老年高血压患者左室质量与动脉僵硬度关系探讨

摘要目的：探讨老年高血压患者左室肥厚与动脉僵硬度的关系。方法：左室质量指数（LVMI）和脉搏波传导速度（PWV）分别作为评价左室肥厚和动脉僵硬度的指标，对108例老年高血压病患者的LYMI与PWV及其他影响因素之间进行简单相关分析及逐步回归分析。并对不同程度左室肥厚的PWV值进行比较。结果：LYMI与PWV、收缩压、舒张压、脉压、高血压病程、性别及体质量指数呈正相关，与高血压的治疗呈负相关。PWV、高血压治疗、性别和舒张压进入最优回归方程。PWV在左室肥厚者明显高于无左室肥厚者，左室肥厚越明显则PWV越高（F=24．473，P〈0.001）：结论：动脉僵硬度增加是导致老年高血压患者左室肥厚的重要原因。     

肱踝脉搏波速度对老年男性急性冠状动脉综合征后再发心血管事件的预测价值

目的 探讨肱踝脉搏波速度(baPWV)对老年男性急性冠状动脉综合征后再发心血管事件的预测价值.方法 选择急性冠状动脉综合征人院的老年男性患者118例,年龄61～92岁,平均(76.6±6.7)岁.测量baPWV、血生化指标等.随访时间平均(617±297)d,记录终点事件(不稳定性心绞痛、心力衰竭、心原性死亡、脑卒中等)的发生情况.结果 无事件组90例,baPWV为(17.48±3.54)m/s,有终点事件组和主要终点事件组baPWV分别为(21.91±4.86)m/s和(24.48±4.39)m/s,与无事件组比较差异有统计学意义(均P＜0.05).共有28例患者发生心血管事件30人次,其中主要终点事件12人次.采用受试者工作特征曲线确定baPWV预测全部终点事件的截断点为19.51 m/s,主要终点事件的截断点为20.52 m/s.多变量Cox比例风险模型显示以上两个截断点的相对危险度差异均有统计学意义(P＜0.01),分别为全部终点事件相对危险度1.37(95%可信区间:1.16～1.63),主要终点事件相对危险度=1.71(95%可信区间:1.23～2.36).结论 baPWV能够作为老年男性急性冠状动脉综合征后再发心血管事件的预测指标.     

老年单纯收缩期高血压患者大动脉弹性的改变

目的：探讨老年单纯收缩期高血压患者大动脉弹性的改变。方法：采用动脉硬化检测仪测定56例健康老年人、79例老年单纯收缩期高血压（IsH）患者和50例老年双期高血压（SADH）患者的臂-踝脉搏波速度（baPwV）作为衡量大动脉弹性的指标。结果：老年单纯收缩期高血压患者baPWV显著高于老年双期高血压患者和健康老年人（P〈0．05,P〈0．01）;baPWV与收缩压（r=0．467,P=．000）和年龄（r=0．460,P=-0．000）呈显著正相关,收缩压和年龄是baPWV最主要的影响因素。结论：随着年龄的升高老年单纯收缩期高血压患者的大动脉弹性明显减低。     

综合治疗对老年代谢综合征的干预效果

代谢综合征(MS)以肥胖、高血糖、血脂异常以及高血压等聚集发病,其主要危害是引发糖尿病和心脑血管疾病[1].随着社会的发展和人们生活方式的改变,MS从1999年命名至今,发病率逐年升高,严重影响人们的生活质量甚至危及生命.     

肱踝脉搏波速度对老年男性急性冠状动脉综合征后再发心血管事件的预测价值

Objective To explore whether brachial-ankle pulse wave velocity (baPWV) can be used as a predictor of recurrent cardiovascular events in elderly male patients with acute coronary syndrome (ACS). Methods The baPWV and biochemical indicators were measured in 118 elderly men with ACS, aged 61-92 years (mean age 76.6±6.7 years). During the follow-up period (617±297 days), all cardiovascular events (unstable angina, heart failure, cardiac death and stroke, etc.)were recorded. Results The baPWV was (17.48±3.54)m/s in non-event group(n=90),(21.91±4.86) m/s in event group and (24.48±4.39) m/s in major endpoint event group, respectively (both P＜0. 05). There were 30 cardiovascular events that occurred in 28 patients, including 12 major endpoint events. The receiver operating characteristic curve demonstrated that the cut-off point of baPWV for predicting a cardiovascular event was 19.51 m/s and that for predicting a major endpoint event was 20.52m/s. The multivariate Cox proportional hazards model demonstrated that the above cut-off points had significantly relative risk for cardiovascular event: 1.37(95% CI: 1.16-1.63)and for major event:1.71(95% CI: 1.23-2.36). Conclusions The baPWV can be used as a predictor of recurrent cardiovascular events in elderly men with ACS.     

