中国人群血压分类与高血压患病率研究-1991年血压抽样调查资料的进一步分析

目的进一步分析我国人群血压水平分类、高血压患病率和正常高值的比例,为进一步调查提供可比性资料.方法使用1991年高血压抽样调查资料,依照1999年世界卫生组织/国际高血压联盟对血压水平的分类标准进行分类,资料中组间率的检验使用χ2检验.结果 1991年调查正常血压者(包括理想血压)在15岁及以上人群中占77.21%,其中理想血压在正常血压中占75.07%和在人群中占57.96%.血压在正常高值的人数占9.59%.1级(轻度)、2级(中度)和3级(重度)高血压总患病率是13.19%,其中1级是8.47%、2级和3级分别是3.1%和1.62%.1级高血压中亚组患病率是7.48%,其占1级高血压患者的88.32%.单纯性收缩期高血压(ISH)的患病率是5.17%,其中亚组占52.03%.1级高血压和2级高血压合计患病率是11.57%,占高血压总患病率的87.7%.女性正常血压所占百分率高于男性(P<0.01),而正常高值和1级高血压百分率则低于男性(P<0.01).人群中女性ISH的患病率也较男性偏高(P<0.01).结论在我国高血压患者中轻、中度高血压最常见,占高血压患者的87.7%.有效地预防和治疗轻、中度高血压是卫生健康事业所面临的重要任务之一 .     

中国人群血压分类与高血压患病率的研究——1991年血压抽样调查资料的进一步分析

目的：进一步分析我国人群血压水平分类、高血压患病率和正常高值的比例，为进一步调查提供可比性资料。方法：使用1991年高血压抽样调查资料。依照1999年世界卫生组织／国际高血压联盟对高血压水平的分类标准进行分类，资料中组间率的检验使用X^2检验。结果：1991年调查正常血压者（包括理想血压）在15岁及以上人群中占77．21％，其中理想血压在正常血压中占75．07％和在人群中占57．96％，血压在正常高值的人数占9．59％，1级（轻度）、2级（中度）和3级（重度）高血压部患病率是13．19％，其中1级是8．47％、2级3级分别是3．1％和1．62％，1级高血压中亚组患病率是7．48％，其占1级高血压患者的88．3％，单纯性收缩期高血压（ISH）的患病率是5．17％，其中亚组占52．03％，1级高血压和2级高血压合计患病率是11．57％，占高血压总患病率的87．7％，女性正常血压所占百分率高于男性（P＜0．01），而正常高值和1级高血压百分率则低于男性（P＜0．01），人群中女性ISH的患病率也较男性偏高（P＜0．01），而正常高值和1级高血压百分率则低于男性（P＜0．01），人群中女性ISH的患病率也较男性偏高（P＜0．01）。结论：在我国高血压患者中轻、中度高血压最常见，占高血压患者的87．7％，有效地预防和治疗轻，中度高血压是卫生健康事业所面临的重要任务之一。     

青岛市正常高值血压及高血压人群现况和全身血管损伤情况

目的探讨青岛地区正常高值血压及高血压人群患病情况及全身血管损伤情况。方法对青岛市30岁以上人群进行横断面调查,调查内容包括基本情况、血压、临床生化指标检测、尿白蛋白肌酐比值(UACR)、肱踝脉搏波传导速度(ba PWV)、网膜中央动脉直径(CRAE)及合并心血管危险因素情况。结果 4 346名调查者中,正常高值血压1 165人(26.8%),高血压1 739例(40.0%),男性高血压患病率44.8%,女性36.8%,30~39岁人群高血压患病率9.7%,40~49岁22.4%,50~59岁42.1%,60~69岁(63.2%),≥70岁74.6%。正常高值血压组与高血压组人群年龄、体重指数(BMI)、腰围、收缩压、舒张压、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、尿酸(UA)水平均高于正常血压组,高血压组均高于正常高值血压组(P<0.05)。高血压组合并3种及≥4种危险因素人数比例高于正常高值血压组及正常血压组(P<0.05)。高血压组UACR、ba PWV、CRAE异常率高于正常高值血压组及正常血压组(P<0.05)。多因素Logistic回归分析发现,正常高值血压及高血压均是UACR、ba PWV、CRAE的独立危险因素(P<0.05)。结论青岛市男性高血压患病率高于女性,随着年龄增长,高血压患病率呈不断上升趋势,正常高值血压人群及高血压人群均合并有多种代谢异常及多种心血管疾病危险因素,且已经发生血管损伤,应加强对正常高值血压人群及高血压人群的健康教育,积极控制血压,降低心脑血管事件发生率。     

