口腔负压治疗原发性高血压及对甲襞微循环影响的初步观察

目的:观察口腔负压对原发性高血压患者的治疗作用,探讨其微循环机制。方法:应用Hices口腔负压仪,对6例原发性高血压患者治疗3个疗程,观察临床治疗效果;8例原发性高血压患者作为对照组;治疗前后所有患者均进行甲襞微循环观察。结果:经口腔负压治疗后,疗效满意,表现为血压、体征不同程度的缓解和消失,总有效率达83.3%,微循环障碍明显改善,由治疗前的中度异常恢复到大致正常,总积分值由3.22±0.22降低至1.89±0.16。结论:口腔负压对原发性高血压患者具有较好的辅助治疗效果,其机制与改善微循环障碍有关。     

原发性高血压与高血压合并脑卒中病人甲襞微循环的观察

高 血压靶病变不仅损害大、小血管 ,而且累及微血管。手指甲襞是人体微循环活体观测的主要窗口。我们观察了 78例中老年原发性高血压及高血压合并脑卒中患者和45例健康中老年的甲襞微循环的变化 ,以探讨高血压及合并脑卒中与微循环的关系。1　资料与方法1.1　临床资料原发性高血压病人 78例 ,按 1999年ＷＨＯ/ＩＳＨ高血压诊断标准分类确诊[1] 。男 5 2例 ,女 2 6例 ,年龄 42～ 81岁 ,平均 6 2 .2± 10 .0 8岁 ,其中单纯高血压病人 43例 ,高血压合并急性脑梗死病人 35例 ,诊断符合 1995年第四届全国脑血管病会议修订的各类脑血管病诊断标准 …     

高血压患者甲襞微循环的动态观察

高血压患者甲襞微循环的动态观察文／徐泮，杜和娟，司维建本文观察３１例高血压病人及３０例健康人的甲襞微循环，以探讨高血压患者的微循环障碍情况。１资料与方法１．１对象按１９８２年２月中华医学会规定的健康老人标准选择健康组与疾病组。其中健康组３０例，男２３...     

依那普利对糖尿病合并高血压患者甲襞微循环的影响

随机观察应用依那普利治疗３８例Ⅱ型糖尿病合并高血压患者甲襞微循环（ＮＭＣ）的变化，依那普利每日５～３０ｍｇ，分二次口服，与口服尼群地平３６例比较。治疗前，糖尿病合并高血压患者均有不同程度ＮＭＣ异常。依那普利治疗１２周ＮＭＣ总改善率９４．７％。糖尿病与高血压病程愈长，ＮＭＣ总改善率愈低。观察同时发现，依那普利治疗优于尼群地平。     

高血压及冠心病患者甲襞微循环观察

高血压及冠心病患者甲襞微循环观察徐章，杨福珍，楚天舒血压与冠心病是以中小血管病变为主的常见心血管病，同时也影响到微循环，我们选择了高血压与冠心病患者各５０例，观察其甲襞微循环表现，并与正常组对照，发现该二种疾病甲襞微循环有明显的改变。１资料与方法１．...     

负压对原发性高血压患者微循环障碍的影响及疗效评价

目的探讨口腔负压对原发性高血压患者微循环的影响 ,并对其疗效进行评价。方法观察6例原发性高血压患者 ,4例为高血压Ⅰ期 ,2例为高血压Ⅱ期且伴有左心室肥厚。应用Hices口腔负压仪(发明专利申请号 :98101665) ;实施负压(0.05±0.01)mPa治疗 ,每日1次 ,每次持续10min ,连续治疗15d后 ,通过微循环显微电视技术对其治疗效果和微循环的变化进行评价。结果治疗前甲襞微循环明显障碍 ,总积分值为3.022±0.216 ,血液流态1.622±0.121 ,16项指标中主要表现为微血管输入枝缩窄、微血流流速变慢呈粒流或粒缓流、红细胞中度聚集。治疗后微循环障碍明显改善 ,总积分降为1.892±0.162 ,与治疗前比较有明显差异 (P<0.01)。4例患者头痛、心慌、头晕症状消失或大部分消失 ,微循环的微血管口径缩窄、红细胞聚集等异常变化缓解 ,微血流流态改善、流速增快 ,微循环障碍减轻 ,显效率为66.7%。1例负压治疗后 ,血压降至临界血压值 ,虽头痛、头晕症状改善 ,但微循环的微血管缩窄和血细胞聚集改善不明显 ,症状体征改善≥50 % ,作为有效 ,有效率16.7 %。1例患者治疗后 ,血压、症状及微循环障碍改善不明显 ,无效率16.7 %。总有效率83.3 %。结论口腔负压治疗能改善原发性高血压患者的微循环障碍 ,尤其对Ⅰ期患者具有明显的治疗作用     

