原发性高血压患者心理状况及个性特征分析

目的 了解原发性高血压患者心理状况及个性特征。方法 采用症状自评量表（SCL-90）及艾森克个性问卷（EPQ）对40例原发性高血压患者进行调查,并与40名健康者进行配对比较分析。结果 ①原发性高血压组患者在SCL-90总分、总均分、阳性项目分、阳性均分及各因子分均明显高于健康对照组（P〈0．05或0．01）,主要表现在躯体化、抑郁、焦虑等几个方面。②原发性高血压组患者的Ⅳ维度t分明显高于对照组（P〈0．01）。结论 原发性高血压患者存在明显的心理问题,心理状况较差,且病前个性以情绪不稳多见,提示我们在治疗原发性高血压的同时有必要进行针对性心理干预。     

老年高血压患者心理状况分析及护理干预策略

目的：探讨老年高血压患者心理状况分析及护理干预策略。方法选择我院老年原发性高血压患者50例，随机分为治疗组与对照组各25例，两组都给予常规降压药物治疗与常规心理干预，在此基础上治疗组给予积极地特殊心理干预措施，干预周期为3个月。结果干预后治疗组与对照组的总有效率分别为96.0%和84.0%，治疗组的总有效率明显优于对照组，对比差异有统计学意义(<0.05)。干预后经过调查，治疗组的生理功能、生理职能、躯体疼痛评分都明显高于对照组，对比差异有统计学意义(<0.05)。结论老年高血压患者心理状况多不佳，积极地心理护理干预能有效降低血压，提高患者的健康水平，值得推广应用。     

心身放松疗法治疗原发性高血压的临床疗效观察

紧张焦虑情绪和Ａ型行为均与原发性高血压的发病密切相关[1]。单纯药物治疗因不能完全缓解患者心理应激和纠正其心理行为障碍而影响临床疗效。据世界高血压同盟报告,目前的抗高血压的药物,仅能预防6%的脑卒中和4%的缺血性心脏病的发生[2]。然而已经证实,综合性的非药物治疗方法可产生显著的降压效果,可单独用于临界高血压和轻型高血压患者,对于中重度高血压也有补充治疗作用[1-4]。本研究运用自编的心身放松疗法治疗原发性高血压40例,现将其降压疗效及其对患者心理行为的影响报告如下。1　对象与方法1.1　观察对象根据1978年ＷＨＯ制定的高…     

116例高血压病患者血浆肾素、血管紧张素Ⅱ、醛固酮的RIA

了解患者的血浆肾素、血管紧张素以及醛固酮的状况对可治疗性高血压的诊断，治疗以及与原发性高血压的鉴别诊断十分重要。本文就116例高血压病人的PRA、AT-Ⅱ、Aldo的RIA结果分析，现报告如下。     

原发性高血压患者常见心理问题及护理

原发性高血压又称高血压病，是引起脑卒中、冠心病和肾功能衰竭的重要因素，首诊时有的病情已较严重，患者思想情绪波动大，如不及时进行心理干预，会严重影响血压控制。现就我科2004年6月至12月对96例首诊原发性高血压病人常见心理问题及护理干预报告如下。     

动态血压监测技术的临床应用价值

分析了58例原发性高血压患者治疗前后的动态血压监测,结果显示动态血压监测可真实、全面反映患者24小时血压状况,昼夜节律,治疗后降压疗效。因此,动态血压监测对高血压治疗、估计预后等方面,具有重要的临床价值。     

时间护理对原发性高血压患者疗效的影响

原发性高血压是老年人群中最为常见的疾病之一,是影响心脑血管疾病治疗效果和预后的重要因素之一。该病病程较长,在长期的高血压应激状态下,各种靶器官严重受损,不仅给患者身体带来极大的痛苦,同时也给患者心理造成巨大的伤害。为了提高高血压患者的生活质量,降低心脑血管疾病的发病率和致死率,控制血压是最有效的方法。本文针对高血压患者采用时间护理措施,根据患者昼夜血压变化情况,适时调整服药时间和心理护理方法,可以很好地提高患者的依从性、生活质量和降压效果,现报告如下。     

