尼群地平与苯那普利联用治疗老年高血压病疗效观察

目的 :观察尼群地平与苯那普利联用治疗老年高血压病的临床疗效。方法 :将 6 0例老年高血压病人随机分为两组 :对照组 30例 ,单用尼群地平 10mg ,每日 3次口服。联用组 30例 ,尼群地平 10mg ,每日 3次 ,苯那普利 5mg ,每日 2次。两组病人均于用药第 1周、2周、3周、4周各测量两次血压及心电图 ,根据病情调节服药剂量。结果 :联用组在降低血压、减慢心率、改善心电图S—T段下移等方面均优于对照组 (P <0 .0 5 )。结论 :尼群地平与苯那普利联用治疗老年高血压病副作用少 ,只要注意禁忌症 ,治疗老年高血压病是安全有效的。     

原发性高血压患者防治依从性及血压控制达标调查

目的探讨原发性高血压患者防治依从性及血压控制达标情况,为控制原发性高血压的发展提供参考。方法选取2019年5月至2021年12月在庐江县中医院就诊的原发性高血压患者696例为研究对象,对患者进行问卷调查及体格调查,进一步分析不同人群特征、不同防治依从行为对血压控制达标的影响。结果696例原发性高血压患者中血压控制达标率为16.24%(113/696)。禁烟、限制饮酒、减少钠盐摄入、控制体重、适量运动、遵医嘱服药的依从性分别为24.86%、28.45%、64.51%、58.05%、66.38%、83.05%。多因素Logistic回归分析显示,年龄55~69岁(OR=1.567)、文化程度为高中/中专及以上(OR=2.849)、病程≤10年(OR=1.431)、禁烟依从性好(OR=1.852)、限制饮酒依从性好(OR=2.083)、减少钠盐摄入依从性好(OR=3.511)、控制体重依从性好(OR=1.145)、适量运动依从性好(OR=1.670)、遵医嘱服药依从性好(OR=1.399)的高血压患者血压控制达标的可能性较高。结论原发性高血压患者血压控制达标情况有待进一步提高,且与人群特征、防治依从项目密切相关,应针对重点人群、危险因素开展高血压综合防治,提高患者的防治依从性,促进血压控制达标。     

Einflu\ eines Β1-Rezeptorenblockers auf die Plasmaspiegel des atrialen natriuretischen Peptids bei Patienten mit essentieller Hypertonie unter Ergometerbelastung

Summary In order to investigate the behaviour of atrial natriuretic peptide (ANP) in untreated mild to moderate essential hypertension and the influence of blood pressure normalisation by a ₁-receptor blocker a study was conducted in groups of normotensive and hypertensive middle aged subjects. 10 normal subjects and 10 patients with essential hypertension (WHO I–II) without any medication and on betaxolol monotherapy were studied at rest and during graded exercise. In addition the response of ANP, cyclic guanosine monophosphate (cGMP) and the renin-aldosterone-system was investigated.Normal subjects and hypertensive patients did not differ in ANP levels at rest and also responded with a comparable exercise dependent increase at all workload levels. A steady decrease of ANP was noticed during the recovery period in both groups. After-blocker treatment in the hypertensive patients ANP concentrations significantly rose, both at rest and more pronounced during exercise. cGMP reacted in a similar way but showed a more inert response. A counter-regulatory behaviour between ANP and PRA or aldosterone, as seen under volume shifts, could not be detected. These findings demonstrate that plasma ANP is not altered in untreated essential hypertension. Increased ANP levels in ₁-blocker treatment may contribute to its blood lowering effect.

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Abkürzungsverzeichnis ANP atriales natriuretisches Peptid - ALD Aldosteron - C_In Inulin Clearance - cGMP zyklisches Guanosinmonophosphat - irANP immunoreaktives atriales natriuretisches Peptid - PAH Paraaminohippursäure - PRA Plasma-Renin-Aktivität - RAA-System Renin-Angiotensin-Aldosteron-System - RBF renaler Blutflu - RIA Radioimmunoassay - RVR renaler Gefä\widerstand     

高血压病及糖尿病患者肾血流的彩色多普勒速度能量图评价及其影响因素分析

目的：本研究旨在观察高血压病（ＥＨ）及糖尿病（ＤＭ）患者肾动脉血流的彩色多普勒速度能量图（ＣＣＤ）变化并探讨其影响因素。方法：以正常对照组及ＥＨ组,ＤＭ组为研究对象,每组各６０例,均为男３０例,女３０例,对照组年龄３７～７５岁,ＥＨ组４０～７７岁,ＭＤ组４１～７３组,采用ＡＣＵＳＯＮ公司生产的ＡＳＰＥＮ彩色多普勒超声显像仪,探头频率４～２ＭＨＺ及３．５ＭＨＺ,应用ＣＣＤ测量肾动脉主干最大血流速度（     

Evaluation of regional haemodynamics and alterations of vascular wall of the lower limbs in hypertensive subjects

