原发性高血压患者红细胞~(86)铷摄取的研究

对21名男性原发性高血压患者进行了红细胞~(86)R_b摄取率测定。与22名男性正常血压者相比,患者的哇巴因敏感~(86)摄取率降低R_b提示男性原发性高血压患者的红细胞钠泵活性降低。患者组的哇巴因敏感~(86)R_b摄取率与血压负相关;而正常血压组这一组分的摄取率与血压不相关,但与年龄负相关。二组间其它摄取组分均无差别。本文还对原发性高血压患者红细胞钠泵活性低下的意义和原因作了讨论。     

原发性高血压患者钠泵抑制性体液因子的研究

本文以~(86)铷(Rb)摄取速率为钠泵活性指标,以正常人红细胞与原发性高血压患者和正常人血浆分别进行体外孵育,观察不同血浆交叉孵育后细胞钠泵活性的变化。结果表明经原发性高血压患者血浆孵育的正常红细胞之~(86)Rb摄取速率显著低于经正常血压者血浆孵育的红细胞摄取速率,且主要存在于哇巴因敏感的摄取部份而哇巴因不敏感的~(86)Rb摄取速率两种孵育结果无显著差别。本文结果提示原发性高血压患者中可能存在着钠泵抑制性体液因子。     

延吉市朝鲜族原发性高血压与吸烟关系的研究

本文报道延吉市1216名朝鲜族成年男性原发性高血压与吸烟关系的调查结果。吸烟者与不吸烟者高血压患病率有显著差异。吸烟者的高血压患病率随吸烟年限和吸烟量的增加而上升,吸烟卷与吸烟丝者的患病率之间无明显差异。     

体重变化及相关因素与老年原发性高血压发病的关系

目的：研究老年原发性高血压与体重变化及其相关因素的关系。方法：利用天津市滨江医院内科门诊高血压抽样调查资料进行病例对照研究。病例为调查前2年内或调查时新诊断的127例年龄≥60岁高血压病人，对照则为无心血管病史的其他门诊病人。二者按年龄和性别1：1配比。应用条件Logistic回归模型分析资料。结果：与老年高血压发病相关的因素有：低文化水平，职业，同胞高血压史，调查时体重或体重指数（kg/m^2)、体重增加程度和体重增加的开始年龄，未显示吸烟和饮酒与老年高血压有关。结论：控制体重或尽量减低肥胖程度和推迟发胖年龄，可降低老年人发生高血压的危险性，是老年高血压防治的有效措施。     

红细胞钠泵活性与原发性高血压关系的研究

近年来的研究发现,在实验性与人类高血压中均存在细胞内阳离子含量及其转运机制的异常,可能与原发性高血压的遗传病因、发病机理有密切联系。细胞膜钠泵为细胞转运钠、钾离子的主要途径。钠泵功能异常可引起细胞钠、钾跨膜梯度的改变及一系列继发变化而影响血管平滑肌张力与血压的调节。本文以红细胞作为模式,测定了原发性高血压患者与高血压家族正常血压子女的红细胞膜钠—钾 ATP 酶活性。以了解细胞膜钠泵在高血压发生、发展中可能存在的异常及其影响。     

原发性高血压发病机制研究进展

原发性高血压发病机制尚未充分阐明。目前认为,原发性高血压主要由于外周小动脉壁平滑肌张力增强和对血管活性物质(例如儿茶酚胺、5-羟色胺及血管紧张肽-等)反应性增强(功能性变化),以及血管腔狭窄(结构性变化)等所致的外周血管阻力提高的结果。有关原发性高血压发病诸因素,例如儿茶酚胺、肾上腺皮质激素、血管紧张肽-醛固酮之类已提出30多年了,七十年代后期和八十年代前期先后提出钠泵抑制因子和心房肽,而内皮素则是在1988年提出的。这些表明对原发性高血压的研究是与对动脉血压主要调节因素的研究相联系的。肾排钠缺陷在高血压发病中的作…     

