氨氯地平与硝苯地平治疗原发性高血压的疗效比较

将 44例Ⅰ、Ⅱ期高血压病人随机进行研究 ,40例完成研究。氨氯地平组服用氨氯地平 5mg,每日 1次 ,硝地平组服用硝苯地平 10mg,每日 3次 ,治疗 2周。根据血压情况 ,若血压≤ 140 / 90mmHg ,给予维持剂量 ,再服用 4周。若血压≥ 140 / 90mmHg ,剂量加倍 ,即氨氯地平 10mg每日 1次 ,硝苯地平 2 0mg ,每日 3次 ,治疗 2周若血压降到正常给予维持量再治疗 2周。结果 ,氨氯地平组血压从 175± 9/ 10 2± 6mmHg降到 130± 12 / 87±7mmHg ,前后降压有极显著性差异 (P <0 .0 0 1)。硝苯地平组血压从 173± 8/ 10 2± 7mmHg降至 144± 18/ 92±7mmHg(P <0 .0 1)。两组降压疗效有极显著性差异 (P <0 .0 1)。氨氯地平组 ,总有效率 95 % ,硝苯地平组总有效率 70 % ,两组间有显著性差异 (P <0 .0 )。提示 ,氨氯地平降压疗效明显优于硝苯地平 ,氨氯地平能维持 2 4小时血压稳定 ,病人对药物有良好的耐受性。     

高血压病人24小时血压变异性及依那普利的干预影响

目的 :研究高血压患者 2 4小时血压变异性和依那普利的干预影响。方法 :4组对象中EHⅠ -Ⅱ期 90例 ,EHⅢ期4 2例 ,健康对照 6 0例 ,治疗组EHⅠ -Ⅱ期者 4 5例均进行 2 4小时动态血压监测并分析血压变异性 (BPV)。结果 :两组高血压各时段SBPV及MAPV ,EHⅢ期组的DBPV均大于对照组 (P <0 .0 1或 0 .0 5 ) ;EHⅢ期组比EHⅠ -Ⅱ期者各时段SBPV、DBPV、MAPV均明显增大 (P <0 .0 1或 0 .0 5 ) ;治疗组治疗前后各时段BPV无差异 (P >0 .0 5 )。结论 :高血压病人在血压平均值升高的同时 ,血压变异性 (尤其是SBPV)也明显高于正常人 ,Ⅲ期高血压病人尤其显著 ;依那普利治疗 4周降压有效以后对血压变异性无显著性影响。     

24小时动态血压监测评价非洛地平缓释片治疗原发性高血压病临床疗效(附38例报告)

目的:评价非洛地平缓释片(波依定)对原发性高血压病的疗效。方法:对38例原发性高血压病患者(Ⅰ期15例,Ⅱ期23例)给予波依定口服5~10 mg／d,治疗4周后观察病人动态血压的变化。结果:显效20例,有效15例,总有效率为92.1％。治疗后昼夜血压均有明显下降,降压幅度一致,治疗前后的收缩压与舒张压谷峰比率平均>50％。结论:波依定是长效钙拮抗剂,降压作用平衡持久,有利于保护靶器官的功能,副作用少,耐受性好,是理想的降压药物。     

非洛地平缓释片每日一次治疗高血压病疗效观察

目的：观察非洛地平缓释片的降压效果和副反应。方法：对65例高血压病人随机配对分为非洛地平缓释片5－10mg组（A组，32人）和硝苯地平控释片30－60mg组（B组，33人），每日一次，4周后观察降压纪录。结果：非洛地平缓释片最大降压辐度为3．01／2．27kPa；有效降压32人，总有效率93．8％；T／P比率65．3／69．2。硝苯地平控释片依次为2．68／2．24kPa，90．9％，30人，66．5／67．2。两组无显差异（P＞0．05）。副反应A、B组分别为21．4％，32．1％。无显性差异（P＞0．05）。结论：非洛地平缓释片5－10mg每日一次口服24h降压作用可靠、平稳、病人耐受性，与硝苯地平30－60mg每日口服一次降压作用相似，具有临床推广使用价值。     

非洛地平联合厄贝沙坦治疗老年性高血压病56例临床分析

目的观察非洛地平联合厄贝沙坦治疗老年性高血压的临床疗效。方法笔者所在医院2009年5月～2011年5月收治老年性原发性高血压56例,口服非洛地平缓释片5mg/d,联合厄贝沙坦150mg/d,晨起一次顿服治疗,疗程为8周。观察用药期间血压、心率及不良反应情况。结果经过治疗,患者第4周收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)均显著降低,较治疗前差异有统计学意义(P0.05)。此后随着疗程延长,收缩压、舒张压、平均动脉压则进一步下降,于第8周收缩压和舒张压均降至正常,与治疗前比较差异有统计学意义(P0.01)。结论非洛地平联合厄贝沙坦治疗老年性高血压病,降压平稳,不良反应小,疗效明显。     

氨氯地平治疗老年高血压病72例的疗效观察

目的 观察氨氯地平对老年高血压病的降压效果. 方法选择72例门诊老年高血压病患者,每日早晨顿服氨氯地平 2.5mg,2周后根据血压情况调整为5mg～10mg1次早晨顿服,疗程4周.每周测量患者血压情况及观察不良反应发生情况. 结果服药4周后,血压明显下降,与治疗前相比,差异有显著性( P<0.01).72例患者中显效35例,有效30例,总有效率达90.28 % (65例).不良反应2例,且轻微而短暂.结论 氨氯地平能有效降低老年高血压病患者的血压,且副作用小,是理想的降血压药物.     

