心脑血管病社区干预效果及人群依从性分析

目的：了解城市社区人群在心脑血管病防治上的需求和社区人群对干预措施的依从性。方法：从北京上海和长沙三城市社区年龄在３５岁以上的人群中随机抽取了３１８８名调查对象,采用面对面的问卷方法调查。结果：在３１８８名被调查者中,６１．９２％的被调查者关心医学保健知识。５５％以上的被调查者从宣传单中、３６％以上的被调查者从黑板报中获取心脑血管病、高血压和糖尿病防治知识。９０％以上的被调查者受到社区内开展的健康     

音乐疗法对心胸外科患者焦虑抑郁的影响

目的 探讨音乐疗法对心胸外科患者心理状态的影响.方法 将80例心胸疾病患者随机分为观察组40例和对照组40例,对照组实施常规护理,观察组在此基础上由专门培训的医护人员实施音乐干预.干预前后采用抑郁自评量表（SDS）、焦虑自评量表（SAS）对两组患者进行评估.结果 干预后观察组SDS、SAS值与对照组比较,差异有统计学意义（P〈0.05,P〈0.01）.结论 音乐疗法可以明显改善心胸外科患者心理状态,减轻患者的抑郁焦虑情绪.     

541例受检者心脏脚踝血管指数影响因素观察

目的探讨影响人群心脏脚踝血管指数（cardio ankle vascular index,CAVI）临床的相关因素。方法随机入选541例受检者,男性167例,女性374例,年龄21～86（56．2±12．4）岁。询问病史,使用VS-1000动脉硬化检测仪测量CAVI,分析年龄、性别、疾病、血压对CAVI测量值的影响。结果541例受检者中健康组285例,疾病组256例。CAVI检测阳性150例（27．7％,150／541）。在健康组人群,控制年龄因素后,性别与CAVI无相关性;在控制性别因素后,年龄与CAVI测量值呈较强的正相关,相关系数左右两侧分别为0．724、0．725（P均〈0．01）。各疾病组CAVI值均高于健康组,但在控制年龄因素后,各疾病组CAVI值与健康组未见显著差异。在控制年龄、性别、疾病因素后,收缩压与舒张压均与CAVI测量值呈弱正相关,与收缩压的相关系数左右两侧分别为0．267、0．299,与舒张压的相关系数左右两侧分别为0．189、0．211,（P均〈0．01）。结论年龄是影响CAVI测量值的最重要因素,随年龄增大CAVI值增高。     

长沙市区老年职工心脑血管疾病与生存质量关系分析

目的随着世界精神文明，物质文明的提高，老年人的平均寿命年龄逐步延长，老年人的生存质量被提到老年医学重要讨论课题，本文旨在探讨心脑血管疾病对老年人生存质量的影响。方法采用中华医学会老年医学组设计的“老年生存质量调查问卷”对５５５例６０岁以上企业职工中有无心脑血管疾病者进行比较研究，数据通过ＩＢＭ－ＰＣ／ＸＴ微机作统计学处理。结果主客观评价显示：心脑血管疾病患者生存质量水平明显低于无心、脑血管疾病者（Ｐ＜０．０１）。经多元逐步回归分析，其显著影响因素，依次是：年龄、吸烟、生活事件、体力活动、酗酒及体型６项。结论认为建立合理的生活方式和加强心理卫生指导是当前防治老年人心脑血管疾病的关键措施。     

