66例高血压患者经络诊察的临床分析

目的:观察高血压病的经络反应,探索其临床经络诊断意义.方法:对66例高血压病患者分2种方法进行经络检测:首先,采用康威人体经络特性诊断分析系统,检测分析十二经脉原穴的伏安特性曲线;检验完毕,休息5 min后,采用传统经络诊察法,循按十二经肘膝关节以下及督脉、头背部循行部位有无压痛、结节、条索状反应物等变化.结果:66例高血压患者中,65例经络伏安特性曲线有异常,其中足少阴肾经、足太阳膀胱经均为28例,异常率43.1%为最高;采用传统经络诊察方法,41例有异常经络反应,其中督脉28例,异常率68.3%为最高.结论:高血压病主要异常经络反应是督脉、足少阴肾经、足太阳膀胱经,从而为经络诊断提供临床依据.     

苯磺酸左旋氨氯地平对高血压病颈动脉内膜中层厚度及左室质量指数的影响

目的探讨苯磺酸左旋氨氯地平对高血压病患者颈动脉内膜中层厚度（IMT）及左室质量指数（LVMI）的影响。方法选取高血压病患者80例,随机分为2组。治疗组40例予苯磺酸左旋氨氯地平片2．5～5mg,每日1次口服。对照组40例予硝苯地平片10～20mg,每日2～3次口服。2组均6个月为1个疗程,治疗前后用彩色超声多普勒检测颈动脉IMT和左室相关数据,计算左室质量指数（LVMI）。结果治疗后2组血压与本组治疗前比较差异均有统计学意义（P〈0．05）,2组间比较差异无统计学意义（P〉0．05）;治疗组治疗后颈动脉IMT、LVMI与治疗前比较差异有统计学意义（P〈0．05）,对照组治疗前后IMT、LVMI比较差异无统计学意义（P〉0．05）。结论苯磺酸左旋氨氯地平片可有效降低血压,降低颈动脉IMT、LVMI的增加,改善动脉粥样硬化和左室肥厚。     

Association between Sleep Duration and Hypertension among Adults in Southwest China

Objective:This study aimed to evaluate the association between sleep duration and hypertension among adults in southwest China.Methods:Baseline variables were collected from a representative sample of 20,053 adults aged 23–98 years in southwest China who received physical examinations from January 2019 to December 2020. All participants were categorized into either a hypertension group or a non-hypertension group. Sleep duration was classified as short (<6 h/day), normal (6–8 h/day),or long (>8 h/day). Baseline variables were compared between individuals with and without hypertension by rank-sum tests for two independent samples or χ² tests for nonparametric data. Multivariate logistic regression analysis was performed to evaluate the association between sleep duration and hypertension.Results:The overall incidence of hypertension was 51.2%. Unadjusted analysis showed that the risk of hypertension was higher in individuals with short (<6h/day) or long (>8h/day) sleep durations compared with those with a normal (6–8 h/day) sleep duration. The risk of hypertension was significantly increased by 30.1% in participants with a long (>8h/day) sleep duration compared with those with a normal (6–8h/day) sleep duration (OR = 1.301, P < 0.010, 95%CI = 1.149–1.475). The risk of hypertension was also increased by 1.1% in participants with a short (<6h/day) sleep duration compared with participants with a normal (6–8h/day) sleep duration, but the difference was not significant (OR = 1.011, P = 0.849, 95%CI = 0.905–1.129). After fully adjusting for confounding factors (model 4), the risk of hypertension was increased significantly (by 25%) in individuals with a short (<6h/day) sleep duration (OR = 1.25, P = 0.02, 95%CI = 1.036–1.508) but not in those with a long (>8h/day) sleep duration (17.5% increase) compared with participants with a normal (6–8h/day) sleep duration (OR = 1.175, P = 0.144, 95%CI = 0.946–1.460).Conclusion:The results of this study indicate that a short (<6h/day) sleep duration is related to an increased risk of hypertension, suggesting that sleep helps to protect against hypertension.     