40例高血压病人甲襞微循环观察

本文田XG—5型微循环体视显微镜对10例高血压病人进行甲襞微循环观察。以田牛教授的加权积分法综合分析。结果:微循环改变34例,占85％。管襻数异常占65％。畸形增多占40％。血流速减缓占92.5％。交叉增多占57.5％。红细胞聚集占82.5％。渗出占22.％。出血占25％。皮肤乳头改变占95％。高血压分期不同加权积分值也不同。高血压1期20例,1.59±0.182(P<0.05)。Ⅱ期14例4.06±0.418(P<0.01)。Ⅲ期6例,5.08±0.561(P<0.01)。与正常值相比都有改变。说明高血压对微循环形态、流态、管周状态部有影响。血压越高,改变越明显。     

高血压病人毛细血管压与血压及甲襞微循环的关系

用无创性弹簧压片法,加压阻断毛细血管血流测量高血压病人治疗前后的毛细血管压,并同步观测甲襞微循环和上肢节段性血压。结果发现:治疗前后毛细血管压值分别为8.77±2.47、7.46±1.91kPa,治疗前值明显高于对照组(P<0.01),治疗后较治疗前明显下降(P<0.05)。同时发现高血压病人的毛细血管压与甲襞微循环加权积分值呈正相关(r=0.51,P<0.05);与肱、桡动脉压呈正相关(r=0.597、r=0.563,P<0.05);与指动脉压相关性差(r=0.297、P>0.05)。     

不同危险分层原发性高血压病患者甲襞微循环改变

目的:观察原发性高血压病不同危险分层患者甲襞微循环变化。方法:115例原发性高血压病患者,根据心血管危险分层分为低危组(n=7)、中危组(n=28)、高危组(n=34)和极高危组(n=46),以同期20例年龄、性别匹配的健康志愿者为健康对照组。采用ZL-104型微循环检测仪和微循环图像分析系统检测各组甲襞微血管视野清晰度、管袢长度、管袢数、畸形管袢数、交叉管袢数、输入支管径、输出支管径、袢顶直径、血流速度、红细胞聚集程度、白细胞数、白微栓、袢周渗出、出血、甲襞微血管乳头及乳头下静脉丛的统计学差异。结果:低危组甲襞微循环各项指标与健康对照组比较均无统计学差异(P0.05),中危组到极高危组甲襞微循环渐次出现明显的形态、流态和袢周状态的变化,且与低危组差异均有统计学意义(P0.05)。形态上主要表现为:视野清晰度变差、微循环管袢数减少、畸形管袢数占比增加、输入支管径变细;流态上主要表现为:微血管内血流速度减慢、红细胞聚集增多;在袢周状态上主要表现为:微血管袢周渗出增多。且有高血压危险分层越高,上述改变越严重的趋势。结论:高血压病患者出现与危险分层相关的甲襞微循环改变。甲襞微循环变化对高血压病患者病情评估、治疗与预后判断有重要临床意义。     

