用脉压/平均动脉压比率评估动脉硬化程度的研究

目的探讨采用脉压/平均动脉压比率（PP/MAP Ratio）评估动脉硬化程度的可行性.方法将受检男女200例分为四个年龄组,每组各50例,排除可能影响受检者血压的因素以后,测量血压并计算PP/MAP Ratio,用统计学的方法加以比较.结果 PP/MAP比率在各年龄组男女之间的差异有统计学意义.结论用PP/MAP Ratio评估动脉硬化的程度,理论上有合理性,临床上可行,值得进一步探讨.     

脉压/平均动脉压比率预测脑出血的可行性研究

目的通过对脑出血患者发病时脉压和脉压／平均动脉压比率与对照组的比较，探讨脉压／平均动脉压比率预测脑出血的可行性。方法选取脑出血患者108例，测定入院时的首次血压（不受治疗因素影响），计算其脉压（PP）、脉压／平均动脉压比率（PP／MAPRatio），与年龄、性别匹配的健康对照组102例的PP、PP／MAP Ratio进行比较、分析。结果脑出血组的PP、PP／MAP Ratio显著高于对照组（PP：χ^2=196．000，PP／MAP Ratio：χ^2=249．771，P〈0．01），PP、PP／MAP Ratio分布频率与对照组差异有统计学意义（PP：χ^2=87．469，PP／MAP Ratio：χ^2=18．960，P〈0．01）。全部病例进人Logstic回归分析，PP≥50 mmHg者脑出血发病的危险性是PP低于50mmHg者的5倍（0R=5．000，95％CI为2．642～9．461）；PP／MAP Ratio高于0．45者脑出血是PP／MAP Ratio低于0．45者的2．6倍（0R=2．647，95％CI为1．516～4．622）。PP〉50mmHg、PP／MAP Ratio〉0：45，脑出血的发病率明显增大。结论PP／MAP Ratio也和PP-样都可以用于预测脑出血发病的危险性，PP／MAP Ratio是无量纲值，具有可比性，因此优于PP。     

脓毒性休克患儿平均动脉压与预后的关系

近年来重度脓毒症和脓毒性休克的发病率及病死率居高不下,目前在住院患者中严重脓毒症的病死率约为30％,而脓毒性休克的病死率为50％～60％。因此,有必要对如何提高脓毒性休克患儿生存率积极探寻有利因素,从而给予有力的干预措施,使得病死率降低。本研究对72例脓毒性休克患儿的平均动脉压与预后的关系进行分析如下。     

孕中期平均动脉压与红细胞比容联合预测妊高征的价值

妊娠高血压综合征 (妊高征 )是产科常见的严重并发症 ,对母婴危害极大。近年来对妊高征进行筛查和防治一直是产科工作者的研究课题。本研究旨在探讨联合检测孕中期平均动脉压 (ＭＡＰ)与红细胞比容(ＨＣＴ)水平对妊高征的预测价值 ,试图把ＭＡＰ与ＨＣＴ联合检测列入产前常规监测的内容 ,为筛查和防治妊高征开辟新的途径。1　资料与方法1 1　研究对象及分组　选择 1999年 10月～ 2 0 0 0年10月在我院产前检查并分娩的孕妇共 180例 ,年龄 2 1～ 36岁 ,平均 2 5 .3岁 ,孕周 2 2～ 2 6周 ,且均为单胎 ,并排除高血压、心脏病、糖尿病及慢性肝肾…     

孕中期子宫动脉血流评分与平均动脉压检测对妊娠期高血压的预测价值

目的 探讨孕中期超声检测子宫动脉血流联合平均动脉压（MAP）检测对妊娠期高血压（HDCP）的预测效能。方法 选取2021年4月至12月于三明市第一医院接受产前检查的86例产妇,随访至妊娠终止,按HDCP的诊断标准,将发生HDCP的31例产妇划定为观察组,未发生HDCP的55例产妇为正常妊娠组。对所有产妇施以孕中期超声检查,比较两组孕中期的子宫动脉搏动指数（PI）、子宫动脉阻力指数（RI）与MAP。绘制受试者工作曲线（ROC）,探究3项指标单独与联合检测对HDCP的预测价值。结果 观察组患者PI、RI以及MAP均高于正常妊娠组,差异有统计学意义（P<0.05）。ROC结果显示,PI、RI、MAP三者联合检测的曲线下面积（AUC）为0.913,高于三者单独检测（0.784、0.871、0.783）。结论 孕中期对子宫动脉血流评分与MAP进行联合检测可有效提高HDCP诊断准确率,对于临床早发现、早预防、及时治疗HDCP具有重要意义。     