人红细胞钠泵及大黄对其影响的研究

用(30)~Rb摄入法研究了人红细胞钠泵的阳离子转运活性。在实验的最适条件下,测定了正常人70例红细胞钠泵活性,其值为0.449±0.059mmol/(L·h)(X±SD)。在此基础上观察了大黄液在体外对人红细胞钠泵活性的抑制作用。讨论了大黄降温机理与大黄抑制钠泵的关系。研究提示了钠泵活性异常在细胞产热的病理生理学上的可能作用。     

医海拾贝

近期的Hypertension（2008：51：928-32）对众所周知的低出生体重和成年后高血压之间的关系作出了解释。慢性高血压需要肾压力和促钠排泄之间的关系发生转变,从而导致血压的盐敏感性升高。科学家发现,出生体重与血压的盐敏感性呈负相关,而这可能对低出生体重者患高血压有一定作用。     

原发性高血压患者体重指数与动态血压指标的关系探讨

目的：探讨原发性高血压患者动态血压指标与体重指数的关系。方法：依据体重指数将原发性高血压患者行动态血压监测者分为正常体重组(79例)、超重组(75例)和肥胖组(22例)。分析体重指数与动态血压指标及血压昼夜节律的关系。结果：超重组及肥胖组患者24小时、白昼和夜间的平均收缩压/舒张压、夜间平均脉压水平以及血压昼夜节律异常发生率均高于正常体重组,有显著性差异(P<0.05～0.01)。结论：动态血压指标与原发性高血压患者体重指数之间有密切的关系;超重及肥胖的高血压患者应用动态血压监测和判定其预后具有重要的意义。     

孕前体重指数和孕期体重增加与妊娠结局关系的分析

目的 探讨孕前体重指数(BMI)和孕期体重增加对新生儿体重及妊娠期高血压的影响.方法 分析470例足月单胎初产妇孕前BMI、孕期体重增加与新生儿体重及妊娠期高血压疾病的关系.结果 不同孕前BMI组新生儿出生体重比较差异无统计学意义(P＞0.05);随孕前BMI增加及孕期体重增加值增大妊娠期高血压疾病的发生率增加(P＜0.05).结论 孕前BMI和孕期体重增加超过一定限度时,均会影响新生儿体重及妊娠期高血压疾病发生率.     

轻度下调血液透析液钠浓度可有效降低处于干体重的行维持性血液透析的终末期肾病伴高血压患者血压和血钠：多中心、自身对照研究

背景　高血压是终末期肾病维持性血液透析患者常见并发症之一,研究表明降低血液透析液钠浓度可改善终末期肾病维持性血液透析伴高血压患者水钠负荷并降低其血压,但多数研究样本量较小,降低血液透析液钠浓度的临床意义尚存在争议。目的　通过扩大样本量而进一步证实降低血液透析液钠浓度对处于干体重的行维持性血液透析的终末期肾病伴高血压患者血压、血钠的影响,并验证其安全性。方法　本研究为多中心、自身对照研究,共选取2018年9-11月在北京市7家血液净化中心行维持性血液透析的终末期肾病伴高血压患者154例,2018年12月开始将其血液透析液钠浓度调整至138 mmol/L并维持1个月（干预前）,2019年1月开始下调其血液透析液钠浓度至136 mmol/L并维持4个月（干预后）。比较所有患者干预前1个月最后1周、干预后1周血液透析前血红蛋白、血白蛋白、血钙、血磷、甲状旁腺激素、收缩压、舒张压及血液透析前后血钠、血液透析间期干体重增长数,记录所有患者使用降压药物种数及血液透析过程中不良事件发生情况。结果　154例患者干预后血液透析前平均血红蛋白、血白蛋白、血钙、血磷、甲状旁腺激素与干预前比较,差异无统计学意义（P>0.05）,干预后血液透析前后平均血钠、血液透析间期干体重增长数、血液透析前收缩压及舒张压、使用降压药物种数较干预前降低（P<0.05）。154例患者干预前后血液透析过程中低血压、肌肉痉挛发生率比较,差异无统计学意义（P>0.05）。结论　轻度下调血液透析液钠浓度可有效降低处于干体重的行维持性血液透析的终末期肾病伴高血压患者血压、血钠,且安全性较高,宜于在基层血液透析机构推广应用。     