63例中老年高血压甲襞微循环对比观察

为了解中老年高血压甲襞微循环改变及其特点 ,笔者于1999年 10月～ 11月对 6 3例中老年高因压进行了甲襞微循环检测 ,同时与 6 1例健康中老年进行了对比观察。1　资料与方法1.1　一般资料老年高血压 (老年组 ) 32例 ,男 14例、女 18例 ,年龄 6 0～ 72岁 ,平均 6 0 .8± 3.5岁 ,高血压 1级 10例 ,2级 9例 3级 13例。中年高血压 (中年级 ) 31例 ,男 15例、女 16例 ,年龄 43岁～ 5 9岁 ,平均 45 .2± 4.2岁 ,高血压 1级 9例 ,2级10例 ,3级 12例。 6 1例健康中老年选自工厂机关健康体检者 ,其中健康老年组 30例 ,男 16例、女 14例 ,年龄 6 0岁～…     

有氧运动在血压控制中的作用

高血压作为一种常见慢性病,是心血管疾病的主要危险因素之一。大量研究表明有氧运动能够降低血压,改善高血压的风险因素,特别是对于血压正常高值人群和高血压患者。本文首先综述了有氧运动对高血压的有益效果和作用机制,即有氧运动能够改善外周血压、中心动脉压和心脏功能,并且对动脉硬化、内皮功能和交感神经系统活动产生有益影响。然后,介绍了高血压患者运动处方的制定规则,及其在不同特征人群中的差异性,如性别、年龄、血压基础值等,并且讨论了过量运动带来的风险和规避方法。最后,针对精准医疗的需求,结合安全性考虑,提出了为制定个性化运动处方需要开展的研究方向。     

原发性血小板减少性紫癜患者甲皱微循环观察及血中5-羟色胺(5-HT)的测定

用不热的光束作为光源,用生物显微镜观察44例原发性血小板减少性紫癜患者的甲皱微循环,观察结果为;甲皱微循环的视野星云雾样不清晰,微血管袢轻度迂曲,颗粒状血流,血管袢顶出血斑块等等,与正常人比较有显著差异。血中5-HT的测定用Curzon的方法,测定结果为:全血5-HT的均值为34.60ng/ml(SD=16.71ng/ml),正常对照为54.28ng/ml(SD=27.16ng/ml)。血浆游离的5-HT均值为13.92ng/ml(SD=3.22ng/ml)。正常对照为12.47ng/ml(SD=2.58ng/ml)。全血的5-HT低于正常对照,血浆游离5-HT则高于正常对照,全血5-HT与患者血小板数呈正相关。本文就血中5-HT的水平与患者的甲皱微循环所见进行了联系分析。     

The effect of acute aerobic exercise on stress related blood pressure responses: a systematic review and meta-analysis

The beneficial impact of regular exercise on cardiovascular health is partly mediated by psychobiological mechanisms. However, the effect of acute exercise on psychobiological responses is unclear. Thus, we performed a systematic review of randomised controlled trials (RCTs) that examined the effect of acute aerobic exercise on blood pressure (BP) responses (the change from baseline to stress) to psychosocial laboratory tasks. Fifteen RCTs met inclusion criteria of which ten demonstrated significant reductions in post-exercise stress related BP responses compared with control (mean effect sizes for systolic and diastolic BP, 0.38 and 0.40). Studies involving greater exercise doses tended to show larger effects, with the minimum dose to show a significant effect being 30 min at 50% VO2max. No other moderators emerged from the examination of participant characteristics, research designs and stressor characteristics. In conclusion, an acute bout of aerobic exercise appears to have a significant impact on the BP response to a psychosocial stressor.     

Gas exchange responses to continuous incremental cycle ergometry exercise in primary pulmonary hypertension in humans