原发性高血压患者发生心房颤动的危险因素及其预测价值

目的探讨原发性高血压患者发生心房颤动的危险因素及其预测价值。方法选取2018年1月至2019年10月在安徽省第二人民医院心内科住院的原发性高血压患者共104例,根据患者有无心房颤动分为观察组(高血压合并房颤,38例)和对照组(高血压未合并房颤,66例),分别对两组一般资料(性别、年龄、高血压病程、吸烟饮酒史、家族史、糖尿病史)、血液生化指标[三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇(LDL-C)、尿酸、肌酐、尿素氮、血浆D二聚体、空腹血糖、纤维蛋白原、血红蛋白、同型半胱氨酸(HCY)]及心脏超声参数[左心房内径(LAD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、右心室内径(RVD)、左心室射血分数(LVEF)]进行单因素、多因素分析,同时通过受试者工作特征(ROC)曲线分析相关指标对此类患者并发心房颤动的预测价值。结果多因素logistic回归分析结果显示,LAD及LVPWT大、HCY高、LDL-C低是原发性高血压患者发生心房颤动的危险因素(P<0.05)。ROC曲线结果显示,LAD、LVPWT、HCY、LDL-C对原发性高血压患者发生心房颤动均具...     

联合用药治疗糖尿病肾病伴高血压的临床观察

目的 探讨联合用药对糖尿病肾病伴高血压患者的临床疗效.方法 将西安市第九医院2011年5月至2012年5月收治的50例糖尿病肾病伴高血压患者随机分为观察组和对照组,对照组（25例）给予依那普利10 ～20 mg/d,观察组在此基础上加用普伐他汀10 mg/d,治疗时间为3个月.观察并比较两组患者的临床疗效以及24 h尿蛋白定量、血压、总胆固醇、三酰甘油、肌酐等指标.结果 观察组总有效率为88.0%,对照组总有效率为72.0%,两组疗效比较差异有统计学意义（P＜0.05）;观察组治疗后TC、TG均较治疗前显著降低（P＜0.05）,且均显著低于对照组（P＜0.05）.24 h尿蛋白较治疗前降低（P＜0.05）,且观察组下降更为明显（P＜0.05）;舒张压和收缩压较治疗前均有显著下降（P＜0.05）.结论 联合用药可以起到保护肾功能和改善糖代谢的双重作用,效果满意,应在临床中推广应用.     

中医药治疗高血压早期肾损害的进展

原发性高血压被认为是当代最大规模的流行病及危害人类健康的主要原因之一,而肾脏作为其主要靶器官之一,常出现严重的损害而导致终末期肾病的发生.目前,对高血压肾损害,特别是早期损害认识不足,对其发病病机及治疗存在一定的误区.因此,重新认识和积极防治逆转高血压肾损害,正确判断预后,特别是早期进行干预治疗成为近年来中西医防治的重点.     

首次通过肺灌注显像对瓣膜性心脏病合并肺动脉高压的临床价值

目的　探讨首次通过肺灌注显像 (FPPPI)联合肺灌注显像 (PPI)对瓣膜性心脏病合并肺动脉高压 (PH)的临床价值。方法　以二尖瓣病变为主的瓣膜病患者 116例 ,术前均行右心导管、FPPPI及PPI、超声心动图检查。其中 10 5例患者术后 5～ 14d再次行FPPPI及PPI,33例患者于术后 3～ 11个月进行第 3次FPPPI及PPI复查。按右心导管测得的平均肺动脉压力 (MPAP)水平分为正常、轻度升高、中度升高、重度升高组。结果　① 116例患者FPPPI法所测肺平衡时间 (LET)、上肺野与下肺野比值 (S L)及超声心动图所测肺动脉压力 (EPAP)与右心导管所测肺动脉收缩压 (SPAP)的r值分别为0 85 6 ,0 5 0 3及 0 5 72 (P <0 0 1)。②以MPAP为标准 ,FPPPI、PPI及FPPPI PPI测定肺动脉压力的灵敏度分别为 94 7%、78 8%及 96 4 % ,特异性分别为 6 8 3%、5 2 8%及 72 7% ,准确性分别为 85 3%、70 7%及 89 7%。③ 10 5例患者术前与术后 5～ 14dLET分别为 (2 7 71± 10 85 )s和 (2 0 96± 6 2 5 )s(P <0 0 0 1) ;S L分别为 1 4 3± 0 4 1和 1 30± 0 35 (P <0 0 0 1)。④LET在MPAP轻度、中度、重度升高组的完全改善率分别为 4 7 6 %、34 5 %及 1 4例 ;部分改善率分别为 4 0 5 %、6 2 1%及 3 4例 (P <0 0 0 1)。S L在各组完     