NT-proBNP与维持性血液透析患者预后的相关性研究

目的探讨维持性血液透析患者血清中N末端B型钠尿钛前体（N-terminal pro-B-type natriuretic peptide,NT-proBNP）水平及其变化对患者预后的影响。 方法选取天津医科大学第二医院2013年12月至2014年12月收治的300例维持性血液透析患者,分别测定患者入组时和6个月后血清NT-proBNP水平,并随访1年,分析NT-proBNP水平及其变化与患者并发症、死亡发生的关系,以及与生存预后的关系。 结果300例维持性血液透析患者的NT-proBNP水平均高于正常值。（1）有、无并发症透析患者的原发病、血管通路及NT-proBNP水平均存在明显差异,差异有统计学意义（χ²=7.670、5.293,Z=-2.374、-2.787;P<0.05或0.01）,其余各相关因素的差异均无统计学意义（均P>0.05）;以性别、年龄、原发病、血管通路、透析龄、基线及6个月后NT-proBNP为自变量,以是否发生心脑血管并发症为因变量做Logistic回归分析,未发现各因素与心脑血管并发症发生有关（均P>0.05）。（2）存活透析患者与死亡透析患者的原发病、血管通路及NT-proBNP水平均存在明显差异,差异有统计学意义（χ²=8.572、5.911,Z=-4.447、-5.086;P<0.05或0.01）,其余各相关因素的差异均无统计学意义（均P>0.05）;以性别、年龄、原发病、血管通路、透析龄、基线及6个月后NT-proBNP为自变量,以是否死亡为因变量做Logistic回归分析,结果显示血管通路、透析龄、基线及6个月后NT-proBNP与死亡风险有关（P<0.05或0.01）。（3）半年内NT-proBNP的升高幅度<1 000 ng/L的患者,其并发症及死亡发生率高于升高幅度≥1 000 ng/L的患者,但差异无统计学意义（χ²=1.05,P>0.05）。（4）Kaplan-Meier生存分析显示,NT-proBNP≥5 000 ng/L患者的平均生存时间较NT-proBNP<5 000 ng/L患者短,差异有统计学意义（χ²=9.964,P<0.05）。 结论维持性血液透析患者NT-proBNP水平升高,其升高幅度与心脑血管并发症和死亡风险呈正相关。     

A preliminary report on physical activity patterns among children aged 8–14 years to predict risk of cardiovascular diseases in Malwa region of Punjab

ObjectiveTo determine the pattern of physical activity specific to age and gender among young Indian school going girls and boys aged 8-14 years.DesignCross-sectional study.SettingPrivate and government sponsored schools in Patiala and Mansa District of Punjab, India. Participants: Two hundred thirty four school going girls and boys aged 8–14 years.MethodologyA structured questionnaire recorded the various forms of daily physical activity, sedentary activity as well as physical activity level of all the participants. The energy expenditure was also calculated using the standard metabolic equivalent index.ResultsThere is a significant difference between mean weights of participants belonging to different physical activity levels (p < .04). In comparison to boys, the girl participants have significant lower values of physical activity duration as well as total metabolic equivalent expenditure (p < .05). The total duration of moderate/vigorous physical activity declined in both girls and boys as the age increased.ConclusionPhysical activity among children in Northern regions of India is on decline as their age increases especially among girls. It is important to determine physical activity duration in early age groups and motivate children for daily physical activity.     

Limb performance and patient satisfaction after radial artery harvesting: endoscopic versus open techniques

Background  The differences in hand functionality after harvesting the radial artery for coronary artery bypass grafting (CABG) in an endoscopic technique relative to open technique are unclear. Methods  One hundred and sixty-four patients who had CABG and their non dominant hand radial artery was harvested either in an open technique (n = 92) or in an endoscopic technique (n = 72) in a period of 9.8 ± 3.5 months after the operation were studied. Surgical technique was surgeon specific. Patients were asked either five questions (endoscopic group), or six questions (open group), to assess how radial artery harvesting affected them. Results  Significantly more patients in the open group experienced significant limitations in their work and regular daily activities (12% versus 0%, p = 0.02), social activities (13% versus 0%, p = 0.005), and experienced significant pain (8% versus 0%, p = 0.04) compared with the endoscopic group. More patients in the open group complained that their arm incision disturb them (24% versus 10%, p = 0.01). Forty-two patients (46%) in the open group would prefer smaller incision. A “limitation score” variable was created from the first four questions to reflect overall functionality. Severe limitation was present in 3% of the open group versus 0% in the endoscopic group (p = 0.04). Female sex and open harvesting technique were found to be independently associated with higher limitation score. Conclusions  After a mean of 9.8 months after surgery, patients reports good overall upper-limb function. However, more patients in the open technique had significant disabilities and dissatisfaction.     

心脏跳动中手术治疗主动脉窦瘤破裂的临床体会

目的评价心脏跳动中手术治疗主动脉窦瘤破裂的疗效。方法将1996年1月～2011年11月我院收治的83例主动脉窦瘤破裂患者随机分为不停跳组（42例）和停跳组（41例）。对两组患者术前一般情况、心功能情况、手术时间、体外循环时间等进行分析。结果不停跳组体外循环时间、呼吸机使用时间均短于停跳组（P〈0.05）;正性肌力药使用量少于停跳组（P〈0.01）;随访中停跳组有2例术后10年发生中度主动脉瓣反流,不停跳组一例术后7年发生中度主动脉瓣反流。结论在浅低温心脏不停跳直视下治疗主动脉窦瘤破裂安全、有效,对合并主动脉瓣关闭不全的处理应该更加积极。