In patients suffering from primary pulmonary hypertension (PPH), a raised pulmonary vascular resistance may limit the ability to increase pulmonary blood flow as work rate increases. We hypothesised that oxygen uptake (V˙O₂) may not rise appropriately with increasing work rate during incremental cardiopulmonary exercise tests. Nine PPH patients and nine normal subjects performed symptom-limited maximal continuous incremental cycle ergometry exercise. Mean peak V˙O₂ [1.00 (SD 0.22) compared to 2.58 (SD 0.64) l · min⁻¹] and mean V˙O₂ at lactic acidosis threshold [LAT, 0.73 (SD 0.17) compared to 1.46 (SD 0.21 · l) ml · min⁻¹] were much lower in patients than in normal subjects (both P < 0.01, two-way ANOVA with Tukey test). The mean rate of change of V˙O₂ with increasing work rate above the LAT [5.9 (SD 2.1) compared to 9.4 (SD 1.3) ml · min⁻¹ · W⁻¹, P < 0.01)] was also much lower in patients than in normal subjects [apparent δ efficiency 60.3 (SD 38.8)% in patients compared to 31.0 (SD 4.9)% in normal subjects]. The patients displayed lower mean values of end-tidal partial pressure of carbon dioxide than the normal subjects at peak exercise [29.7 (SD 6.8) compared to 42.4 (SD 5.8) mmHg, P < 0.01] and mean oxyhaemoglobin saturation [89.1 (SD 4.1) compared to 93.6 (SD 1.8)%, P < 0.05]. Mean ventilatory equivalents for CO₂ [49.3 (SD 11.4) compared to 35.0 (SD 7.3), P < 0.05] and O₂ [44.2 (SD 10.7) compared to 29.9 (SD 5.1), P < 0.05] were greater in patients than normal subjects. The sub-normal slopes for the V˙O₂-work-rate relationship above the LAT indicated severe impairment of the circulatory response to exercise in patients with PPH. The ventilatory abnormalities in PPH suggested that the lung had become an inefficient gas exchange organ because of impaired perfusion of the ventilated lung. Accepted: 17 April 2000     

有氧运动联合康复护理干预在乳腺癌术后淋巴水肿的应用效果

目的 探讨有氧运动联合康复护理干预乳腺癌术后淋巴水肿的应用效果.方法 选取2018年1月至2020年1月间于首都医科大学附属北京世纪坛医院住院治疗的120例乳腺癌根治术后淋巴水肿患者纳入研究,按随机数字表法将其分为对照组和康复组,每组各60例,对照组实施常规临床护理;康复组在常规护理基础上运用有氧运动联合康复护理干预;...     

Impact of moderate versus mild aerobic exercise training on inflammatory cytokines in obese type 2 diabetic patients: a randomized clinical trial

Background

Recently some plasma biomarkers of inflammation have been recognized as important cardiovascular risk factors. There is little information about the effects of aerobic exercise training on these biomarkers and the risk of metabolic complications in obese type 2 diabetes patients.

Objective

To compare the impact of moderate versus mild aerobic exercise training on the inflammatory cytokines in obese type 2 diabetic patients.

Methods

Fifty obese type 2 diabetic patients of both sexes with body mass index (BMI) varying from 31 to 36 kg/m², non smokers, free from respiratory, kidney, liver, metabolic and neurological disorders, participated in this study. Their age ranged from 40 to 55 years. The subjects were included into two equal groups; the first group (A) received moderate aerobic exercise training. The second group (B) received mild aerobic exercise training, three times / week for 3 months.

Results

The mean values of leptin, TNF- alpha, IL2, IL4, IL6, HOMA-IR and HBA1c were significantly decreased in group (A) and group (B). Also, there were significant differences between both groups after treatment.

Conclusion

Moderate aerobic exercise training modulates inflammatory cytokines more than mild aerobic exercise training in obese type 2 diabetic patients.     

Reversible hypertension in primary hyperparathyroidism — Pre-and posteroperative blood pressure in 75 cases

Summary In 75 operatively proved cases of primary hyperparathyroidism (PH) mean systolic and diastolic blood pressure (BP) values were significantly higher pre- than postoperatively. There were 27 patients (36%) who showed hypertension before operation (systolic BP150 mm Hg, mean 169±20 mm Hg). In 20 of these the hypertension was reversible after successful treatment of PH, in seven cases elevated values persisted. The mean age of patients with persisting hypertension was significantly higher than the group with normalization of BP after operation (P<0.01). As far as clinical presentation of PH was concerned it were those cases with hypercalcaemic syndrome and with accidentally discovered hypercalcaemia who most often showed hypertension. In cases with recurrent urolithiasis and with osteitis fibrosa as leading symptoms there was no significant increase of hypertension as compared to the whole group. Because of the relatively high incidence of hypertension in PH this possibility should be taken into consideration in each diagnostic clarification of hypertensive patients.     