社区原发性高血压患者生活质量调查

目的 :探讨社区高血压患者的生活质量及其影响因素。方法 :对 1992年参加社区原发性高血压综合干预跟踪研究的 177名患者进行随访及生活质量调查 ,被试者年龄范围 5 1～ 77岁。采用自编调查表和生活质量综合评定问卷 -74(GQOLI-74) ,完成各种测查者共 15 2人。结果 :79 6%的患者除服药外采用了调整生活方式、行为方式等非药物治疗的方法 ;生活质量问卷测查结果显示 ,被试者对健康状况和生活质量的总体评价及主观满意度在中等水平 (X±SD :12 89± 2 19) ;比较不同治疗模式下 (分为三组 :药物治疗 ,综合治疗 ,药物 运动治疗 )患者的生活质量 ,综合治疗组的物质生活维度、经济状况因子得分略高于其它两组 (P <0 0 5 ) ,药物 运动组的心理功能维度、正性情感因子及精神紧张度因子得分略高于其它两组(P <0 0 1)。结论 :综合干预措施对提高原发性高血压患者的生活质量、改善整体健康状况可起到积极的促进作用     

原发性高血压患者血浆脑钠肽水平变化及意义

目的:观察原发性高血压伴左室肥厚和舒张功能不全患者血浆B型脑钠肽(BNP)水平变化以及BNP浓度与高血压分级的相关性。方法:使用微粒子酶免疫分析方法检测94例不同级别原发性高血压患者血浆BNP浓度,分析有无左室肥厚及左室舒张功能不全各组之间的差异及其关系。结果:原发性高血压患者BNP浓度显著高于正常对照组(P<0.01);高血压伴左室肥厚、舒张功能不全患者的BNP浓度也显著高于单纯高血压患者(P<0.01);血浆BNP浓度与原发性高血压分级呈正相关。结论:原发性高血压,尤其是伴有左室肥厚和舒张功能不全患者BNP浓度升高。检测血浆BNP水平的变化及其与原发性高血压的相关性有重要临床意义。     

原发性高血压患者心血管危险分层与血浆B型脑钠肽的关系

目的:探讨血浆B型脑钠肽(BNP)与原发性高血压患者心血管危险分层的关系及临床意义。方法:根据2005年中国高血压指南将131例原发性高血压患者分为低危、中危、高危和极高危四组,另选38名健康人组成对照组,采用微粒子酶免疫自动检测仪测定各组血浆BNP水平。结果:原发性高血压患者组BNP水平明显高于正常对照组(P0.01);低危至极高危组原发性高血压患者血浆BNP逐渐升高,各组间有显著性差异(P0.01);血浆BNP浓度水平与原发性高血压心血管危险分层呈显著正相关性(r=0.69,P0.01)。结论:BNP对原发性高血压患者的病情及预后评估具有重要临床意义。     

Psychological variables in hypertension: relationship to casual or ambulatory blood pressure in men

OBJECTIVE: The evidence linking hypertension with personality or psychological characteristics, such as anger, anxiety, or depression, remains equivocal. This may be due in part to limitations of personality theory, confounding by awareness of hypertension, and/or inherent difficulties in measuring blood pressure. This study was designed to investigate the association between mild hypertension as defined by both ambulatory and casual (clinic) blood pressure measurements and various measures of personality and psychological characteristics. METHODS: We examined this association in a population-based sample of 283 men between the ages of 30 and 60 years from eight work sites in New York City, using an ambulatory blood pressure monitor and controlling for age, race/ethnicity, and body mass index. RESULTS: We found no consistent difference between participants with mild hypertension and those with normal blood pressure on any of the psychological variables assessed, including Type A behavior pattern, state and trait anger, anger expression, anxiety, symptoms of psychological distress, locus of control, or attributional style. Results were not due to the use of antihypertensive medication by some of the participants with hypertension nor to the dichotomization of blood pressure into those with and without mild hypertension. This contrasts with previous findings from this study showing a sizable association of ambulatory blood pressure and hypertension with job strain (a situational measure), age, and body mass index. CONCLUSIONS: These null results suggest that situational, biological, and perhaps behavioral factors are the primary determinants of mild hypertension and that the predictive significance of psychological or dispositional factors is low or negligible in those without overt cardiovascular disease.     