上海市普陀区正常高值血压人群流行状况调查

目的:了解上海地区正常高值血压人群的流行状况并进行相关影响因素分析。方法:在上海市普陀区10个社区采取分层整群抽样方法,对35岁以上的自然人群进行现场调查、体格检查和实验室检查。结果:1共调查9 807人,总应答率为81.7%。纳入统计分析的9 623人,其中男3 757人,女5 866人;2正常高值血压检出率26.6%,其中男性27.6%,女性25.9%;3正常高值血压组平均年龄(62.64±10.71)岁,BMI(23.81±3.32)、腰围(82.58±8.86)cm,介于正常血压组和高血压组之间,3组间差异有统计学意义(P=0.001);4正常高值血压患病率男性高于女性,单纯收缩压正常偏高占64.6%,45岁以后随年龄增长患病率逐年下降,女性各年龄段下降趋势较平缓,而男性65岁前下降幅度达30.25%;5肥胖患病率正常高值血压组(30.5%)高于正常血压组(24.8%)(P=0.001);6Logistic回归分析显示,正常高值血压的患病与性别呈负相关,与年龄、BMI呈正相关,年龄每增加10岁,BMI每增加1kg/m2,正常高值血压患病风险分别增加29%和8%。结论:60岁之前的中青年男性是正常高值血压重点干预人群,BMI是正常高值血压的主要影响因素,降低BMI可能是防治正常高值血压的主要途径。     

长沙市公务员正常高值血压、高血压流行现状及危险因素分析

目的 调查湖南省长沙市公务员正常高值血压、高血压流行现状,进行危险因素分析,为制定防治策略提供依据.方法 对长沙市公务员进行横断面调查,根据血压水平分为正常血压、正常高值血压和高血压三组.计算长沙市公务员正常高值血压和高血压现患率;比较吸烟、饮酒等危险因素在三组人群的差异,用多分类Logistic回归分析法进行危险因素分析,并统计三组人群合并危险因素的状况.结果 长沙市公务员正常高值血压、高血压患病率分别为42.54%、22.87%.正常高值血压人群吸烟、饮酒、有早发心血管病家族史者比例明显高于正常血压组而低于高血压组(P均<0.05).正常高值血压人群体质指数、空腹血糖、总胆固醇、低密度脂蛋白胆固醇和甘油三酯水平均高于正常血压组(P均<0.05),低于高血压组(P均<0.05),而高密度脂蛋白胆固醇水平低于正常血压组(P<0.05),高于高血压组(P<0.05).男性较女性正常高值血压发生率显著升高(P<0.01),高血压患病率差异无显著性(P>0.05).年龄、体质指数、吸烟、饮酒、早发心血管病家族史、血脂异常、血糖等危险因素与正常高值血压、高血压的发生显著相关.12.94%的正常高值血压人群和14.02%的高血压人群合并3种及3种以上危险因素.结论 湖南省长沙市公务员人群正常高值血压发生率和高血压现患率高于全国平均水平.男性较女性更易发生正常高值血压,年龄、吸烟、饮酒、家族史、血脂、血糖、体质指数等危险因素与正常高值血压、高血压的发生密切相关.10%以上的正常高值血压、高血压公务员合并3种及3种以上危险因素.     

成都市社区居民血压分层调查及动脉粥样硬化性心血管病风险评估

目的了解2017年成都市社区居民正常高值血压的流行病学特征,心血管病危险因素及动脉粥样硬化性心血管病(ASCVD)风险现状。方法采用整群随机抽样对成都市6个社区调查点年龄≥18岁常住居民5 022人进行调查。对所有调查对象进行问卷调查、体格检查(测量血压、心率、腰围)和血液生化检查(血糖、血脂、尿酸、肌酐、尿素氮等)。参照《中国心血管病预防指南(2017)》中ASCVD风险评估方案进行ASCVD风险评估。结果完成有效调查问卷的社区居民4 894人,其中,高血压患者2 430例,高血压患病率为49.7%,标化患病率为27.3%,正常高值血压检出率为23.3%,标化后为27.4%。正常高值血压检出率从年龄40～50岁组达到高峰后呈现下降趋势。和正常血压人群相比,正常高值血压人群年龄、体质量指数(BMI)、腰围、心率、尿素氮、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、尿酸水平及男性、高血压家族史、肥胖、吸烟、饮酒比例较高。多因素Logistic回归分析显示,年龄[OR(95%CI),1.013(1.004～1.021)]、男性[1.424(1.107～1.831)]、高血压家族史[2.390(1.563～3.656)]、BMI[1.099(1.012～1.195)]是正常高值血压发生的影响因素。ASCVD风险评估显示,高危人群比例随血压分级增高而增高(正常血压13.5%比正常高值血压15.2%比高血压39.5%,P0.001),女性高危人群比例较男性低(22.3%比33.0%,P0.001)。正常高值血压人群中,血压水平130～139/85～89 mm Hg者高危患者比例高于120～129/80～84 mm Hg者(16.6%比13.1%,P0.001)。结论成都市社区居民正常高值血压检出率高,存在多种代谢异常,ASCVD风险增高。     

