简介:Hypertensionisaleadingriskfactorforcardiovasculardisease,theleadingcauseofdeathandmorbidityinoursocietyandonaglobalscale.Majorcomponentsofcardiovasculardiseaseincludestroke,coronaryarterydisease,heartfailure,andchronickidneydisease,inallofwhichhypertensionplaysamajorrole.Theriskofthesecomplicationsincreasesdirectlyandlinearlywithsystolicbloodpressurestartingat115mmHg.Althoughusuallyasymptomatic,hypertensionisreadilydetectableonphysicalexaminationandisamenabletobothlifestylemodificationandpharmacologictreatmentinmostpatients.However,largeproportionsofthehypertensivepopulationremainundetectedandundertreated.Numerousguidelineshavebeenissuedduringthepastfewdecadestopromotedetectionandoptimaltherapy.Despitetheincreaseinriskwithsystolicbloodpressuregreaterthan115mmHg,thegenerallyacceptedthresholdfordiagnosisandtreatmenthasbeensystolicbloodpressuregreaterthan139mmHganddiastolicbloodpressuregreaterthan80mmHgbecauseuntilrecentlytreatmenttolowerlevelshasbeenassociatedwithanunfavorablerelationbetweenclinicalbenefitandharm.Inthepastseveralyears,newguidelines,advisories,commentaries,andclinicaltrialshaveprovidedevidenceforapotentialchangeincurrentrecommendationsforthemanagementofhypertension.Inthisregard,thelong-awaitedeighthreportoftheJointNationalCommitteeonthePrevention,Detection,Evaluation,andTreatmentofHighBloodPressurerecommendedpatientsolderthan60yearsbetreatedtoasystolicbloodpressureoflessthan150mmHg,whichhasgeneratedconsiderablecontroversyandcaution.ThestrikingfindingsoftheSystolicBloodPressureInterventionTrial(SPRINT)havereceivedconsiderableattentionbecauseofthedemonstrationthatintensivetherapytoatargetsystolicbloodpressurebelow120mmHgdecreasescardiovascularmortalityandmorbiditymorethanlessintensivetreatmenttoatargetsystolicbloodpressurebelow140mmHg
简介:目的探讨高血压患者血清同型半胱氨酸(Hcy)水平与肌酐(Cr)、尿酸(UA)、甲状旁腺激素(PTH)的关系。方法根据Hcy水平将189例高血压患者分为Hcy正常组(68例)和Hcy升高组(121例)两组,检测其Cr、UA、PTH水平,分析Hcy与Cr、UA、PTH的关系。结果Hcy升高高血压组患者Cr[(78.65±27.75)μmol/Lvs(61.96±10.97)μmol/L,P〈0.01]、UA[(370.34±93.54)μmol/Lvs(328.04±80.78)μmol/L,P〈0.05]、PTH[(59.51±11.95)pg/mlvs(37.30±10.18)pg/ml,P〈0.05]显著高于Hcy正常高血压组。皮尔逊相关系数分析发现高血压患者中Hcy水平与PTH呈正相关(r=0.66,P〈0.05)。结论Hcy升高的高血压患者易出现Cr、UA、PTH升高,且Hcy水平变化与PTH相关。
简介:目的探讨尿白蛋白肌酐比值(UACR)和胱抑素C(CysC)水平与冠状动脉病变积分(CAS)的关系.方法共入选173例冠心病(CHD)患者,均行冠状动脉造影并计算CAS,同时选取健康成人60名为对照组.检查入选对象血压、血糖、血脂、血清糖化血红蛋白、UACR及CysC水平,比较两组UACR和CysC与冠状动脉病变的相关性.结果冠心病组的UACR和CysC明显高于对照组.冠心病组中双支病变组患者UACR和CysC明显高于单支病变组(P<0.01),而多支病变组患者UACR和CysC显著高于双支病变组(P<0.01).UACR和CysC与ACS积分呈明显的正相关(r分别为0.651,0.649,P均<0.01),冠状动脉狭窄支数越多,UACR和CysC水平越高.结论UACR和CysC与冠状动脉积分呈明显的正相关,且随冠状动脉狭窄病变支数的增加呈相应增高趋势,可初步预测冠状动脉狭窄程度.
简介:ObjectivesToelucidatethepotentialroleofcytokinesinthepathogenesisofcoronaryheartdisease(CHD).MethodsTNF-αandIFN-γactivity,IL-8levelsofplasmaandsupernatantsweremeasuredin62patientswithCHDand30healthcontrolsbymethodsofdirectcytotoxicityassay,cytopathiceffectinhibitiontestandELISArespectively.ResultsBothTNF-αactivityandIL-8levelsofplasmainCHDpatientswerehigherandIFN-γactivityofsupernatantsinCHDpatientswerelowerthanthoseofhealthycontrols(P<0.001),TherehavesignificantdifferencesbetweenhealthycontrolsandthesubgroupsofCHD(P<0.01).IL-8levelsofplasmaincreasedwiththeadvancingofthediseaseandtherehaveobviousdifferencesamongsubgroupsoftheillness(P<0.05).TNF-αactivityofplasmainstableanginapectoris(SAP)subgroupwaslowerthanthoseofunstableanginapectoris(UAP)andacutemyocardialinfarction(AMI)subgroups,thedifferencesbetweenSAPandUAPorAMIweresignificant(P<0.05),ButtherehavenosignificantdifferencesbetweenUAPandAMI(P>0.05).However,IFN-γactivityofsupernatantsshowednodifferenceamonganysubgroups.ConclusionstherehavecloserelationsbetweenTNF-α,IFN-γ,IL-8andCHD.