两种心身疾病患者的述情障碍及相关因素研究

目的：探讨心身疾病患者的述情障碍及相关因素。方法：采用多伦多述情障碍量表（TAS）,艾森克成人个性问卷（EPQ）,SIMH精神卫生自评量表（SCL－90）测查了42例原发性高血压患者,40例2型糖尿病患者,并以45例正常人作对照。结果：两组患者均有述情障碍;原发性高血压患者描述情感的能力欠缺,不易认识和区别情绪和躯体感受,多属外向型思维;2型糖尿病组除以上三方面述情障碍外,还具有缺乏纪想和想象力的特点。多元相关分析发现,原发性高血压组,个性越内倾,描述情感能力越欠缺;2型糖尿病组,个性越内倾,越难以认识和区分情绪和躯体的感受;两组情绪越不稳定,对情感的描述能力以及认识,区别情绪和躯本的感受的能力越低下。多元逐步回归分析发现,心怀敌意及情绪不稳定的个性缺陷是原发性高血压患者述情障碍的重要因素。偏执和精神质个性缺陷是2型糖尿病患者述情障碍的重要因素。结论：原发性高血压和2型糖尿病患者普遍存在述情障碍,且与个性特征及心理卫生状况有密切关系。     

心理社会因素及干预在高血压发生和治疗中的作用

目的 探讨心理社会因素在高血压发生和治疗过程中的作用及综合心理干预的临床意义.方法 对40例高血压患者回顾性测评和社会再适应评定量表(SRRS),并随机分为综合心理干预组和对照组,评定、比较焦虑自评量表(SAS)、抑郁自评量袁(SDS)、ABP、住院时间及临床疗效.结果 ①高血压患者SRRS均大于150生活变化单位(L...     

Urinary excretion of kallikrein before and after operation for aldosterone-producing adenoma

Urinary kallikrein excretion (UKal), determined by the esterase method, was measured in 10 normotensive volunteers, 10 patients with essential hypertension and in 7 patients with primary aldosteronism before and after operative removal of the adenoma. UKal values were low in 5 of the patients with essential hypertension. Preoperative UKal values in the patients with aldosteronism did not differ significantly from those of the normal subjects, but decreased in all after operation in parallel with changes in urinary excretion of tetrahydroaldosterone and plasma aldosterone concentration. The study supports the assumption of an association between the renal kallikrein-kinin system and the mineralocorticoid state in man.     

Anxiety and hope during the course of three different medical illnesses: a longitudinal study

BACKGROUND: Somatic illness and its consequences evoke strong emotions of various kinds. They may affect the course of illness and the treatment results through their physiological components. The purpose of the study was to explore emotional reactions to different kinds of illnesses and changes of these emotions over time. METHODS: Subjects were 259 medical patients suffering from: primary hypertension, myocardial infarction and cancer of the lungs or pharynx. The study was longitudinal and consisted of three phases. The first was performed immediately after the patient was diagnosed, the second was done 5 weeks later and the third about half a year after the onset of illness. The patients' emotional state was evaluated with the Gottschalk-Gleser Content Analysis Scales: the Anxiety and the Hope Scales. RESULTS: Significant effects of the kind of illness and of its interaction with the phase of the study were found. In the hypertension group, both anxiety and hope were slightly elevated immediately after diagnosis, then slightly lowered. The myocardial infarction group exhibited a low level of these emotions in the first phase, an increase in the second and then a little decrease. Cancer patients manifested high anxiety and relatively low hope in the initial phase, then a decrease in anxiety and an increase in hope. CONCLUSIONS: Both anxiety and hope accompany the illness in its consecutive phases, reflecting properties of illness as a source of psychological stress and the coping process.     