红细胞膜Na~+泵缺陷与原发性高血压——多元条件Logistic回归分析

1986年在一个工厂对红细胞膜Na~+泵缺陷与原发性高血压的关系进行了103对配比调查。采用了条件logistic回归分析方法。研究结果提示RBC Na~+的增高,RBCK~+及RBC Na~+,K~+ATPase的降低与高血压有显著的联系;血浆Na~+与体重这两个高血压的主要危险因素均与RBCNa~+K~+ATPase降低有关。提出细胞膜的Na~+泵功能缺陷可能是这两个因素对高血压的共同作用环节。     

普瑞巴林微孔渗透泵片的制备及体外评价

制备日服1次的普瑞巴林微孔渗透泵片,并进行处方优化和释药机制考察。采用单因素试验考察了处方和工艺因素对普瑞巴林释放的影响,并对柠檬酸钠、聚乙二醇400的用量和包衣增重3个因素进行3水平的正交试验。结合单因素和正交试验结果得到最优处方和工艺,最终处方为普瑞巴林82.5 mg,微晶纤维素40%,柠檬酸钠27.5%,硬脂酸镁0.5%,黏合剂为5%聚乙烯吡咯烷酮K30溶液,包衣液为醋酸纤维素和60% PEG400致孔剂,包衣增重为3%。释药动力学研究表明,所制备的微孔渗透泵片释放机制以渗透压机制为主,受pH影响较小。对普瑞巴林微孔渗透泵片释放曲线进行拟合,显示12 h内的释放曲线与零级方程拟合的相关性最高,相关系数为0.991 6,呈零级动力学特征。所得微孔渗透泵片可有效减缓药物释放,可提高药物安全性和减少用药次数,有一定的应用前景。     

Blood pressure control during maintenance haemodialysis with isonatric (high sodium) dialysate

Isonatric (high sodium) dialysis has several advantages, including relative freedom from cramps. The diastolic blood pressures and body weights of nine originally hypertensive patients on maintenance haemodialysis have been recorded for 15 months throughout alternating periods on isonatric (145 mEq/l) and low (132·5 mEq/l) dialysate sodium concentration. Isonatric dialysis resulted in a temporary 1-2 kg increase in mean pre-dialysis weight, requiring increased ultrafiltration. This coincided with a slight increase in mean pre-dialysis diastolic blood pressure which was corrected when post-dialysis body weights were lowered to compensate for the increased weight gain between dialyses. Once the ‘ideal’ individual post-dialysis body weight for each patient was established, pre-dialysis diastolic pressures less than 90 mmHg were achieved routinely. Ten subsequent patients who have never received low sodium dialysis also have well controlled pressures. These findings are contrary to the orthodox view that low sodium dialysis is mandatory to avoid hypertension.     

Studies of red cell cation transport in white and black essential hypertensives

It has been reported previously in white patients with essential hypertension that red cell sodium pump activity as measured by ouabain-sensitive uptake of the potassium analogue ⁸⁶Rb from a potassium-free medium, is very significantly greater than in white controls. In a further study of black (West Indian) subjects reported here no similar abnormality was present in black hypertensives when compared with black normotensive individuals. Red cell rubidium uptake was significantly lower in normotensive blacks than in normotensive whites although sodium pump activity was the same. These results may be relevant to observed racial differences in sodium handling and in the pathophysiology of essential hypertension.     