老年男性踝臂指数与冠心病的关系

目的:通过无创的方法测量踝臂指数(ABI),评价其作为老年男性冠心病危险因素的地位和作用。方法:随机选取符合实验设计条件的61例老年男性(>65岁)冠心病患者(30例)和非冠心病患者(31例)作为患者组和对照组,分别测量踝臂指数(ABI)和其它相关变量。采用t检验、二分类logistic回归等方法进行统计处理。结果:经统计学处理两组踝臂指数(ABI)比较,患者组比对照组踝臂指数低(t=47.664,P<0.05)具有统计学意义;logistic回归显示,ABI(OR=0.533,95%CI,0.399～1.521,P<0.05)与脉压(OR=1.367,95%CI,0.536～1.998,P<0.05)、C反应蛋白(OR=1.701,95%CI,1.363～1.952,P<0.05)等传统的冠心病危险因素一同进入回归方程。结论:本实验设计从根本上排除了高血脂和糖尿病对血管造成危害而引起的混杂因素,从而更能说明ABI的降低可能是冠心病的独立危险因素之一。     

心绞痛患者采用丹红注射液治疗的临床疗效观察

目的：观察丹红注射液治疗心绞痛的疗效。方法：入选心绞痛患者108倒,随机分为治疗组56例,对照组52例。治疗组用丹红注射液30ml加入5％葡萄糖250ml中静脉滴注,1次／d。两组均连续给药10d,分别在治疗前后进行心电图检查及患者症状检测。结果：治疗10d后治疗组和对照组有效率分别为92．84％和82．68％,差异有统计学意义（P〈0．05）。结论：丹红注射液治疗·心绞痛有优越性,值得临床进一步研究。     

肱踝脉搏波速度对老年男性急性冠状动脉综合征后再发心血管事件的预测价值

Objective To explore whether brachial-ankle pulse wave velocity (baPWV) can be used as a predictor of recurrent cardiovascular events in elderly male patients with acute coronary syndrome (ACS). Methods The baPWV and biochemical indicators were measured in 118 elderly men with ACS, aged 61-92 years (mean age 76.6±6.7 years). During the follow-up period (617±297 days), all cardiovascular events (unstable angina, heart failure, cardiac death and stroke, etc.)were recorded. Results The baPWV was (17.48±3.54)m/s in non-event group(n=90),(21.91±4.86) m/s in event group and (24.48±4.39) m/s in major endpoint event group, respectively (both P＜0. 05). There were 30 cardiovascular events that occurred in 28 patients, including 12 major endpoint events. The receiver operating characteristic curve demonstrated that the cut-off point of baPWV for predicting a cardiovascular event was 19.51 m/s and that for predicting a major endpoint event was 20.52m/s. The multivariate Cox proportional hazards model demonstrated that the above cut-off points had significantly relative risk for cardiovascular event: 1.37(95% CI: 1.16-1.63)and for major event:1.71(95% CI: 1.23-2.36). Conclusions The baPWV can be used as a predictor of recurrent cardiovascular events in elderly men with ACS.     

法安明治疗不稳定型心绞痛的临床观察

心绞痛的产生主要由于心肌缺氧。心肌能量来源主要是葡萄糖、自由脂肪酸、乳酸盐、丙酮酸盐、乙酸盐及乙酰乙酸盐等基质。在缺氧情况下,局部乳酸、磷酸等酸性代谢产物及组织胺蓄积,这些化学产物刺激局部传入神经,通过第1～4胸交感神经节传导到相应脊髓节段,经传入神经传至大脑皮质产生痛觉,因此内脏疼痛常反应在脊髓相应阶段的脊神经所分布的皮肤区域,所以心绞痛常反映为胸痛,主要是胸骨后和左心前区,亦可向左肩、左臂、左下颌、颈部等部放射。