硝苯地平控释片与非洛地平降压疗效及其对心率影响的比较

目的 比较硝苯地平控释片(拜新同)与非洛地平(Felodipine,波依定)对高血压患者的降压疗效及对心率的影响.方法 对治疗的轻、中度原发性高血压患者,随机分为硝苯地平控释片组(N=44,硝苯地平控释片30 mg,每日1次),非洛地平组(N=46,非洛地平5 mg,每日一次),治疗2个月后比较两组治疗前后血压与心率的改变.结果 硝苯地平控释片组比非洛地平组有更好的降压疗效,对心率影响不大(P＞0.05).而非洛地平白天与夜晚平均心率较治疗前均有增加(P＜0.05).结论 硝苯地平控释片治疗高血压与非洛地平相比有更好的疗效,且不增加心率,有利于防止交感神经激活的作用.     

阿托伐他汀钙对高血压患者的治疗作用及血清中细胞因子TNF-a、CRP、IL-4和IL-10的影响

目的 观察阿托伐他汀钙对高血压患者治疗前后血清中细胞因子的影响及其降压效果.方法 82例高血压病(EH)患者,随机分为2组:治疗组41例,每日晨服硝苯地平控释片30mg,晚睡前服阿托伐他汀钙20mg;对照组41例,服用硝苯地平控释片30mg,疗程均12周.于治疗前后采用酶联免疫法测定细胞因子TNF-a、IL-4和IL-...     

苯那普利、非洛地平和硝苯地平对高血压病患者血压和肾功能的影响

目的:比较苯那普利、非洛地平与硝苯地平对高血压病患者血压和肾功能的影响。方法:90例高血压病患者随机分成3组:苯那普利组(30例,10mg,1次/d),非洛地平组(30例,5mg,1次/d),硝苯地平组(30例,10mg,3次/d),疗程24周,治疗前、后观察偶测血压和动态血压(24h平均血压,白天平均血压,夜间平均血压)及肾功能变化。结果:苯那普利组和非洛地平组治疗后,偶测血压和动态血压及血、尿β_2微球蛋白,24h尿微量白蛋白均显著降低(P<0.01),硝苯地平组治疗后偶测血压和白天平均血压明显下降(P<0.01),夜间平均血压及24h平均血压下降幅度小,与苯那普利组和非洛地平组比较差异显著(P<0.01)。硝苯地平组治疗后肾功能各项指标无明显变化(P>0.05)。结论:苯那普利和非洛地平能有效降低高血压病患者血压和改善肾功能,而硝苯地平不能平稳降压,无肾脏保护作用。     

非洛地平联合厄贝沙坦对青年男性原发性高血压患者血尿酸、血清脂联素及肾功能的影响

目的:探讨非洛地平联合厄贝沙坦对青年男性原发性高血压(EH)患者血尿酸(UA)、血清脂联素(APN)及肾功能的影响。方法:选取青年男性EH患者134例为研究对象,随机分为观察组和对照组,对照组患者口服非洛地平缓释片5 mg/次,1次/d,观察组在对照组基础上口服厄贝沙坦150 mg/次,1次/d,两组患者4周后血压未降至140/90mmHg以下,非洛地平缓释片增加至10mg/d,达理想降压效果后,依个体情况改为维持量。两组于治疗前和治疗4、12周后,采集清晨空腹静脉血,采用ELISA法测定APN水平,尿酸酶-过氧化物酶法测定UA水平,采用全自动生化分析仪测定血尿素氮(BUN)、血清肌酐(Scr),计算内生肌酐清除率(Ccr);留取尿液,放射免疫法测定24h尿蛋白定量(24h Upro)。采集治疗前和治疗24、48周后清晨空腹静脉血,采用放射性免疫法测定血清睾酮(T)、性激素结合球蛋白(SHBG)水平。结果:两组治疗4、12周后Scr、24hUpro逐渐降低,Ccr逐渐升高,观察组治疗12周后BUN降低(P<0.05),而观察组治疗4、12周后Scr、24hUpro低于同期对照组,Ccr高于同期对照组,观察组治疗12周后BUN低于同期对照组(P<0.05);两组治疗24、48周后T水平逐渐升高(P<0.05),治疗后SHBG无明显变化,而观察组治疗24、48周后T水平高于同期对照组(P<0.05);两组治疗4、12周后APN逐渐升高,UA逐渐降低(P<0.05),且观察组治疗4、12周后APN高于同期对照组,UA低于同期对照组(P<0.05)。结论:非洛地平联合厄贝沙坦治疗青年男性EH可有效调节APN、UA水平,保护肾功能,提高性激素水平,在降低靶器官损伤和改善预后方面具有重要意义。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.