草酸艾司西酞普兰对老年良性前列腺增生伴抑郁患者的总体疗效

目的探讨草酸艾司西酞普兰对老年良性前列腺增生(BPH)伴抑郁患者的总体临床疗效。方法选取104例老年良性前列腺增生合并抑郁症患者,随机分为研究组和对照组,各52例。对照组患者给予常规改善BPH的药物治疗以改善前列腺增生症状,研究组在此基础上给予草酸艾司西酞普兰治疗。比较两组的国际前列腺症状评分(IPSS)、健康调查简表(SF-36)评分和汉密尔顿抑郁量表(HAMD)的评分变化。结果治疗前两组患者上述量表评分组间无明显差异(P0.05)。治疗后两组患者的IPSS评分均低于治疗前且研究组患者的IPSS评分低于对照组;治疗后研究组HAMD评分显著低于对照组;两组患者治疗后SF-36评分均升高,且观察组高于对照组,上述差异均有统计学意义(P0.05)。结论老年良性前列腺增生伴抑郁患者在常规改善BPH药物的基础上给予草酸艾司西酞普兰治疗,能够更好地改善其抑郁症状及前列腺增生症状,并能提高患者生活质量。     

脑出血患者尿动力学参数对治疗和预后的影响

目的评价尿动力学参数在脑出血患者中的检测意义及其对治疗方案和预后的影响。方法选择驻马店市中心医院82例脑出血伴前列腺增生患者(观察组),以同期80例脑出血无前列腺增生患者作对照,进行尿动力学参数(最大尿流率、残余尿量、膀胱顺行性、初始尿意容量、最大膀胱容量、逼尿肌最大压、最大尿流率时伴逼尿肌压力、最大尿道闭合压)检测,观察治疗前、治疗后7、30d的生活质量评分及前列腺国际症状评分(IPSS)。结果观察组残余尿量、逼尿肌最大压、最大尿流率时伴逼尿肌压力、最大尿道闭合压显著高于对照组(P0.05)。治疗后7d及30d2组生活质量评分显著高于治疗前(P0.05),治疗后7d与30d的生活质量评分比较差异无统计学意义(P0.05)。观察组治疗后7d及30d的IPSS显著低于治疗前(P0.05),治疗后30d的IPSS显著低于治疗后7d(P0.05)。结论对脑出血伴前列腺增生患者尿动力学参数进行检测,可指导治疗方案的选择,从而改善患者生活质量及临床症状。     

特拉唑嗪治疗老年性高血压并前列腺增生的临床观察

高血压及前列腺增生症均为老年男性的常见病，高血压并前列腺增生也不少见。我们应用特拉唑嗪治疗老年高血压井前列腺增生取得较好疗效，现报道如下。1 对象与方法1．１ 一般资料 将门诊应诊的原发性高血压患者８８例，按照ＷＨＯ／ＩＳＨ诊断标准，收缩≥１４０ｍｍＨｇ，舒张压≥９０ｍｍＨｇ，入选病人年龄６０～８６岁，平均７４．３２± ６．１６岁，常规检查血糖、血脂尿素氮、肌酐、心电图、心脏超声及前列腺Ｂ超1．２ 治疗方法 所有入选病人随机分为特拉唑嗪组４６例，口服特拉唑嗪１ｍｇ，每日２次，卡托普利组４２例，口服卡托普…     

珍菊降压片治疗原发性高血压的疗效观察

目的：观察珍菊降压片对原发性高血压的疗效。方法：67例原发性高血压患者为观察对象，珍菊降压片0．48g/次，每日3次，4周为1疗程，用药前及用药期间测右臂坐位血压，并观察症状改善情况。结果：本方法对高血压患者均有效，症状好转，无明显不良反应。结论：采用珍菊降压片治疗高血压病，无论在降压、缓解症状等方面疗效满意，且副作用小，病人易于接受。     

帕金森病并发排尿障碍的研究进展

帕金森病患者表现为运动障碍的同时,70%伴有排尿障碍。帕金森病引起的排尿障碍表现为刺激症状和梗阻症状,通常以刺激症状为主。其发病与纹状体多巴胺神经元减少及D1受体机能低下有关。对帕金森病引起的排尿障碍症状多采用国际前列腺症状得分(IPSS)评定。IPSS调查表可用于测定排尿障碍的严重程度及区分梗阻和刺激症状。目前治疗帕金森病的方法有药物治疗、手术治疗及其它对症治疗。     

