胫前动脉压与肱动脉压对比观察

选择血压在正常范围、无影响血压之疾病及未服用影响血压药物者２００例，其中男１００例，女１００例，分别测量肱动脉压、胫前动脉压。结果显示：男性左胫前动脉收缩压与舒张压较左肱动脉收缩压高（Ｐ＜０．０５），女性差异无显著性（Ｐ＞０．０５）。右胫前动脉收缩压与舒张压与右肱动脉收缩压与舒张压经统计学处理，差异无显著性（Ｐ＞０．０５）。     

心血管病调查研究中血压测量的标准化

本文报告《中美心（肺）血管病流行病学合作研究》中采用血压测量标准化方法实践的体会，强调测压装置性能的校正和袖带型号尺码的选择，操作时快速平稳充气，寻找最高充气压和以恒定下降速度放气，从而准确地确定收缩压和舒张压。本法避免了因“生物学变异”和“测压变异”而出现的误差，对医学科研和临床的血压测量具有一定的指导作用。     

影响测压相关因素研究

目的　探讨几种影响测压相关因素及其对收缩压及舒张压的不同影响。方法　随机选择在校学生 10 0名 ,设计了 1)心脏与肱动脉的相对位置 ;2 )绷袖带的松紧程度 ;3)测压时间 ;4 )测压时体位 ;5 )测压部位共 5个影响因素 ,并做干预前后或相关自身血压对照。结果　血压计相对位置在很大程度上影响血压的值 ;绷袖带太紧明显使血压偏低 ;体位改变主要影响舒张压 ;右肱动脉的收缩压明显高于左肱动脉。结论　测压时尽量避免影响测压的相关因素     

Measuring Absolute Blood Pressure Using Microbubbles

Gas microbubbles are highly compressible, which makes them very efficient sound scatterers. As another consequence of their high compressibility, the radii of the microbubbles are affected by the pressure of the fluid around them, which changes their resonance frequency. Although the pressures present within the human body cause only minor variations in the radii of uncoated microbubbles (∼0.2% per 10 mmHg) and, therefore, very small variations in the resonance frequency (∼1 kHz per 10 mmHg), it was found in the work described here, through both simulations and in vitro measurements, that large changes in resonance frequency can occur in phospholipid-coated microbubbles for small blood pressure variations because of the exotic buckling dynamics of phospholipid monolayers (up to 240 kHz per 10 mmHg). This method should allow non-invasive measurement of the gauge blood pressure in deep blood vessels as long as the microbubble physical properties are well controlled.     

偶测血压与踝臂脉搏波速度的相关性研究

目的：探讨健康人群的血压与脉搏波速度（PWV）的相关性和意义。方法：对402名健康体检者,进行血压及PWV的测定,并根据PWV结果将受检者分为3组,PWV≤20%预测值组（n=301）,20%预测值〈PWV≤30%预测值组（n=67）,以及30%预测值〈PWV≤50%预测值组（n=34）,检测中未见PWV〉50%预测值。结果：3组人群的收缩压（SBP）、舒张压（BBP）彼此之间有明显不同（P〈0.05）,PWV随血压的升高而加快。结论：血压的增高与PWV密切相关,控制血压对减轻动脉硬化有重要的意义。     

血液透析过程中进餐对血压的影响

作者对９０例维持性血液透析的患者进行血压观察,根据血透中进餐与否,分为进餐组和未进餐组。进餐组的血压波动明显大于不进餐组,尤其是血透３ｈ后进餐的患者,其血压波动尤为明显。结果表明：血透中后期的进餐也是引起症状性低血压的原因之一。     

运动对老年冠心病血压血脂的影响

对１１１例老年冠心病患者进行３年跟踪观察,以探讨运动对老人血压血脂的影响。６５例运动组与４６例对照组３年后血压血脂比较,结果显示均有显著差异（Ｐ＜０．０１）。     

静脉全凭异丙酚诱导对体内一氧化氮含量及血压的影响

目的：探究全凭异丙酚（得普利麻，propofol)静脉诱导对患者体内一氧化氮（NO）含量及血压变化的影响。方法：经全麻胸外科手术患者30例，随机分成异丙酚组、输液异丙酚组及依托咪酯组，每组各10例，于麻醉诱导用药前后测定体内NO含量并记录血压，心率。结果：（1）麻醉诱导前三组NO含量及血压心率无差异。（2）诱导后异丙酚组和输液异丙酚组NO含量明显增高，与术前及依托咪酯组比有显著差异，P＜0．05。（3）诱导后三组血压均下降，异丙酚组最明显，输液异丙酚组有下降，依托咪酯组稍有下降。结论：（1）异丙酚可刺激体内NO分泌增加，此为异丙酚在诱导期易使血压下降的原因之一。（2）诱导前输液500－1000ml可减少低血压的发生率。     

