依那普利联合氯沙坦治疗老年糖尿病肾病合并高血压的疗效

目的观察依那普利联合氯沙坦治疗老年糖尿病肾病(DN)合并高血压的临床疗效。方法 70例DN患者随机分为观察组38例及对照组32例,对照组常规治疗的基础上给予氯沙坦治疗,观察组在对照组基础上加用依那普利,两组均连续治疗12周。结果两组均有较佳的降压疗效,组间无显著差异(P0.05);治疗后两组血肌酐(Scr)、尿素氮(BUN)及24小时尿微量白蛋白排泄率(UAER)均较治疗前显著下降(P0.01),且观察组显著低于对照组(P0.05或P0.01)。结论依那普利联合氯沙坦治疗老年糖尿病肾病合并高血压疗效确切,其对肾功能的改善效果较单用氯沙坦更优,且不增加不良反应。     

江苏省农村高血压防治知识知晓及治疗依从性分析

目的：分析江苏省农村地区高血压患者防治知识知晓和依从性情况及其影响因素,为探索农村高血压县乡村协作管理策略提供依据。方法：采用率等描述性分析防治知识知晓和治疗依从性,通过χ2检验和Logistic回归等推断性分析影响因素。结果：高血压防治知识知晓率为75.6%（苏南64.8%,苏中74.6%和苏北84.0%）,婚姻状况、文化程度和地区是影响因素;88.2%患者的服药依从性较好（苏南92.9%,苏中92.6%和苏北79.0%）,地区和防治知识知晓情况是影响因素。结论：不同地区需结合自身特点,组建县乡村高血压纵向协作团队,提高患者防治知识知晓和治疗依从性。     

原发性高血压患者颈动脉内膜中层厚度与踝臂指数的相关性研究

目的探讨原发性高血压患者颈动脉内膜中层厚度（IMT）与踝臂指数（ABI）的关系。方法156例原发性高血压患者作为高血压组,137例健康体检者作为对照组,所有患者行双侧颈动脉内膜中层厚度（IMT）及踝臂指数（ABI）的测定。结果①高血压NIMT大于对照组（P〈0．05）,ABI小于对照组（P〈0．01）。（参高血压组IMT与ABI呈负相关（R〈0．01）,对照组二者无显著相关性（P〉0．05）。结论ABI可作为高血压患者颈动脉粥样硬化的指标,适合作为高血压人群常规筛查的手段。     

312经络锻炼法对函授学员高血压病的疗效研究

目的 研究312经络锻炼法（简称312）以函授班形式教学,对原发性高血压病近、中期疗效追踪及相关机理。方法 40例函授班学员有高血压病者,进行教、学、练、督导312,自身对照分组。于312前及后第1,3,6,12个月分别观察其症状、体征、血压、用药、疗效等指标的变化,数据综合分析总结;并与以往面授班者作比较。结果 ①血压：40例于312后1,3,6个月与312前比较各均有显著性差异,P〈0.01（图1、表1）。②疗效：症状其他指标,用药指标等相应地有所好转。312后1,3,6个月显效率逐渐递增,各分别为18%,35%,42.5%;总有效率各为95%,97%,100%;无效率各分别为5%,2.5%,0%,呈逐渐递减趋势,（表2）。③本文函授班血压和疗效结果与以往面授班者比较,完全等同。结论 312函授班对高血压病有良好效果。     

Inverse association between total testosterone concentrations,incident hypertension and blood pressure

Background.?Studies on the relationship between testosterone concentrations and blood pressure have yielded inconsistent results. Therefore, this study investigated the prospective association of total testosterone (TT) concentrations with risk of incident hypertension and blood pressure change in 1484 men aged 20–79 years.

Methods.?Data from the population-based Study of Health in Pomerania, Germany, were used. Serum TT concentrations, measured by chemiluminescent enzyme immunoassays, were categorised into age-specific quartiles. Generalised Estimating Equation (GEE) models, adjusted for age, waist circumference, physical activity, smoking and alcohol consumption were specified.

Results.?During a median follow-up time of 5.0 years, the prevalence of hypertension increased from 50.6% to 57.1%. TT concentrations were significantly lower in men with baseline and incident hypertension. Analyses revealed that men with baseline TT concentrations in the lowest quartile had an increased risk of incident hypertension (odds ratio (OR), 1.19 (95% CI, 1.10–1.28)) compared to men with higher TT concentrations. Furthermore, we found a significant inverse association of TT concentrations and blood pressure, showing that men with baseline TT concentrations in the lowest quartile showed the slightest change in systolic blood pressure (?6.01?mmHg), diastolic blood pressure (?2.11?mmHg) and pulse pressure (?3.98?mmHg). Sensitivity analyses in a subpopulation of men without antihypertensive medication confirmed these findings.

Conclusion.?These results show that low male TT concentrations are predictive of hypertension, suggesting TT as a potential biomarker of increased cardiovascular risk.     