前列腺增生术后患者的性功能与生活质量、心理状况的相关性

目的分析前列腺增生术后患者的性功能与其生活质量、心理状况的相关性。方法选取我院100例前列腺增生患者,均在我院行尿道前列腺切除术,依据患者术后国际勃起功能评分(IIEF)分为轻中度组(n=50)与重度组(n=50),对比两组患者的一般资料,医院焦虑与抑郁量表评分(HADS),生活质量评分量表(SF-36),以及最大尿流速(Qmax)、排空后残余尿量(PVRU)。结果两组患者的年龄、病程、收入情况、工作状况以及文化程度等一般资料比较没有统计学意义(P0.05);对照组的生活质量评分,最大尿流速高于观察组,焦虑、抑郁评分以及排空后残余尿量低于观察组(P0.05);最大尿流速和生活质量与性功能障碍呈负相关,抑郁评分、焦虑评分及排空后残余尿量与性功能障碍呈正相关(P0.05)。结论前列腺增生术后患者的生活质量以及心理状态与其性功能密切相关,提高患者健康生活质量,缓解其焦虑、抑郁情绪可以预防术后性功能障碍的出现。     

缬沙坦治疗轻中度原发性高血压的疗效观察

目的：观察缬沙坦对轻中度原发性高血压患者降压疗效及耐受性。方法：33例轻中度原发性高血压患者口服缬沙坦80mg，每天晨服一次，总疗程6周。服该药后第4周若舒张压降至90mmHg以下，则继续治疗至第6周，若舒张压超过或等于90mmHg，则增加剂量为160mg，每日晨服一次至第6周。结果：用缬沙坦治疗2周起，收缩压、舒张压均显著下降（P＜0．01），至第6周降压幅度最显著（P＜0．001），6周降压治疗总有效率82％，用药前后心率无明显变化，不良反应少而轻。结论：缬沙坦治疗轻中度高血压有效、安全。     

脑卒中急性期血压变化规律及影响因素的研究

目的 观察脑卒中急性期血压变化规律及其影响因素.方法 研究发病24h内入院的急性脑卒中患者704例.监测入院后7d内血压,收集详细病史资料,对病程中伴发疾病进行评分,记录入院后血压的管理方式及干预时间等.运用简单和多因素统计方法进行数据的统计分析.结果 脑卒中急性期血压升高,并且存在自发下降趋势,8h内下降最明显,36h趋于稳定.其中脑梗死患者血压在入院30h内趋于稳定,脑出血患者血压在入院96h内趋于稳定.出血性卒中患者血压要高于缺血性卒中患者.缺血性卒中患者TOAST分型和OCSP分型间血压无显著差异.神经功能缺损程度影响入院时和入院后36h内血压.独立影响入院时收缩压的因素有卒中类型、入院时NIHSS评分、心脏病史、高血压史,其中心脏病史与入院时血压成负相关.独立影响入院时舒张压的因素有卒中类型、年龄、入院NIHSS评分、高血压史.年龄与入院时舒张压呈负相关.独立影响7d内平均收缩压的因素有卒中类型、入院NIHSS评分、伴发疾病评分、心脏病史、高血压史、既往史评分.心脏病史与7d平均血压呈负相关.影响入院7d内舒张压的因素有卒中类型、年龄、伴发疾病评分、入院NIHSS评分、心脏病史.心脏病史和年龄与7d平均舒张压呈负相关.结论 脑卒中急性期血压升高,并有自发性下降趋势.卒中类型及高血压史与血压呈正相关,心脏病史及年龄与血压呈负相关.     

长沙脑血管病综合预防对队列人群血压的影响

目的　评价队列人群血压的变化及综合预防对血压的影响。方法　 1987年在长沙市按整群随机抽样的原则选取一个干预人群和一个对照人群 ,并对 35岁以上居民进行脑血管病危险因素调查。对干预组进行 14年的脑血管病危险因素综合干预。结果　干预组和对照组 35岁以上社区人群人均收缩压 (SBP)和舒张压 (DBP)及高血压患病率均随年龄增加而增加 ,经过 14年干预后 ,干预组 35岁以上人群人均SBP和DBP低于对照组 ,干预组人群高血压患病率明显低于对照组。结论　队列人群血压及高血压患病率有随年龄增加而升高的趋势 ,脑血管病危险因素的综合干预是降低此种趋势的重要途径。     

