关于高血压病诊治的几点刍议

血压“不高”能否诊断为高血压 ?血压的“高”“低”是基于群体的诊断阈值来确定 ,还是应由个体的基础血压值来确定 ?高血压治疗是否都得一律“达标”,能否允许有个体差异的例外 ?高血压“终生治疗”是否指“终生服降压药”?这些问题常使医生在实际工作中陷入困境 ,也给高血压健康教育带来难题。前不久 ,美国高血压预防检测评估及治疗联合委员会第七次报告 (JNC7) (美国指南 )和欧洲高血压学会 /欧洲心脏学会(ESH/ ESC)高血压指南 (欧洲指南 )先后出台 ,引发了国内外高血压相关学术界广泛争议 ,立论仁智互见 ,推动了认识的深化。《中国…     

血浆和血小板内维生素E浓度的增龄性改变

为了检测维生素E(VE)在人增龄过程中的作用,有必要确定VE营养状态是否随着增龄而发生变化。因此,作者通过液相层析法研究了血浆总脂和四型(α、β、γ和δ)VE的浓度,并从这些标本中测出血小板内每一型VE的浓度。 24～91岁志愿者48名,空腹12小时后采集血浆     

老年人发热的问题

老年人的感染,临床上往往只有些非特异性表现或没有任何症状。在原有的疾病基础上又添增了感染以及机体困生物学老化储备力降低时,就造成老年人日常活动减少,意识模糊和尿失禁。此时老年人感染就缺乏常见的体征,确诊也就更成问题。这些预期应出现的体征中,发热就是其中一项。     

景德镇市儿童血铅水平及相关因素分析

目的:了解景德镇市儿童血铅水平及影响因素。方法:用石墨炉原子吸收光谱法测定4 761例儿童末梢血铅浓度,并进行铅中毒因素的调查。结果:景德镇市儿童平均血铅水平为(79.29±105.68)μg/L,有1 108例儿童血铅水平>100μg/L,陶瓷业家庭儿童血铅水平为(153.31±197.76)μg/L,明显高于非陶瓷业家庭儿童血铅水平(72.58±119.26)μg/L,t=136.83,P<0.01。结论:景德镇市儿童尤其是陶瓷业家庭儿童铅中毒状况不容乐观,应引起全社会重视,并应采取综合措施防治儿童铅中毒。     

老年性甲状腺功能亢进误诊分析

老年性甲状腺功能亢进(甲亢)临床上并非罕见。但本病的临床表现不如青年型甲亢典型,易误诊、漏诊。尤对其临床表现多样化,特别是以甲亢外某一系统症状为突出表现者仍易被疏漏而延误治疗。一般资料 1981～1984年间,三单位收治老年人不典型甲亢百余例,误诊43例,资料保存完整     

儿童群体非致死性损伤的基础研究

<正> 1981年,美国有700万6岁以下的儿童,1,500万6～16岁的青少年遭受损伤,美国儿童夭折的首位原因也是各种类型的损伤。本文使用随机数字拨号电话普查法(Random-Digit-Dialing Telephone Sampling),调查加利福尼亚圣地亚哥港14岁以下的儿童群体,重点咨询看护儿童人员。调查中,认真答复询问者1,595人,374人拒绝答复,8人在询问途中不继续合作。结果: 一、住户的特征91.5%自称是孩子的主要看护人,其中约1%是儿童的亲属,86%是母亲,9%是父亲。每个家庭中孩子的中位数为2人,83%的家庭有1～2个孩子,仅4%家庭的孩子数是4个或4个以上。涉及儿童2,183人,其中35%是男孩,     

小儿饮食与心血管疾病

<正> 改变小儿饮食是否能降低日后心血管疾病的发生有待阐明。1983年,英国国家营养教育咨询委员会(NACNE)为英国人制定了营养守则,但第二年该委员会中的食品政策医疗问题委员会(COMA)对推荐的食谱特别强调不应包括5岁以下的小儿。营养师们对促进健康的饮食特别重视;而儿童营养师则对改变小儿饮食尤其小心。     

抑郁对急性心肌梗死大鼠心室重构的影响及其机制探讨

Objective To observe the effect of depressive disorder on ventricular remodeling and its mechanism in acute myocardial infarction (AMI) rats. Methods Forty-six AMI Wistar rats were randomly divided into sham-operation (n=10), AMI (n=12), depression (n=12), neurostan by open field test, and the detection of angiotensin Ⅱ (Ag Ⅱ ), aldosterone (ALD), malondialdehyde (MDA), superoxide dismutase (SOD) were performed, the pathological sections were observed under light and electron microscopes. Results Compared with sham-operation group, depression group had decreased values of squares crossing times, rearing times and grooming time, increased time of staying in the central square and defecation. Compared with depression group, AMI and neurostan treatment groups had increased values of squares crossing times, rearing times and grooming time,decreased time of staying in the central square and defecation (F=16. 9, 44.56, 71.79, 34.86,29. 18, P＜0.01). At the 4 week of test, the left and right ventricular relative weights (LVRW,RVRW) and thickness of interventricular septum were (1.63±0.15) mg/g, (0. 48±0. 10) mg/g and (1.75 ± 0. 38) mm in sham-operation group, the corresponding data were (2.06±0.21) mg/g,(0.62±0.10) mg/g and (2.25±0.30) mm in AMI group, (2.90±0.47) mg/g, (1.00±0.28) mg/gand (2.58±0.34) mm in depression group, (2.20±0.34) mg/g, (0.67±0.15) mg/g and (2. 25±0.23) mm in neurostan treatment group. Compared with sham-operation group, AMI, depression and neurostan groups had obviously increased values of LVRW, RVRW and thickness of interventricular septum. Compared with depression group, AMI and neurostan groups had decreased LVRW, RVRW and thickness of interventricular septum (F=6.31, 21.9, 115.7, 9.91, P＜0.05). And the depression also could aggravate edema and injury of ultrastructure in myocardial tissue. The values of AgⅡ , ALD, MDA and SOD were (1957.5±662.6) ng/L, (0.453±0.111) ng/L, (16. 00±3.03)nmol/L and (80.57 ± 7.00) U/ml in depression group, the corresponding data were (1143.8± 98.0)ng/L, (0.198±0.087) ng/L, (8.03 ± 0.44 ) nmol/L and (95.20 ± 4.87) U/ml in sham-operated group, (1407.5±255.8) ng/L, (0.295±0.027) ng/L, (11.18±4.30) nmol/L and (87.33±3.51)U/ml in AMI group, (1400.0±239.0) ng/L, (0.326±0.073) ng/L, (11.88±3.36) nmol/L and (89.13 ±0.17) U/ml in neurostan group. After 4 weeks, the values of Ag Ⅱ , ALD and MDA increased in depression group while the level of SOD reduced (F=6.58, 11.9, 11.39, 8. 82, P＜0.05). Conclusions Depressive disorder after AMI in rats can aggravate ventricular remodeling and lower the ability of antioxygen.