江苏无锡地区机关人员血压与心电图异常的关系

目的:探讨机关人员的血压水平及其与临床心电图异常的关系。方法:通过对江苏无锡地区部分机关的8 540名工作人员的系统查体,计算不同性别的血压分类及高血压患病率,分析不同血压水平的心电图异常检出率。结果:(1)男性正常高限血压占12.12%,高血压占37.15%;女性正常高限血压占7.37%,高血压占21.08%,男性正常高限及高血压患病率显著高于女性(P<0.01);(2)高血压患病率随年龄增高而增高,除70~79岁组外,均为男性显著高于女性(P<0.01);(3)随着血压升高,临床心电图异常分类如ST-T改变、左室高电压、左室肥厚、束支传导阻滞、室性早搏、陈旧性心梗等检出率显著升高。结论:随着血压升高,临床心电图异常特别是室性异常心电图的发生率显著升高。血压达到正常高限时,临床心电图异常率已开始升高。     

佛山市普君街道办事处老年高血压患病率调查

目的　探讨广东佛山市普君街道办事处老年高血压患病率情况。方法　按统一方法对佛山市禅城区普君街道办事处 6 0岁以上常住居民 3382人进行现场问卷调查 ,同时测量人体基本参数如血压、身高、体重等 ,并进行餐后 2小时血糖测定 ,以及空腹血糖、血脂常规、血尿酸等测定。结果　高血压粗患病率 4 0 0 % ,标化率为 4 0 0 % ,较佛山 1993年 (5 1 5 % )明显下降。单纯收缩期高血压 (ISH)粗患病率 2 1 3% ,标化率为 2 2 1%。女性患病率高于男性。新检出高血压患者占高血压病患者总数的 4 0 1% ,ISH占高血压病患者总数的 5 3 9% ,随年龄增长高血压患病率增高。老年人群平均收缩压 (SBP)为 12 6± 17mmHg、舒张压 (DBP)为 77± 8mmHg、脉压 (PP)为 4 9± 11mmHg。高血压组的年龄、血压、体重、体重指数、餐后 2小时血糖、空腹血糖、尿酸及血脂 (总胆固醇、甘油三酯 )与非高血压组比较有差异 ,(P <0 0 1～ 0 0 5 )。结论　高血压与多种危险因素有密切相关 ,佛山市老年人高血压患病率高 ,应当重视开展高血压的社区防治。     

老年单纯收缩期高血压的诊治进展

<正>目前,我国高血压患病率达18%,老年高血压患者已超过8000万,数量占世界各国首位,而单纯收缩期高血压(ISH)是老年高血压患者较常见、最重要的血压特征,患病率将近50%,其中ISH占高血压的60%[1-3]。近年来,越来越多的流行病学调查及临床研究证实,ISH已成为老年人群心脑血管病发病、死亡最重要的预测因子[4]。探讨老年ISH     

21322名科技人员血压分类及其与临床心电图诊断类型的关系

目的　研究科技人员的血压水平及其与临床心电图类型的关系。方法　对中国科学院的 2 132 2名科技人员进行了查体 ,计算不同性别的血压分类及高血压患病率 ,分析不同血压水平的临床心电图表现。结果　 (1)血压水平随年龄增高而增高 ,收缩压平均为男 (12 1 3± 2 0 5 )mmHg(1mmHg =0 133kPa) ,女 (116 3± 2 3 4)mmHg ,舒张压平均为男 (79 9± 2 7 8)mmHg ,女 (76 0± 2 7 30mmHg ,均为男性显著高于女性 (P <0 0 1)。 (2 )男性正常高限血压占 10 1% ,高血压病占 2 8 8% ;女性正常高限血压占 8 5 % ,高血压病占 2 0 4% ,男性高血压病患病率显著高于女性 (P <0 0 1)。经过年龄调整后 ,仍存在这种关系。 (3)随着血压升高 ,临床心电图异常分类如左室肥厚、左室高电压、ST T改变、束支传导阻滞、陈旧性心梗、室性早搏等的检出率显著升高。结论　随着血压升高 ,临床心电图异常特别是心室性异常心电图的发生率显著升高。血压达正常高限时 ,临床心电图异常的检出率已开始升高。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.