简介:我院自1998年6月以来,采用“沈大牌”膀胱碎石镜直视下钳夹碎石治疗膀胱结石8例,效果满意,报告如下。
简介:摘要目的探讨在发生骨关节软组织损伤所致肢体肿胀的患者中应用甘露醇加低分子右旋糖酐治疗的临床效果。方法选择2012年1月至2015年1月期间我院收治发生骨关节软组织损伤所致肢体肿胀患者98例,随机分为对照组和观察组,每组49例。对照组给予常规处理,观察组在常规处理基础上给予甘露醇加低分子右旋糖酐治疗,观察两组患者肢体肿胀消退时间和疼痛消失时间以及张力性水泡和骨筋膜室综合征的发生情况。结果与对照组相比较,观察组肢体肿胀消退时间和疼痛消失时间明显缩短(P<0.05),同时张力性水泡形成率和骨筋膜室综合征发生率明显降低,差异具有统计学意义(P<0.05)。结论对于骨关节软组织损伤所致肢体肿胀患者,应用甘露醇加低分子右旋糖酐治疗可有效促进局部肿胀消退和疼痛的消除,明显降低局部张力性水泡和骨筋膜室综合征的发生率,值得临床应用推广。
简介:目的探讨厄贝沙坦氢氯噻嗪对老年高血压患者尿微量白蛋白与尿肌酐比值(UACR)的影响。方法连续入选2012年2月~2015年2月徐州医学院附属医院老年医学科住院126例1级、2级高血压患者,根据UACR分为:正常对照组(UACR〈30mg/g)46例、微量蛋白尿组(30mg/g≤UACR〈300mg/g)43例、临床蛋白尿组(UACR≥300mg/g)37例,3组均给予厄贝沙坦氢氯噻嗪降压治疗,比较3组患者治疗前及治疗后6个月末UACR的变化。结果与治疗前比较,正常对照组、微量蛋白尿组、临床蛋白尿组3组患者治疗后收缩压[(128.93±8.77)mmHgvs.(157.66±9.23)mmHg;(130.18±8.56)mmHgvs.(158.35±8.88)mmHg;(131.54±9.07)vs.(158.66±9.15)mmHg]、舒张压[(79.37±6.15)mmHgvs.(98.93±5.26)mmHg;(80.64±5.84)mmHgvs.(99.24±5.35)mmHg;(80.94±5.59)mmHgvs.(99.36±5.21)mmHg]皆明显下降,差异有统计学意义(P〈0.01)。微量蛋白尿组患者UACR治疗后与治疗前比较明显下降[(143.27±55.73)mg/gvs.(167.22±62.84)mg/g],差异有统计学意义(P〈0.05);正常对照组和临床蛋白尿组患者UACR治疗后与治疗前比较[(18.67±3.97)mg/gvs.(19.53±4.57)mg/g;(348.61±23.52)mg/gvs.(356.17±27.35)mg/g]差异无统计学意义(P〉0.05)。结论厄贝沙坦氢氯噻嗪可有效降低老年高血压患者的血压,并降低微量蛋白尿患者的UACR,对正常范围蛋白尿患者及临床蛋白尿患者的UACR短期作用不明显。
简介:BackgroundEssentialhypertension(EH)hasbecomethemostcommonchronicnon-infectiousepidemicandisoneofthemostcommonriskfactorsforthedamagetoheart,brain,kidneyandotherorgans.TheserumlevelsofICAM-1,IGF-1andIL-8playimportantrolesinthepathogenesisofEH.MethodsInthemedicalcheck-upcenteroftheAffiliatedHospitalofQingdaoUniversityMedicalCollege,sixtynormaloffspringwithafamilyhistoryofEHwererandomlyrecruitedintotwogroups:30offspringwithafatherormothersufferingfromEHassingle-parentgroup,and30offspringwithbothparentssufferingfromEHasdouble-parentgroup,andanother30normaloffspringwhoseparentsdidnotsufferfromEHascontrolgroup.TheserumlevelsofICAM-1,IGF-1andIL-8weredeterminedbyenzyme-linkedimmunosorbentassay(ELISA).ResultTheserumlevelsofICAM-1,IGF-1andIL-8weresignificantlyhigherinbothsingle-parentgroupanddouble-parentgroupthaninthecontrolgroup(P<0.05),andtheserumlevelsofICAM-1,IGF-1andIL-8werehigherinthedouble-parentgroupthaninthesingle-parentgroup(P<0.05).TheserumlevelsofICAM-1,IGF-1andIL-8werepositivelycorrelatedwiththeseverityofbloodpressureelevation(r=0.375,r=0.465,r=0.326,P<0.05,P<0.01,P<0.05respectively).ConclusionsDuetotheinfluenceofheredity,theseruminflammatoryfactorcontentsinnormaloffspringwithEHfamilyhistorymayincreasebeforebloodpressurerise.DetectionofseruminflammatoryfactorsinhealthyoffspringwithafamilyhistoryofEHcouldpredictoccurrenceofhypertension,andprovideamorereliablebasisfortheprimarypreventionofhypertension.