抗心磷脂抗体、血钙、平均动脉压对妊娠高血压综合征的预测价值

目的探讨妊娠中期血抗心磷脂抗体(ACA)、血钙(Ca2+)、平均动脉压(MAP)检测对妊娠高血压综合征(PIH)的预测价值。方法对180例妊娠中期孕妇采用酶联免疫吸附法测定血ACA,自动生化分析仪检测血Ca2+水平,同时测量并计算MAP,对检测结果进行统计学分析。所有患者按检查结果分为PIH组和正常妊娠组。结果 PIH组血Ca2+水平低于正常妊娠组,差异有统计学意义(P<0.05)。以血ACA阳性、血Ca2+<2.20mmol/L、MAP≥85mmHg为联合预测指标,PIH阳性预测值为84.62%,阴性预测值为87.78%,敏感度为82.76%,特异度为97.04%,显著高于各单项检测的预测价值。结论妊娠中期联合检测血ACA、Ca2+、MAP对预测PIH具有较高的敏感性和特异性。     

抗心磷脂抗体、C-反应蛋白、平均动脉压联合预测孕早期妊娠高血压综合征的意义

目的测定孕早中期血抗心磷脂抗体（ACA）、C-反应蛋白（CRP）、平均动脉压联合预测妊娠高血压综合征的发生,寻求一种简便、易行并具有临床价值的预测方法。方法采用酶联免疫吸附法测定血ACA,乳胶免疫比浊法测定血CRP,同时测量平均动脉压进行研究。结果妊高征孕妇在孕10～16周CRP值、CAC阳性率及mABP≥85mmHg的发生率均较正常妊娠组明显升高,差异有统计学意义（P〈0.01）。三者联合预测指标,阳性预测值为81.81%,阴性预测值98.64%,敏感度91.66%,特异度97.32%。结论孕早中期联合检测血ACA、CRP、平均动脉压有较高的敏感性和特异性。     

硬腰联合麻醉产妇分娩前10min平均动脉压水平与新生儿1分钟Apgar评分之间的关系探讨

目的 探讨硬腰联合麻醉后,剖宫产产妇分娩前10min平均动脉压水平与新生儿1分钟Apgar评分之间的关系.方法 选取我院247例剖宫产手术的产妇,在硬腰联合麻醉、蛛网膜下腔给药后,记录胎儿分娩前10min产妇平均动脉压变化,根据平均动脉压波动范围随机分为3组,波动在75～105mmHg之间的为A组82例,波动在60～75mmHg之间的为B组102例,小于60mmHg为C组63例,记录3组产妇新生儿1分钟Apgar评分.结果 B组新生儿出生后1分钟Apgar评分不足10分的较A组增多,1分钟Apgar评分不足7分的较A组增多;C组新生儿出生后1分钟Apgar评分不足10分的较B组明显增多,不足7分的较B组显著增多.结论 硬腰联合麻醉产妇分娩前10min平均动脉压水平过低对新生儿生命体征和窒息构成一定的危险,胎儿娩出前,将平均动脉压控制在75～105mmHg之间较为安全.     

脉压和脉压指数在临床应用中的对比分析

2000年世界卫生组织(WHO)报告全世界有1 700万人死于心血管病,即所有原因死亡中的1/3由动脉硬化为基础的心血管病所致[1],故防治动脉硬化势在必行。目前评价动脉硬化多用脉压(PP),但PP在同一个体存在     

高血压病患者24小时平均脉压与靶器官损害的关系

目的探讨高血压病患者24小时平均脉压（ABPP）与靶器官损害的关系。方法把246例高血压病患者根据动态血压检测的结果分为ABPP≥60mmHg和ABPP〈60mmHg两组,将两组的超声心动图、心电图、血肌酐、颅脑CT资料进行对比分析。结果与ABPP〈60mmHg组比较,ABPP≥60mmHg组心肌肥厚、心脏收缩和／或舒张功能减退、心电图异常、肾功能损害、脑血管意外病例明显增多。结论高血压病患者中,随着脉压增大,增加了对心脏、大脑、肾脏等靶器官的损害,进而造成心脑血管疾病发病率增高,因此在高血压治疗中积极控制脉压将有效减轻靶器官损害。     

脉压差、载脂蛋白AI/B比值对颈动脉硬化者的意义

目的评价脉压差、载脂蛋白AI／B比值与颈动脉硬化的关系。方法根据超声学检查结果将颈动脉硬化患者分为3组，即正常组、血管增厚组、斑块组，分析比较每组脉压差、载脂蛋白AI／B比值，并进行统计学处理。结果脉压差在斑块组中有所增大（P〈0．05）；而载脂蛋白AI／B比值在增厚组降低（P〈0．05），在斑块组明显降低（P〈0．01）。结论脉压差、载脂蛋白AI／B比值与颈动脉硬化有明显的相关性．可能参与动脉粥样硬化的形成和发展。     