强化阿托伐他汀治疗高血压并发阵发性房颤的相关性研究

目的观察探讨强化阿托伐他汀治疗对高血压并发阵发性房颤干预治疗的价值及对超敏C反应蛋白（highsensitivity Creaction protein,hsCRP）和低密度脂蛋白胆固醇（LDL-C）水平的影响。方法选择高血压并发阵发性房颤患者98例,随机分成治疗组和对照组,治疗组50例给予阿托伐他汀40mg/d口服,对照组48例给予常规治疗。入选时及治疗3、6、12个月后,检测两组患者hsCRP水平,记录房颤发作频度及持续时间。结果治疗后3个月、6个月时,两组阵发性房颤发生率比较差异无统计学意义（P〉0.05）,而治疗后12个月随访时,治疗组阵发性房颤发生率（14.9%）明显低于对照组（43.5%）,两组间比较差异有统计学意义（P〈0.05）,治疗组hsCRP及LDL-C水平均显著低于对照组（P〈0.05）。结论强化阿托伐他汀治疗可以减少高血压并发阵发性房颤的复发且具有较好的安全性。     

选择性远端脾腔静脉分流术治疗门静脉高压症

目的探讨远端脾腔静脉分流术治疗门静脉高压症的远期疗效。方法用远端脾静脉腔静脉直接吻合分流,并行脾胰断流和胃小弯侧门静脉奇静脉断流。结果分流术后,自由门静脉压平均下降０５３ｋＰａ,并仍维持在３２９±０４４ｋＰａ较高水平;再出血率７５８％;腹水发生率２７３０％;无明显肝性脑病发生;手术病死率７５８％;５年生存率７０４５％。结论远端脾腔静脉分流术是一种较理想的选择性分流术式。     

Urinary electrolytes and hypertension in elderly Kazakhs

Background. Deficiency of potassium (K) intake is associated with hypertension, and high dietary K intake may have a preventive effect. The prevalence of hypertension and incidence of stroke are higher in Kazakhs than in other ethnic groups in the People's Republic of China (PRC). The Barkol area in the Xinjiang region in PRC is an area with a high population of Kazakhs. We carried out a study in this region that involved blood pressure monitoring and the examination of serum and urinary electrolytes in the Kazakh and Han populations of the area. Methods. Twenty-four-hour ambulatory blood pressure monitoring and urine collections were performed for each study subject. In each subject, urine was collected simultaneously for 24 h during the blood pressure monitoring. Serum and urinary electrolytes were measured. Results. The prevalence of hypertension was higher in the Kazakh population than in the Han (men, 53%; women, 43% in the Kazakhs; men, 40%; women, 30% in the Han; P < 0.001). Urinary excretion of potassium was lower in Kazakhs than in Han (Kazakh, 18.9 ± 8.7 mmol/day; Han, 36.5 ± 11.3 mmol/day; P < 0.001). Urinary excretion of sodium was lower in Kazakhs than in Han (Kazakhs, 181.4 ± 77.6 mmol/day; Han, 194.1 ± 75.9 mmol/day; P < 0.001). Mean 24-h blood pressure was higher in Kazaks than in Han, and this value correlated positively with the urinary sodium/potassium ratio (r = 0.39; P < 0.001). Conclusions. The prevalence of hypertension was higher in Kazakhs than in Han in the Barkol area in the Xinjiang region. Kazakhs had a low intake of potassium. The sodium/potassium ratio was higher in Kazakhs than in Han. A high Na/K ratio, together with low intake of potassium, may be a factor in Kazakh hypertension. Received: February 8, 2001 / Accepted: July 5, 2001