衰竭的临床研究

目的探讨厄贝沙坦联合加味生脉散治疗慢性充血性心力衰竭（CHF）的疗效。方法将90例CHF病人随机分为两组，治疗组口服厄贝沙坦与加味生脉散，对照组口服厄贝沙坦。结果治疗10周后，两组心功能均明显改善，但治疗组心功能改善显效率为41．3％，优于对照组的22．7％（P〈0．05）。两组治疗后左房内径（IA）、左室舒张末期容积（LVEDV）、左室收缩末期容积（LⅦSV）均较治疗治疗前明显缩小（P〈0．05或P〈0．01），但治疗组明显优于对照组（P〈0．05）。结论厄贝沙坦联合加味生脉散治疗CHF优于单用厄贝沙坦治疗。     

Satisfaction with ambulatory care of persons with AIDS

OBJECTIVE: To examine the relation of patient characteristics and site of care to the perception of ambulatory care quality by persons with AIDS (PWAs). DESIGN: Patient surveys and medical record review were used to determine PWAs’ perceptions of their ambulatory care, self-perceived health status, primary care relationships, sociodemographic characteristics, and severity of illness. SETTING: A public-hospital HIV clinic, an academic group practice, and a staff-model health maintenance organization (HMO) that together care for 20% of all Massachusetts PWAs. PATIENTS: All active patients as of February 12, 1990, and all new AIDS patients at each of the three sites during the subsequent 13 months. MEASUREMENTS AND MAIN BESULTS: The primary outcome measure was a six-item scale of patient-rated quality of care (PRQC), a newly developed measure that combined patients’ ratings of their physician care, nursing care, involvement in medical decisions, and overall quality of care. Multiple logistic regression was carried out with low PRQC (lowest quart He) as the dependent variable, to identify correlates of patient perceptions of poor quality. Patients who had a primary nurse were significantly less likely to have low PRQC scores (OR=0.50, 95% CI=0.26 to 0.97). Black patients and patients who used injection drugs were significantly more likely to rate their care in the lowest quartile (OR=2.22, 95% CI=1.04 to 4.78; and OR=2.43, 95% CI=1.13 to 5.23, respectively), as were those who had lower self-perceived health status, after controlling for confounders; no association was found by site or severity. CONCLUSIONS: These results show that primary nursing may be an important determinant of how PWAs rate the quality of their ambulatory care. Furthermore, PWAs who are black or who are injection drug users are less satisfied than are others with the quality of their ambulatory AIDS care. Presented in part at the annual meeting of the Society of General Internal Medicine, April 30, 1993, Arlington, Virginia. Supported by the Agency for Health Care Policy and Research, grant number HS06239.     

Treatment of patients with Eisenmenger's syndrome with Bosentan

We treated prospectively 14 patients with Eisenmenger's syndrome, with a mean age of 10 years, ranging from 3 to 18 years. Treatment continued for 12 months, and demonstrated a lasting symptomatic improvement, but no improvement in terms of mean saturation of oxygen over 24 hours. Exercise capacity, as judged by peak uptake of oxygen, worsened in the six patients able to perform a treadmill test. The symptomatic benefit from dual blockage of endothelin receptors in these patients may be due to mechanisms other than selective pulmonary vasodilatation alone.     

Experience with the treatment of patients with hypertrophic cardiomyopathy with obsidan and isoptin

Forty-five patients with hypertrophic cardiomyopathy were examined clinically and echocardiographically. The results of their treatment with obsidan and isoptin in relation to various types of central hemodynamic disorders are presented. The data have been obtained making it possible to treat patients differentially with regard to the form of the disease. The treatment of this category of patients requires the echocardiographic monitoring of the parameters of the central hemodynamics and myocardial contractility.     

分析老年糖尿病患者应用甘精胰岛素联合阿卡波糖治疗的效果

目的探讨甘精胰岛素联合阿卡波糖在老年糖尿病患者中的临床疗效。方法选取该院2018年7月—2019年7月收治的113例老年糖尿病患者作为研究对象,经随机数字表法,划分A组(n=56,阿卡波糖)和B组(n=57,甘精胰岛素+阿卡波糖),比较两组临床疗效、血糖指标。结果B组患者临床治疗总有效率显著高于A组;经治疗,B组患者空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)水平明显低于A组。两组之间比较差异有统计学意义(P<0.05)。结论在老年糖尿病患者中应用甘精胰岛素+阿卡波糖,临床疗效显著,使患者的空腹血糖、餐后2 h血糖、糖化血红蛋白等指标得到了明显改善,安全性强。     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

以肥厚性硬脑膜炎为主要表现的肉芽肿性多血管炎临床病例分析

目的探讨肉芽肿性多血管炎(GPA)继发肥厚性硬脑膜炎(HCP)的临床特点。方法回顾性分析北京协和医院2004—2018年收治的GPA继发HCP病例资料的特点。结果①GPA患者315例,19例继发HCP,占6.0%;②男性12例,女性7例;年龄19~64岁,中位年龄57岁。③神经系统表现:19例均有头痛,16例颅神经受累。受累部位:额部8例,颞部8例,颅底8例(鞍旁4例,其中海绵窦3例,眶尖2例),小脑幕6例,大脑镰2例,顶部1例,枕部1例,1例合并硬脊膜炎。④系统表现:发热10例,体质量下降8例,肺部受累4例,肾脏受累3例,16例鼻窦炎,10例中耳炎,16例局限型GPA。⑤15例ANCA抗体阳性,8例蛋白酶3(PR3)-ANCA阳性,6例髓过氧化物酶(MPO)-ANCA阳性。⑥16例行腰椎穿刺检查:脑脊液压力9例升高、5例正常、2例降低;脑脊液蛋白升高10例。⑦15例(78.9%)伯明翰系统性血管炎评分(BVAS)>15分。⑧19例均使用糖皮质激素、免疫抑制剂治疗,其中12例行甲泼尼龙冲击治疗,12例鞘内注射地塞米松(或+甲氨蝶呤),19例病情均缓解。结论HCP是GPA少见且严重的表现,主要表现为颅高压和颅神经受累,多见于局限型GPA患者,常伴有全身疾病的活动,需积极治疗。