高血压患者血浆同型半胱氨酸与血压变异的相关性

目的:探讨原发性高血压患者血浆同型半胱氨酸(Hcy)水平与血压变异的相关性。方法:选择原发性高血压患者110例作为研究对象。测量所有患者血生化指标及动态血压水平。将入选患者按血浆Hcy水平分为正常Hcy组(n=56)和高Hcy组(n=54),对两组患者的年龄、性别、血生化、动态血压各参数进行比较。将入选患者按照血压不同昼夜节律分为非杓型组(n=45)、杓型组(n=40)、极度杓型组(n=10)、反杓型组(n=15),对4组患者的年龄、性别、血浆Hcy、血生化进行比较。对患者血浆Hcy与动态血压各参数进行相关性分析。结果:高Hcy组男性比例较正常Hcy组高(P0.001);高Hcy组患者白昼、夜间、24h平均收缩压及平均舒张压较正常Hcy组高(P0.05);高Hcy组高密度脂蛋白较正常Hcy组低(P=0.036),高Hcy组血肌酐水平较正常Hcy组高(P=0.001)。反杓型组患者血浆Hcy较其他3组高(P=0.001)。患者血浆Hcy与白昼、夜间、24h平均收缩压及平均舒张压线性相关(P0.05);血浆Hcy与血压变异、变异系数不存在线性相关。结论:血浆Hcy水平可能与高血压及异常血压昼夜节律有关,在治疗高血压的同时应积极降低血浆Hcy水平。     

Noninvasive Estimation of the Blood Pressure Waveform in the Carotid Artery Using Continuous Finger Blood Pressure Monitoring

To noninvasively estimate the blood pressure continuously in the common carotid artery (CCA), we obtained the distension waveform of the CCA from seven healthy volunteers and 20 hypertensive patients using radio-frequency ultrasound. Consequently, it was calibrated by the mean and diastolic pressure measured in the finger artery and compared with applanation tonometry, calibrated using the systolic and diastolic pressure in the brachial artery. The mean difference in estimating the mean blood pressure was 0.3 mm Hg (limits of agreement: –11.7 to 12.3 mm Hg). In estimating the systolic blood pressure, the mean difference was 8.0 mm Hg (limits of agreement: –29.8 to 45.8 mm Hg) and showed increasing variation with blood pressure. The systolic blood pressure values can be expected between 0.83 and 1.35 times the control method. In this study, we obtained proof-of-principle for noninvasively measuring blood pressure in the CCA using continuous finger blood pressure monitoring. This opens the way to estimating location specific arterial stiffness and intra-plaque elasticity.     

服用抗精神病药物患者血压、心率的测量与观察

为了降低服用抗精神病药物患者体位性低血压的发生率，对62例精神分裂症患者在增药期间，取不同体位进行了血压和心率的测量。结果：平卧位的收缩压、舒张压、心率与直立位比较（经配对t检验）差异有非常显著性（P＜0．01）。直立位与平卧位相比，心率平均快41次／min，舒张压平均高1．1kPa，而收缩压平均低1．32kPa。其中有5例患者平卧位收缩压正常，而直立位时收缩压＜12kPa。作者提出：①给服用抗精神病药物患者测量血压、心率时，应分别取平卧和直立位进行测量，才能了解患者血压和心率的变化。②增药期间应采取直立位测量，对预防体位性低血压有重要意义。     

Characteristics and Referral of Emergency Department Patients with Elevated Blood Pressure

Objectives: To assess the prevalence, characteristics, and referral to health care of emergency department (ED) patients with elevated blood pressure (BP) and to compare those without a history of hypertension (HTN) with suboptimally controlled, known-hypertensive patients.
Methods: A prospective, observational study was conducted in non–critically ill adults with a triage systolic blood pressure (sBP) of ≥140 or with a diastolic blood pressure (dBP) of ≥90 mmHg. Two additional measurements were obtained, and a standardized questionnaire recorded demographics, medical history, and ED staff referrals.
Results: Of 1,719 nonpregnant adults, 991 agreed to participate, of whom 455 had elevated triage BP values. Using the mean of three measurements, 305 (67%) had an sBP of ≥140 or a dBP of ≥90 mm Hg (mean sBP = 157 and mean dBP = 89 mm Hg). Subjects with no prior history of HTN (n = 105) were predominantly male, younger, and more likely to smoke and consume alcohol than were known-hypertensive patients (n = 200). Three quarters of all subjects had access to primary health care; however, time elapsed since the last BP assessment was greater (155 vs. 53 d, p = 0.03) in subjects with no previous history. These subjects were also less likely to be informed of their elevated BP (33% vs. 50%, p = 0.02) or to be instructed by ED staff to obtain a repeat measurement (13% vs. 31%, p = 0.001).
Conclusions: Of ED patients with elevated BP, one third had no prior history, and the remainder were suboptimally controlled hypertensive patients. Both groups were inadequately informed of their elevated BPs, and the group with no prior history of HTN, the population likely to obtain the greatest health benefit, had the lowest referral rate.     