原发性高血压模型大鼠颌骨骨量的吸收*★◆

背景：近年研究发现，高血压病患者中骨质疏松发病率较正常人群增高。 目的：观察原发性高血压与颌骨及牙槽骨吸收的关系。 方法：选用原发性高血压大鼠，随机分为模型组和给药组，正常大鼠作为对照组。模型组和对照组均进食未添加降压药物的普通标准饲料颗粒，给药组进食添加有降压药物的标准饲料颗粒。 结果与结论：模型组大鼠从10~22周龄收缩压逐渐上升，22周龄后血压趋于稳定。给药组和对照组血压较低且平稳。同一周龄大鼠血压值模型组>给药组>对照组(P < 0.01)。模型组和给药组大鼠下颌骨骨量均低于对照组(P < 0.01)。模型组骨皮质较薄，骨小梁稀疏、纤细、弯曲不整或断离，骨髓腔扩大，给药组骨质病理变化程度较模型组减轻。结果证实，血压升高可引起原发性高血压大鼠下颌骨骨量减少，使骨小梁变细、排列紊乱，从而增加牙槽骨吸收的风险。     

Assessment of voiding dysfunction in Parkinson's disease by the international prostate symptom score

OBJECTIVES: To find the incidence of voiding dysfunction in Parkinson's disease and to examine the relation between the voiding dysfunction and various indices of the disease (disease severity, disease duration, age, sex, and treatment with antiparkisonian drugs), the presence of voiding dysfunction was quantitatively estimated in patients sampled on the unselected (consecutive) basis. METHODS: Using the international prostate symptom score, lower urinary tract symptoms were quantitatively evaluated in all patients with Parkinson's disease visiting this neurological clinic during 1 month. RESULTS: Of the 203 patients who had completed the questionnaire, 55 (27%) were considered to have symptomatic voiding dysfunction. The degree of lower urinary tract symptoms in these patients was well correlated with the severity of the disease rather than with the disease duration or the age. Thirty three (16%) patients had irritative symptoms alone, whereas three (1.5%) patients had obstructive symptoms alone. The irritative and obstructive symptoms were concomitant in 13 (6%) patients. Quality of life was disturbed by lower urinary tract symptoms, and this disturbance paralleled the severity of the disease. The influence of antiparkisonian drugs on the lower urinary tract symptoms was uncertain. The incidence of lower urinary tract symptoms seemed to be independent of sex, but obstructive symptoms were prevalent in male patients. CONCLUSIONS: This study suggests that voiding dysfunction in patients with Parkinson's disease progressively develops at advanced stages (> or =Hoehn and Yahr stage 3 of the disability). The International prostate symptom score is useful in evaluating the voiding dysfunction of neurodegenerative disease in both men and women, not only reflecting prostatic symptoms.     

Relationship between urinary symptoms and disease-related parameters in multiple sclerosis

Objective To find the prevalence of voiding dysfunction in patients with multiple sclerosis and to examine the relationship between the voiding dysfunction and various parameters of the disease (disease severity, disease duration, lesion site, age and sex). Methods Using the International prostate symptom score, lower urinary tract symptoms were quantitatively evaluated in all patients with multiple sclerosis who had visited our neurological department during three months. The lesion site in the central nervous system was determined by a combination of neurological and magnetic resonance imaging findings. Results Of the 47 patients who had completed the questionnaire, 25 (53 %) were considered to have symptomatic voiding dysfunction. Even at early stage of the disability, 6 of 19 (32 %) patients were symptomatic. Eight (17 %) patients had irritative urinary symptoms alone, whereas 9 (19 %) patients had obstructive urinary symptoms alone. The irritative and obstructive symptoms were concomitant in 10 (21 %) patients. Compared with reports from Western countries, the ratio of obstructive symptoms to irritative symptoms was high in Japan. The degree of irritative symptoms was well correlated with the disease severity, whereas the correlation of obstructive symptoms with the disease severity was less significant. Irritative symptoms also showed a weak correlation with the disease duration, but obstructive symptoms did not. Among the lesion sites in the central nervous system, only the presence of the spinal cord lesion was related to the degree of urinary symptoms. Urinary symptoms were not significantly influenced by the age or the sex. Quality of life was disturbed by urinary symptoms, and this disturbance paralleled the disease severity. Conclusion Urinary symptoms, especially irritative symptoms, reflect the condition of the disease. Thus, the quantified urinary symptoms may assist neurological diagnosis. Received: 5 September 2001 Received in revised form: 28 January 2002 Accepted: 1 February 2002     