Influence of L-nitro-arginine methyl ester,acetylcholine, and adenosine on mean blood pressure,pulse pressure,and pulse pressure amplification in rats

The blood pressure pattern in spontaneously hypertensive rats (SHRs) involves three main characteristics: increase in mean blood pressure (MBP); increase in thoracic aorta (proximal) and iliac (distal) pulse pressure (PP); disappearance of the normal PP amplification between the proximal and the distal arteries. Whether pharmacologic agents may reduce MBP with different or even opposite effects regarding PP and PP amplification has been poorly investigated. In SHRs and Wistar-Kyoto (WKY) anesthetized rats, the NO inhibitor l-nitro-arginine methyl ester (l-NAME) was infused at the dosage of 1 mg/kg for 30 min. Before and after infusion, 7 microg/kg/min acetylcholine (Ach) and 200 mg/kg adenosine (Ado) were perfused for 4 min. Proximal and distal intra-arterial BP was monitored throughout the procedure. In both WKYs and SHRs, l-NAME increased proximal and distal systolic (SBP), diastolic (DBP), and MBP but not PP. Before l-NAME, SBP, DBP, and MBP were significantly reduced by Ado and Ach. After l-NAME, such blood pressure reductions were abolished with Ach but not Ado. In both strains, the proximal and distal PP, when expressed in percent reduction of MBP, were significantly higher under Ado than under Ach. The Ado but not Ach changed PP amplification, causing a reduction in WKYs and an increase in SHRs independent of l-NAME. Vasodilating agents may reduce MBP with significantly different effects on PP. The Ado alters PP amplification, an effect not obtained with the nitric oxide endothelium-dependent vasorelaxing agent Ach. Tail SBP measurements cannot predict such dissociated changes.     

Local pulse pressure is a major determinant of large artery remodelling

1. The aim of the present brief review is to show that the pulsatile component of blood pressure is a stronger determinant of large artery remodelling than the steady component (i.e. mean blood pressure). 2. Pulse pressure, which is a strong determinant of cardiovascular events, including coronary heart disease and stroke, is increased when large arteries stiffen. Local pulse pressure, measured with applanation tonometry in normotensives and patients with essential hypertension, explains a significant part of the variance of intima-media thickness at the site of the carotid artery, a proximal elastic artery, whereas mean blood pressure does not contribute. Local pulse pressure has no influence on intima-media thickness at the site of the radial artery, a distal muscular artery that undergoes very little stroke change in diameter. 3. The decrease in carotid pulse pressure is also a major determinant of the regression of carotid intima-media thickness after antihypertensive treatment. Local pulse pressure can influence not only intima-media thickness, but also internal diameter. Indeed, there is a significant association between the lumen enlargement of the ascending aorta in patients with Marfan syndrome and pulse pressure. In addition, carotid pulse pressure is positively correlated with carotid internal diameter in normotensives and hypertensives, and the decrease in carotid internal diameter during long-term antihypertensive treatment is influenced by the decrease in carotid pulse pressure and not by the reduction in mean blood pressure. 4. We suggest that the effects of pulse pressure on large artery remodelling may explain part of its predictive value on cardiovascular events.     

脉压和脉压指数与血压关系的研究

目的研究脉压、脉压指数与血压之间的关系。方法将106例高血压病患者按血压水平分为高血压病1、2、3级组,并将62例健康体检者设为正常对照组,分别检测各组脉压、脉压指数。通过高血压病患者间及与正常人群的对比,获得不同分组高血压病患者脉压、脉压指数与血压之间的关系。结果高血压病组脉压明显高于正常对照组(P<0.01),脉压指数明显高于正常对照组(P<0.01);2.高血压病2级组和3级组脉压明显高于1级组(P<0.01),高血压病2级组脉压指数明显高于1级组和3级组(P<0.01)。结论脉压、脉压指数与血压关系密切,其中,脉压表现出随血压水平升高而持续升高的趋势;脉压、脉压指数作为临床评价心血管疾病发生的危险性的指标,具有一定的价值。     

脉压与冠状动脉病变程度及急性心肌梗死的关系

目的探讨脉压水平与冠脉病变程度及急性心肌梗死的关系.方法经冠脉造影确诊冠心病89例,男68例,女21例,年龄26～81(61.22±10.74岁.外周肱动脉压力测定收缩压、舒张压.冠脉病变严重程度用冠脉病变的血管支数表示.根据WHO标准诊断急性心肌梗死.结果急性冠脉综合征患者脉压水平明显高于未发生急性冠脉综合征的患者(P＜0.05);脉压≥ 50 mmHg的冠心病患者2支和3支病变发生率明显高于脉压＜50 mmHg的冠心病患者(P＜0.05).结论高血压病合并冠心病患者脉压差越大,冠脉病变越严重,越容易发生急性心肌梗死.     