手术室护士压力产生的原因分析及对策

笔者报道手术室护士产生压力的主要原因及对策。分析其原因有:工作环境、工作负荷、人际关系冲突、职业危害、媒体不恰当宣传、学习及职称评定等因素。采取相应对策:认识自身价值、处理好各种关系、加强自身防护及普法教育,从而使手术室护士从容面对压力,进一步提高护理质量。     

一次性纸巾对血压测量的影响研究

目的探讨一次性纸巾对血压测量的影响,预防血压计袖带污染。方法将2012年7月1日-31日收治的高血压患者及正常血压者共120例按照分层随机的方法分别归入A组和B组,即每组各有高血压者、正常血压者各30例。A组患者先裸臂测量血压,间隔1～2 min后在同侧上臂垫上一次性纸巾后再绑袖带测量血压,B组患者先垫纸测量血压,再在同侧测量裸臂血压,比较垫纸与否、垫纸顺序对血压测量的差异。结果 120例患者裸臂与垫纸测量的收缩压、舒张压的差异无统计学意义（P〉0.05）,先垫纸与后垫纸测量的舒张压差异无统计学意义（P〉0.05）,但收缩压的差异有统计学意义（P〈0.05）;其中高血压和正常血压患者中裸臂与垫纸之间的血压差异均无统计学意义（P〉0.05）。结论垫纸与否不会影响血压的测量,垫纸顺序在收缩压测量上会影响非高血压患者的血压。     

小儿肱动脉桡动脉处血压值比较

本文对２２０例小儿肱动脉,桡动脉处的血压进行了测量比较,结果不同年龄组,不同体位时,该二处的收缩压及舒张压均无统计学差异（Ｐ〉０．５）。桡动脉处可作为小儿血压测定的另一选择,桡动脉处测甚为方便,临床实用性更大,左右上肢血压值也无显著差异（Ｐ〉０．５）,临床上测定时可任选其一。     

脑卒中急性期体位变化对血压的影响

脑卒中患者急性期因血管调节功能障碍．可随体位变化而致血压下降．进而发生头晕目眩，站立不稳．严重者突然跌倒的脑缺血表现，直接影响病人的康复．本文对照观察了102例脑卒中急性期患者与非脑卒中患者68例的体位改变对血压的影响．     

苯磺酸氨氯地平联合替米沙坦应用对老年原发性高血压患者血压晨峰和血压变异性的影响

目的：探讨苯磺酸氨氯地平联合替米沙坦对老年原发性高血压患者血压晨峰及血压变异性的影响.方法：选择2011年3月-2012年3月齐齐哈尔市第一医院收治的老年原发性高血压患者48例,给予苯磺酸氨氯地平（5mg/d）联合替米沙坦（40mg/d）治疗4周.治疗前后分别进行24 h动态血压监测,采用自身对照研究的方法对比分析治疗前后患者血压晨峰及血压变异性的差异.结果：与治疗前比较,老年原发性高血压患者治疗后的24 h平均收缩压、24 h平均舒张压、白昼平均收缩压、白昼平均舒张压、夜间平均收缩压、夜间平均舒张压、血压晨峰、24 h收缩压标准差、24 h舒张压标准差、24 h收缩压变异系数、24 h舒张压变异系数均下降,治疗前后比较差异均有统计学意义（P＜0.05）.治疗后的总胆固醇、低密度脂蛋白胆固醇较治疗前下降,治疗前后比较差异均有统计学意义（P＜0.01）.结论：氨氯地平联合替米沙坦降压治疗可有效降低老年高血压患者的血压晨峰及血压变异性.     

骨科专科医院手术室护士工作压力源及应对方式调查

目的 了解骨科专科医院手术室护士主要的工作压力源及应对方式,帮助护理人员减轻或消除工作压力.方法 采用问卷调查法,对29名骨科专科医院手术室护士的工作压力源及应对方式进行调查.结果 本组护士的主要工作压力源依次为骨科手术室护士所存在的问题、工作量及时间分配、护理专业及工作、工作环境及资源、病人护理、管理及人际关系;在工作量及时间分配方面,不同年龄、不同工作年限护理人员在其压力程度上的差异存在统计学意义(P＜0.01或P＜0.05).本组护士积极应对方式为(1.50±0.67)分,消极应对方式为(1.02±0.82)分.结论 骨科专科医院手术室护士工作压力源来自多方面,其偏向采取积极的应对方式.建议从管理及个人角度减少或消除手术室护士工作压力源,建立积极的应对措施,以提高护理服务质量.