Hypotensive akathisia: autonomic failure associated with leg fidgeting while sitting

The author describes a distinct clinical syndrome in six patients with autonomic failure who manifested habitual, voluntary, transiently suppressible, yet irresistible leg movements occurring only in the sitting position. Keeping the legs still brought on vague symptoms of fatigue, lightheadedness, or apprehension. Repetitive leg crossing, muscle tensing, foot twirling or wiggling, or heel or toe floor tapping while sitting may have compensated for orthostatic hypotension and raised systolic blood pressure by a mean of 28 mm Hg and diastolic pressure by a mean of 11 mm Hg.     

Adaptive defense use and resting blood pressure in a population-based sample

OBJECTIVES: There is an accumulating body of research related to the psychosomatic study of blood pressure. One variable that has received attention is defense use. We examined the relation between defense use and blood pressure in men and women of different ages. METHODS: A random sample of 667 participants was selected from a population-based study. Resting blood pressure was obtained, and each participant was rated for defense use by a trained observer using Defense-Q. An Adaptive Defense Profile (ADP) score was calculated for each participant, and this score was related to blood pressure. RESULTS: Regression analyses revealed a significant main effect for the ADP score for both diastolic and systolic blood pressure. Those persons with higher ADP scores had lower diastolic and systolic blood pressure. As well, a significant Age x Sex x ADP score interaction was found for diastolic blood pressure. Older women with a less ADP score had higher diastolic blood pressure. CONCLUSIONS: These findings suggest the continued investigation of defense use and blood pressure.     

Structural cardiac changes as a predictor of respiratory complications after adenotonsillectomy for obstructive breathing during sleep in children

BACKGROUND AND PURPOSE: To determine the association between structural cardiac changes and postoperative respiratory complications after adenotonsillectomy for obstructive breathing during sleep. PATIENTS AND METHODS: Forty-eight children, ages 2-18 years, undergoing adenotonsillectomy for obstructive breathing during sleep were recruited for this case control study. The case group consisted of 24 children with postoperative respiratory complications after adenotonsillectomy who also had an echocardiogram. An equal number of children without postoperative respiratory complications after adenotonsillectomy were recruited as controls. Left ventricular mass (LVM) was calculated from 2D guided M mode echocardiographic measurements of the left ventricle. Left ventricular mass index (LVMI) was calculated as left ventricular mass/height(2.7). Left ventricular hypertrophy (LVH) was defined as LVMI index greater than the 95th percentile for age. The two groups were compared for demographic variables and cardiac structure. RESULTS: The two groups did not significantly differ by age, height, gender or racial distribution. LVH and right ventricular (RV) dimension greater than the 95th percentile for age remained significantly associated with the occurrence of postoperative respiratory complications after controlling for body mass index (BMI) Z score, age, gender, race, systolic and diastolic blood pressure. CONCLUSIONS: The increased prevalence of structural cardiac changes in the group with complications (P<0.01) suggests an underlying cardiac origin for postoperative respiratory complications in this group of children.     

高血压脑出血血肿清除术后影响血压变化的因素

目的：探讨影响高血压脑出血血肿清除术后血压变化的因素。方法：对６５例高血压脑出血血肿清除术的临床资料采用多因素逐步回归法进行统计学处理。结果：与术后收缩压有关的自变量为：年龄、出血破入脑室、小脑出血、术前收缩压等，且为正相关。与术后舒张压有关的自变量为：小脑出血、出血破入脑室、基底节内侧型、术前舒张压，为正相关。结论：下列情况易出现高血压脑出血血肿清除术后的血压波动：（１）年龄〈５５岁；（２）术前     

Cerebrovascular risk factors and incident depression in community-dwelling elderly

Objective: The ‘vascular depression’ hypothesis suggests that late‐life depression results from vascular brain damage. We studied the longitudinal association between cerebrovascular risk factors and incident depression in a large population‐based study. Method: Two thousand nine hundred and thirty‐one persons with the age of ≥61 years were followed up. Data on a comprehensive set of cerebrovascular risk factors were collected at baseline. Participants received a psychiatric assessment 5 years later to establish DSM‐IV diagnoses. Results: Only current smoking and antihypertensive drug use were independently associated with incident depressive symptoms. Diabetes mellitus and the Framingham stroke risk score were related to incident depressive disorder. No relation with depression was observed for cholesterol, diastolic and systolic blood pressure, history of cardiovascular disease, atrial fibrillation, left ventricular hypertrophy or the use of statins and anticoagulants. Conclusion: These results moderately support the ‘vascular depression’ hypothesis.     