高血压病患者红细胞钠离子转运及其对降压的反应

本文观察了高血压病(EH)患者的红细胞钠离子转运和血浆内源性类洋地黄物质(EDLC)的变化及硝苯啶和哌唑嗪对其影响,结果:EH患者红细胞的钠泵功能和Na~+-K~+内向协同转运明显低于正常,血浆EDLC显著升高,但其与钠泵非平行改变。经降压治疗,EH患者的钠泵和EDLC明显改善。本文对钠离子转运与EH的关系,及降压药物对其作用作了初步探讨。     

孕妇妊高征发生情况及新生儿出生体重调查

目的调查孕妇孕前体质指数、孕期体重增加情况与妊高征及新生儿出生体重的关系,为降低高危妊娠、巨大儿、低体重儿的发生率提供依据。方法测量623例初产妇孕前体质指数和孕期体重增加情况,并分析妊高征、巨大儿、低出生体重儿的发生情况。结果孕妇孕前体质指数过高则妊高征和巨大儿的发生率明显升高;孕前体质指数过低则低出生体重儿的发生率明显升高;孕妇怀孕期间体重增加过多,则妊高征和巨大儿的发生率明显升高;体重增加过少则低出生体重儿的发生率明显增高,差异均有统计学意义（P〈0．05）。结论孕妇孕前体质指数和孕期增重情况与妊高征及新生儿出生体重有关。要重视母亲孕前体重及孕期体重变化,实现优生优育。     

Sodium Ion Transport by Erythrocytes in hypertensives and Its Response to Antihypertensive Therapy

The transport of sodium ions by erythrocytes and the plasma level of endogenous digitalis-like compound (EDLC) were assessed in 59 patients with essential hypertension before and after theadminstration of nifedipine and prazosin. 20 normal subjects were studied similarly and served as con-trol. It was found that (1) EH patients had a pronounced defect of both the active and passive trans-port of sodium ions by the erythrocytes; (2) a higher plasma level of EDLC was detected in EH pa-tients as compared with that of the control, but the changes of EDLC and soudium pump were notparallel; (3) after the administration of nifedipine and prazosin, the function of sodium pump wasmarkedly improved and the plasma level of EDLC decreased. In addition, the relationship betweenthe transport of sodium ions by erythrocytes and the pathogenesis of EH, and the effects of anti-hypertensive agents were discussed.     

Leucocyte sodium pump activity after meals or insulin in normal and obese subjects: cause for increased energetic efficiency in obesity?

As cellular sodium pumping is an energy consuming process and differences in the obese may account for their energetic efficiency, leucocyte sodium-22 efflux was studied in obese and normal volunteers both in the fasting state and after a test meal or infusion of glucose and insulin intravenously. The 22Na ouabain sensitive efflux rate constant was significantly higher in obese subjects than normal (mean (1 SD) 2.69 (0.40)/h v 2.35 (0.49)/h). Two hours after a 4.2 MJ (1000 kcal) meal there was an increase in the efflux rate constant from its fasting value in normal weight subjects (2.39 (0.33)/h to 2.71 (0.40)/h) but not in obese subjects (2.65 (0.54)/h to 2.61 (0.58)/h). The rise in ouabain sensitive efflux rates was significantly higher in normal than obese subjects. Both groups showed a rise in intracellular sodium concentrations. The euglycaemic clamp produced similar results. Feeding or infusion of insulin increases sodium pump activity more in normal than obese subjects. This difference may contribute to any defective dietary thermogenesis in obesity, which may lead to energetic efficiency and a tendency to gain weight.     

Noradrenaline: a circulating inhibitor of sodium transport

Leucocytes were isolated from venous blood of 11 normotensive volunteers with no family history of hypertension and the sodium efflux rate constants determined both alone and in the presence of increasing physiological concentrations of noradrenaline. There was a significant dose dependent reduction of total sodium efflux rate constant due to a reduction in ouabain sensitive sodium pump activity, glycoside insensitive efflux rate constants being unaffected. The magnitude of this effect was similar to the reduction in leucocyte sodium efflux rate constants observed in hypertensive patients (and their normotensive relatives). The noradrenaline induced depression of sodium pump activity was prevented by propranolol in a further seven experiments, suggesting that the effect was mediated by beta adrenoceptors. Catecholamines possibly functioning as circulating inhibitors of sodium transport may contribute to some of the disturbances in membrane electrolyte handling both in essential hypertension in man and in some experimental models of hypertension.