This study was designed to analyse the relationship betweenarterial hypertension and changes in arterial blood flow andvascular wall damage of the lower limbs in hypertensive patientswith various degrees of hypertension. Six hundred and fifty-four hypertensive patients (421 malesand 233 females) aged 35 to 70 years and 88 healthy subjects(63 males and 25 females) aged 39 to 60 years were studied.Strain-gauge plethysmography of the lower limbs was used tocalculate arterial calf blood flow (RF), arterial calf bloodflow after post-ischaemic hyperaemia (PF), basal and minimalvascular resistances (BVR and MVR), time to reach peak flow(tPF), time until 50% reduction of peak flow (tT) and totalrecovery time (tT). In 108 (67 males and 41 females) of the hypertensive patients,a morphological study by echo-Doppler duplex scanning of thepopliteal artery was performed to measure medial-intimal thickeningand popliteal lumen diameter. Our results indicate that regional haemodynamics of the lowerlimbs worsened in hypertensives in comparison with control subjects.In addition, the change in peripheral haemodynamics was relatedto the degree of hypertension. Moreover, medial-intimal thickeningwas significantly (P<0.05) higher in severe hypertensivesthan mild hypertensives. Popliteal lumen diameter was significantly(P<0.05) lower in severe hypertensives than moderate andmild hypertensives. In all these subjects mean blood pressurewas correlated directly (r=0.31; P<0.001) with medial-intimalthickening and inversely (r= – 0.37; P<0.001) withpopliteal lumen diameter. Multiple regression analysis indicatedthat mean blood pressure, age and serum cholesterol were independentlycorrelated to medial-intimal thickening. This relationship wasnot influenced by the diabetic patients and smokers among thegroups. Our results indicate that hypertension impairs peripheral flowand encourages the development of medial-intimal thickening.     

动态血压正常高限者的左室肥厚

目的：观察动态血压为正常高限者的左室肥厚情况,为该患者群靶器官损害的防治策略提供依据。方法：根据２４小时动态血压监测结果将病人分为３组：Ｎ组（正常血压组）、ＮＨ组（血压正常高限组）和Ｈ组（高血压组）。以超声心动图检测左室舒张末期内径,舒张末期室间隔和左室后壁厚度等,计算左室重量指数（ＬＶＭＩ）。结果：Ｈ组（１２９±４１）和ＮＨ组（１１５±３２）的ＬＶＭＩ明显高于Ｎ组（９７±２３,Ｐ＝０．００００１和０．００５）,Ｈ组和ＮＨ组间无统计学差异。结论：动态血压正常高限者左室肥厚程度明显重于血压完全正常者。对该人群亦应积极采取措施预防和治疗靶器官损害     

延髓血管压迫致高血压的犬模型

为制备延髓血管压迫致高血压模型,将１２只杂种犬随机均分为模型组和对照组,采用带蒂大网膜移植法,将裁剪好的大网膜经皮下隧道移植至左侧延髓腹外侧及Ⅸ、Ⅹ颅神经入脑干区（ＲＥＺ）,利用大网膜与延髓表面蛛网膜及软脑膜间形成的血管吻合,造成延髓血管压迫;对照组犬的大网膜移植于其小脑表面。结果,模型组术后血压较术前明显升高（Ｐ＜０．０１）,对照组血压无明显改变,提示原发性高血压与左侧延髓腹外侧受血管压迫有关。     

组织激肽释放酶基因调控序列多态性与高血压关系的初步分析

目的　初步探讨组织激肽释放酶基因调控序列启动子多态性与中国人原发性高血压 (EH)的相关性。方法　应用PCR技术结合等位基因特异寡核苷酸片段分析 (ASO)方法 ,对 40例EH患者和正常人的组织激肽释放酶基因用A、B两种探针检测 ,比较两组间的等位基因分布频率差异 ,初步分析该SNP位点与高血压的关系。结果　组织激肽释放酶基因A、B型在对照组中频率为 65 %、10 % ,在高血压组中频率为 60 %、10 % ,两组比较有差异 ,但无统计学意义。结论　在中国汉族人群中 ,该基因位点确实有多态性 ;A、B两型均有分布 ,以A型最广     

原发性高血压患者瘦素及神经肽Y与血脂的关系

目的　研究原发性高血压患者瘦素及神经肽Y与血脂的相互关系。方法　对 116例原发性高血压患者及 2 6例健康对照者采用放免分析法测量瘦素 (LE)及神经肽Y(NPY)浓度 ,并同时测定血总胆固醇 (CH)、甘油三脂 (TG)及高密度脂蛋白胆固醇(HDL)浓度。结果　高血压组体重指数 (BMI)、血CH、TG、NPY及LEP浓度均显著高于正常对照组 ,而HDL浓度则显著低于正常对照组 (P均 <0 0 1)。相关分析显示 ,LE浓度与收缩压、舒张压、BMI、血CH、TG及NPY浓度呈显著正相关 (P均 <0 0 5 )。结论　血浆瘦素浓度升高可能是原发性高血压发病患机制之一 ,并通过神经肽Y的作用与原发性高血压患者发生血脂紊乱及肥胖有关     

玻璃体切割手术对角膜内皮细胞的影响

目的 观察玻璃体切割手术对角膜内皮细胞影响的相关因素。 方法 回顾分析21 3例玻璃体切割手术患者213只眼手术前及手术后1周、1、3个月时角膜内皮镜检查结果。其中单纯玻璃体切割手术78只眼，玻璃体切割手术联合白内障摘除手术135只眼；硅油填充34只眼，C³F⁸填充53只眼，无眼内填充物者126只眼。 结果 单纯玻璃体切割组、玻璃体切割联合白内障摘除后囊完整组手术前后不同时期角膜内皮细胞数差异无显著性的意义（P均>0.05）；无后囊且眼内填充C³F⁸或硅油组手术后较手术前角膜内皮细胞数明显减少，其差异有显著性的意义（P<0.05）。 结论 玻璃体切割联合白内障摘除且晶状体后囊不完整者，眼内填充C³F⁸或硅油对角膜内皮细胞有一定的损伤作用。（中华眼底病杂志，2004，20：101-103）