Pathogenic and protective factors of type A behavior in adolescents

This study was based on our previous findings, which suggested that there are two different Type A behaviors: aggressive, maladjusted competition combined with a low self-esteem and social competition combined with a high self-esteem and healthy ambitions. The hypothesis whether these factors are related to different risk levels of coronary artery disease was studied in 990 randomly selected adolescents. Type A behavior was self-evaluated by the subjects and assessed by their mothers using the AFMS questionnaire. Somatic risk variables were serum total cholesterol, LDL, HDL, serum triglycerides, body mass index, pulse frequency, systolic blood pressure and diastolic blood pressure. It was found that a high level of serum lipids and pulse frequency were related to a low score on a suggested non-risk Type A factor and a high score on a suggested risk factor. Relationships between Type A factors and diastolic or systolic blood pressure were not found.     

Effect of meal size on postprandial blood pressure and on postural hypotension in primary autonomic failure

In chronic autonomic failure, food ingestion causes a profound and rapid fall in supine blood pressure and aggravates postural hypotension. Food volume and caloric load are important determinants of gastric emptying and postprandial splanchnic hyperaemia, which appears to be a major contributor to hypotension. We therefore compared the cardiovascular effects of three large meals with six small meals providing an identical daily caloric intake, in seven subjects with primary autonomic failure. Daytime ambulatory blood pressure (BP) was measured by Spacelabs 90207 every 30 min with additional recordings while lying, sitting and standing, 30 min after each meal. Systolic and diastolic BP were lower in all three positions after large meals; systolic 131 versus 151 mmHg (large versus small), p=0.005, 109 versus 124 mmHg, 89 versus 103 mmHg and diastolic 76 versus 90 mmHg, p=0.02, 66 versus 78 mmHg, p=0.07 and 50 versus 66 mmHg, p=0.06 for lying, sitting and standing, respectively. Between meals, BP fell to lower levels with large meals, 88 (20) mmHg versus 104 (19) mmHg, p=0.002 and 48 (13) mmHg versus 63 (13), p=0.0001 mmHg for systolic and diastolic pressure respectively. Five subjects had more symptoms of postural dizziness after large meals. In primary autonomic failure, smaller and more frequent meals reduce postprandial hypotension and diminish postural symptoms post-meal. This is likely to be a useful non-pharmacological method in the management of postprandial hypotension.     

氯氮平治疗精神分裂症引发代谢综合征危险因素研究

目的 探讨氯氮平治疗的精神分裂症患者发生代谢综合征（metabolic syndrome,MS）的危险因素.方法 入组单一使用氯氮平治疗的精神分裂症患者108例,收集患者的年龄、性别、吸烟情况、代谢疾病家族史、服药时间、服药剂量、体质量指数（BMI）、腰围、血压、阳性和阴性综合征量表（PANSS）评分、空腹血糖、甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白、低密度脂蛋白.以是否发生MS分为两组,分析组间代谢相关因素的差异,并进行Logostic回归分析.结果 MS组的腰围、TG、空腹血糖、收缩压、舒张压高于非MS组（P＜0.05）;MS组的年龄、吸烟史、TC、服用氯氮平时间、BMI高于非MS组（P＜0.05）.而MS组的PANSS量表总分低于非MS组（P＜0.05）;经Logistic回归分析筛选,年龄（P=0.008）、腰围（P =0.002）及PANSS总分（P=0.011）进入回归方程.结论 氯氮平治疗发生MS的精神分裂症患者,具有更高的年龄、吸烟比率、腰围、服药时间、BMI、空腹血糖、血压、甘油三酯及胆固醇水平,但精神症状评分较低.发生MS的独立危险因素为：高龄、腰围增加、精神症状评分较轻.