RAAS polymorphisms alter the acute blood pressure response to aerobic exercise among men with hypertension

Limited evidence suggests renin–angiotensin–aldosterone system (RAAS) polymorphisms alter the blood pressure (BP) response to aerobic exercise training. We examined if RAAS polymorphisms influenced postexercise hypotension in men with high normal to Stage 1 hypertension. Forty-seven men (44.2±1.4 years, 145.1±1.6/85.5±1.1 mmHg) randomly completed three experiments: seated rest (control) and two cycle exercise bouts at 40% (LITE) and 60% (MOD) of maximal oxygen consumption. Ambulating BP was measured for 14 h after each experiment. RAAS polymorphisms associated with hypertension (i.e. angiotensin converting I enzyme, ACE I/D; angiotensin II type 1 receptor, AT₁R A/C; and intron 2 of aldosterone synthase, Int2 W/C) were analyzed using polymerase chain reaction and restriction enzyme digestion. Repeated measure ANOVA tested if BP differed between experimental conditions by RAAS genotypes. Compared to men with 0–2 variant alleles, men with ≥3 combined RAAS variant alleles had lower average systolic BP (SBP) (P=0.030) and lower average diastolic BP (DBP) (P=0.009) for 14 h only after LITE. In contrast, average BP was not different for MOD and control between RAAS variant allele groups over this time period (P≥0.05). LITE reduced BP in men with ≥3 variant RAAS alleles for 14 h, whereas MOD had no influence on BP in these men. In order to optimally prescribe exercise for its BP lowering benefits in those with hypertension, additional knowledge of how genetic variation affects the BP response to exercise is needed.Sources of Support: Supported by an American Heart Association Grant-in-Aid # 0150507N     

Association of angiotensin-converting-enzyme gene polymorphism with the depressor response to mild exercise therapy in patients with mild to moderate essential hypertension

We studied the association of angiotensin I-converting enzyme (ACE) gene polymorphism with the depressor response to exercise therapy in 64 Japanese subjects with mild to moderate essential hypertension. Each subject performed 10 weeks of mild (lactate threshold intensity: approximately 50% maximum oxygen consumption) exercise therapy on a bicycle ergometer. Systolic blood pressure (SPB), diastolic blood pressure (DPB), and mean arterial pressure (MAP) were significantly decreased by exercise therapy in subjects with the ACE-II and ID genotypes but not in DD subjects. The time-by-genotype interaction effects were significant for DBP and MAP. According to a multiple logistic regression analysis, the age- and baseline plasma renin activity-adjusted relative risk (odds ratio) for the lack of a depressor response conferred by the D allele (assuming an additive effect) was 2.72 [95% confidence interval (CI), 1.07-6.91; p = 0.034]; for DD genotypes, as compared with the DI and II genotypes (assuming that the D allele is recessive), it was 11.7 (95% CI, 2.25-60.6; p = 0.003). ACE gene I/D polymorphism is associated with the depressor response of essential hypertensives to mild exercise therapy, which suggests that genetic features may underlie, at least in part, the heterogeneity of the depressor response in essential hypertensives to mild exercise therapy.     

Bone metabolism and hand grip strength response to aerobic versus resistance exercise training in non-insulin dependent diabetic patients

BackgroundDiabetes mellitus has been shown in many studies to be associated with reduced bone mass and an increased risk of fracture. Currently, our understanding of how to use exercise effectively in diabetic patients in prevention of osteoporosis is incomplete and has prompted our interest to identify the type of effective osteogenic exercise.ObjectiveThe aim of this study was to compare the changes in handgrip strength and bone metabolism after 6 months between aerobic and resistance exercise training in non-insulin dependent diabetic patients in Jeddah area.ResultsThe mean values of serum calcium and Hand grip strength were significantly increased, while the mean values of parathyroid hormone were significantly decreased in both groups .Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment.ConclusionAerobic exercise training on treadmill is appropriate to improve markers of bone metabolism and hand grip strength in non-insulin dependent diabetic patients.