支扩大咯血病人的心理状况及对止血治疗的影响

目的 :了解支气管扩张大咯血病人的心理状况 ,探讨心理因素对止血治疗的影响。方法 :采用SCL -90调查大咯血病人的心理状况 ,并分组治疗 ,比较治疗组与对照组止血效果 ,分析心理因素对临床止血治疗的影响。结果 :在两组 6 2例大咯血病人中 ,83 87%有焦虑情绪 ,6 6 13%呈恐惧反应。心理因素引起血压升高者占 32 2 6 % ,影响垂体后叶素使用者占 2 0 97%。咯血持续时间 :治疗组平均 5天 ,对照组 7天。结论 :支扩大咯血病人多有短期性心理反应 ,主要表现为焦虑及恐怖性倾向。心理因素可使血压升高 ,在血管破裂的基础上加重咯血 ,并使垂体后叶素使用受限 ,多方面均影响止血效果。故对大咯血病人在止血治疗的同时 ,应加强心理治疗 ,不仅有益于心身健康 ,且可缩短咯血时间     

有氧运动对轻度原发性高血压患者血压和甲襞微循环的影响

目的研究有氧运动对轻度原发性高血压患者血压和甲襞微循环的影响。方法随机选取轻度原发性高血压患者21例为高血压组,同期健康体检者20例为正常对照组。高血压组进行规律的有氧运动训练,检测有氧运动前后血压、甲襞微循环的变化。结果高血压组甲襞微循环形态积分、流态积分、襻周状态积分和总积分值均高于正常对照组（P〈0．05）。有氧运动3个月后,高血压患者血压下降,甲襞微循环形态积分、流态积分、襻周状态积分和总积分值均降低（P〈0．05）。结论有氧运动能有效降低轻度原发性高血压患者的血压,改善其微循环状态。     

Mutation in the gene for bone morphogenetic protein receptor II as a cause of primary pulmonary hypertension in a large kindred

BACKGROUND: Most patients with primary pulmonary hypertension are thought to have sporadic, not inherited, disease. Because clinical disease develops in only 10 to 20 percent of persons carrying the gene for familial primary pulmonary hypertension, we hypothesized that many patients with apparently sporadic primary pulmonary hypertension may actually have familial primary pulmonary hypertension. METHODS: In a study conducted over 20 years, we developed a registry of 67 families affected by familial primary pulmonary hypertension. Through patient referrals, extensive family histories, and correlation of family pedigrees, we discovered shared ancestry among five subfamilies. We established the diagnosis of primary pulmonary hypertension by direct evaluation of patients and review of autopsy material and medical records. We assessed some family members for mutations in the gene encoding bone morphogenetic protein receptor II (BMPR2), which has recently been found to cause familial primary pulmonary hypertension. RESULTS: We linked five separately identified subfamilies that included 394 known members spanning seven generations, which were traced back to a founding couple in the mid-1800s. Familial primary pulmonary hypertension has been diagnosed in 18 family members, 12 of whom were first thought to have sporadic disease. The conditions of 7 of the 18 were initially misdiagnosed as other cardiopulmonary diseases. Six members affected with familial primary pulmonary hypertension and 6 of 10 at risk for carriage have been undergone genotype analysis, and they have the same mutation in BMPR2, a transversion of thymine to guanine at position 354 in exon 3. CONCLUSIONS: Many cases of apparently sporadic primary pulmonary hypertension may be familial. Failure to detect familial primary pulmonary hypertension results from incomplete expression within families, skipped generations, and incomplete family pedigrees. The recent discovery of mutations in BMPR2 should make it possible to identify those with susceptibility to disease.