Sleep quality and stress in women with pregnancy-induced hypertension and gestational diabetes mellitus

BackgroundPregnant women with complications including pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM) often experience disrupted sleep patterns because of activation of the sympathetic nervous system. These pathologies are aggravated by sympathetic nervous system activation and may be related to stress. The present study aimed to clarify the characteristics of and changes in sleep quality and stress in pregnant women with PIH and GDM during the second and third trimesters.MethodsWe enrolled 56 women in their second or third trimesters who were diagnosed with PIH or GDM. Participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS). Secretory immunoglobulin A (SlgA) concentrations were measured as a biological indicator of stress.ResultsPSS scores and subjective stress parameters were significantly higher than those reported from previous studies of healthy pregnant women (15.2 points and 15.1 points for the second and third trimesters, respectively).Mean one-day values for SIgA were 168.3 and 205.7 μg/mL for the second and third trimesters, respectively. During the second and third trimesters, SIgA scores were higher than those reported for healthy pregnant women in previous studies. The PSQI component scores sleep disturbance (C5) and sleep duration (C3) in follow up case were significantly higher in the third trimester than in the second trimester.DiscussionThis investigation suggests that pregnant women with PIH and GDM experience higher stress levels than do non-pregnant women and healthy pregnant women. Further, our results indicate that sleep quality worsens during the third trimester compared with the second trimester.     

苯那普利对原发性高血压左室肥厚与QT离散度的干预

目的 :探讨苯那普利对原发性高血压 (EH)左室肥厚 (LVH)与QT离散度 (QTd)的干预作用。方法 :对 36例EH伴有LVH患者给予口服苯那普利 10mg/日 ,1次 /日 (qd) ;服药 4周时若患者BP≥ 16 0 /10 0mmHg ,则苯那普利剂量增加至 2 0mgqd ,总疗程 2 6周。治疗前后用彩色超声多普勒检测左室相关参数 ,并计算出左室重量指数 (LVMI) ;用ECG计算出QTd、校正的QTd(QTcd)。结果 :(1)治疗后的LVMI、QTd和QTcd分别较治疗前显著降低 ,差别具有显著性 (P <0 .0 1)。 (2 )治疗前的QTd、QTcd分别与治疗前的LVMI呈显著正相关 (r =0 .79,P <0 .0 1及r =0 .77,P <0 .0 1) ,治疗后的QTd和QTcd的降低程度分别与LVMI降低程度呈显著正相关 (r =0 .77,P <0 .0 1及r =0 .75 ,P <0 .0 1)。结论 :苯那普利能有效地逆转EH患者LVH ,降低QTd、QTcd ;QTd与QTcd可作为LVH逆转的评估指标。     

西部农村地区高血压患者随访服务利用研究

目的:了解中国西部农村地区高血压患者随访服务利用现状及随访满意度影响因素,为加强西部高血压随访管理效果提供依据? 方法:数据来源于2014年西部少数民族地区乡村卫生服务一体化专项调查,采用分层随机抽样的方法,在青海农村?青海牧区?内蒙古和新疆4个地区共调查880例高血压患者?运用?字2检验和二分类Logistic回归模型进行数据分析? 结果:4个地区患者一年内接受4次及以上的随访服务比例?面对面随访比例?被告知下一次随访时间比例分别是72.7%?88.3%?64.2%,各地区间差异有统计学意义(P均< 0.05);61%的患者认为无论病情如何都有必要随访,各地区患者随访认知存在统计学差异(P < 0.05)?随访满意度的Logistic回归模型显示地区?离最近医疗单位距离?近一年随访次数?告知下次随访时间是统计显著性的影响因素?结论:西部农村地区应提供个性化随访方式,加强高血压及其并发症的防治宣传,创新慢性病管理方式,促进患者参与随访?     

服刑高血压患者的疾病认知与健康行为调查分析

目的:了解监狱内服刑高血压患者的疾病认知和健康行为,从而探讨高血压的危险因素和防治措施。方法:采用自拟调查表对某监狱所有高血压患者的疾病认知和健康行为进行问卷调查、体格检查,采用Pearsonχ2检验等方法进行统计学分析。结果:300例高血压患者对疾病认知度总体较高,吸烟(χ2=56.43、P<0.001),饮酒(χ2=299.63、P<0.001),BMI≥24(χ2=89.71、P<0.001),每天睡眠时间小于6小时(χ2=69.36、P<0.001),不锻炼(χ2=32.67、P<0.001),不合理饮食(高钠等)(χ2=126.96、P<0.001),心情抑郁、紧张、焦虑(χ2=235.63、P<0.001)与高血压疾病密切相关。结论:服刑高血压患者的健康行为、BMI等与疾病相关性高,建议加强健康教育和健康促进、增加运动并控制体重指数,减轻精神压力以保持平衡心理。