高血压患者血清脂联素浓度与脉压、脉压指数的相关性研究

目的 研究高血压患者血清脂联素水平及脉压(PP)和脉压指数(PPI)的关系.方法 选取原发性高血压患者36例及健康对照者35例,用酶联免疫吸附法检测各组空腹血清脂联素浓度,同时测定各组的血脂、血糖、血压、脉压、脉压指数等指标,并分析血清脂联素与各指标间的相关性.结果 原发性高血压组血清脂联素水平显著低于正常对照组[(5.36±2.04)μg/ml vs(6.83±2.24)μg/ml,P<0.01],原发性高血压组血清脂联素水平与收缩压、舒张压、脉压和脉压指数之间存在显著负相关,相关分析显示脉压指数是影响脂联素水平的独立危险因素.结论 在原发性高血压患者中,脂联素水平下降并与血压之间存在一定的相关性.脉压和脉压指数高的患者,其血清脂联素浓度相对偏低.     

脉压差与老年高血压病患者动脉硬化形成的关系研究

目的老年高血压是动脉粥样硬化形成的因素之一。老年高血压具有脉压差大的特点。本文探讨脉压差与老年高血压患者动脉粥样硬化形成的关系。方法以98例老年高血压患者为对象,按24h平均脉压差大小分为<60mm Hg、60～69mm Hg和≥70mm Hg三组。用彩色多普勒超声检查颈动脉粥样硬化斑块及最大内膜中层厚度(IMT)。对比分析脉压差大小与颈动脉粥样硬化斑块发生率和IMT之间关系。结果本研究结果显示,随着脉压差的逐渐加大,老年高血压病人的颈动脉最大内膜中层厚度逐渐增加,颈动脉粥样硬化斑块发生率也跟着逐渐增高。结论脉压差增大可促进动脉粥样硬化斑块的形成和发展。脉压差是老年高血压病人动脉硬化的良好预测因子之一。     

重组人脑钠肽对慢性失代偿性心力衰竭患者心率与动脉压的影响

目的观察重组人脑钠肽(rhBNP)对慢性心力衰竭(CHF)患者心率及动脉压的影响.方法60例CHF患者随机分为对照组(n=32,接受常规抗心衰治疗)和治疗组(n=28,接受常规抗心衰和rhBNP联合治疗),以两组心率、动脉压、尿量、血NT-proBNP水平及射血分数(EF)的差异评价疗效.结果与对照组相比,治疗组用药后...     

Time-dependent decreases in nucleus accumbens AMPA/NMDA ratio and incubation of sucrose craving in adolescent and adult rats

Rationale and objective

There is evidence that cue-induced sucrose seeking progressively increases after cessation of oral sucrose self-administration (incubation of sucrose craving) in both adolescent and adult rats. The synaptic plasticity changes associated with this incubation at different age groups are unknown. We assessed whether incubation of sucrose craving in rats trained to self-administer sucrose as young adolescents, adolescents, or adults is associated with changes in 2-amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl)propanoic acid (AMPA)/N-methyl-d-aspartate (NMDA) ratio (a measure of postsynaptic changes in synaptic strength) in nucleus accumbens.

Methods

Three age groups initiated oral sucrose self-administration training (10 days) on postnatal day (P) 35 (young adolescents), P42 (adolescents), or P70 (adults). They were then tested for cue-induced sucrose seeking (assessed in an extinction test) on abstinence days 1 and 21. Separate groups of rats were trained to self-administer sucrose or water (a control condition), and assessed for AMPA/NMDA ratio in nucleus accumbens on abstinence days 1–3 and 21.

Results

Adult rats earned more sucrose rewards, but sucrose intake per body weight was higher in young adolescent rats. Time-dependent increases in cue-induced sucrose seeking (incubation of sucrose craving) were more pronounced in adult rats, less pronounced in adolescents, and not detected in young adolescents. On abstinence day 21, but not days 1–3, AMPA/NMDA ratio in nucleus accumbens were decreased in rats that self-administered sucrose as adults and adolescents, but not young adolescents.

Conclusions

Our data demonstrate age-dependent changes in magnitude of incubation of sucrose craving and nucleus accumbens synaptic plasticity after cessation of sucrose self-administration.