肾小球滤过率估测值评判老年高血压及2型糖尿病并发终末期肾病患者血红蛋白浓度的变化

目的探讨用肾小球滤过率估测值(eGFR)评判的老年高血压及2型糖尿病并发终末期肾病(ESRD)患者血红蛋白(Hb)浓度改变。方法收集高血压及2型糖尿病并发慢性肾病且≥60岁患者230例,将eGFR<15ml.min-1.1.73m-2(7.80±3.14ml.min-1.1.73m-2)者归为ESRD组,eGFR≥15ml.min-1.1.73m-2(29.76±12.90ml.min-1.1.73m-2)者归为非ESRD组,回顾性比较两组间Hb浓度。结果较非ESRD组〔Hb(100.8±23.0)g/L〕,ESRD组Hb浓度〔(74.4±22.5)g/L〕显著降低(P<0.05),且在ESRD与非ESRD组中eGFR均与Hb浓度显著正相关(P<0.05)。结论eGFR评判的老年高血压及2型糖尿病并发ESRD患者Hb浓度显著降低,且eGFR与Hb浓度具有显著正相关性。

麝香保心丸联合常规西药治疗气滞血瘀型老年慢性心力衰竭临床观察

目的:观察麝香保心丸联合常规西药治疗气滞血瘀型老年慢性心力衰竭的临床疗效。方法:按照随机数字表法将本院90例气滞血瘀型老年慢性心力衰竭患者分为对照组与治疗组各45例。对照组给予常规西药治疗,观察组在对照组用药基础上联合麝香保心丸治疗。治疗后观察2组心力衰竭症状和心功能的改善情况;观察2组治疗前后的呼吸困难程度评分和左室射血分数(LVEF)、每搏输出量(SV)的变化;记录2组治疗期间的不良反应发生情况。结果:治疗组总有效率为86.7%,高于对照组的60.0%(P<0.05)。治疗前,2组呼吸困难程度评分及LVEF、SV比较,差异均无统计学意义(P>0.05)。治疗后,2组呼吸困难程度评分均较治疗前下降(P<0.05),LVEF与SV均较治疗前升高(P<0.05);治疗组的呼吸困难程度评分低于对照组(P<0.05),LVEF与SV均高于对照组(P<0.05)。治疗期间,2组均未发生严重不良反应。结论:麝香保心丸联合常规西药治疗气滞血瘀型老年慢性心力衰竭,可有效改善患者的心功能和呼吸困难状况,且用药安全。

丹参注射液辅助机械通气对急性肺损伤老年患者肺保护的疗效以及血流动力学影响

目的探讨丹参注射液对急性肺损伤老年患者机械通气后的肺保护疗效以及血流动力学的影响。方法选择2015年11月-2018年11月收治的急性肺损伤老年患者共120例,按随机数字表法分为对照组和观察组,每组均60例,两组患者均给予机械通气。对照组给予常规治疗。观察组在对照组基础上采取丹参注射液静脉滴注,10~20 mL/次,1次/d,连续治疗2周。比较两组血气分析、肺功能、血流动力学。结果治疗2周后,观察组患者的肺泡-动脉氧分压差(AaDO2)、呼吸指数(RI)明显低于对照组以及氧合指数(OI)、用力肺活量(FVC)、第1秒钟用力呼吸量(FEV1)、第1秒用力肺活量占预计值百分比(FEV1%)明显高于对照组(P<0.01);治疗2周后,观察组患者的平均动脉压(MAP)、心率(HR)、心指数(CI)、每搏量指数(SVI)明显高于对照组(P<0.01)。结论丹参注射液能改善急性肺损伤机械通气老年患者的血流动力、动脉血气指标,对肺保护的疗效确切。

鲑鱼降钙素联合阿仑膦酸钠维D3片及钙剂治疗老年骨质疏松的临床效果观察

文章对比观察用或不用鲑鱼降钙素治疗老年骨质疏松的临床效果,探讨鲑鱼降钙素联合阿仑膦酸钠维D3片对老年骨质疏松骨痛、骨密度及生活质量的影响。结果显示,鲑鱼降钙素联合阿仑膦酸钠维D3片治疗老年骨质疏松,可有效缓解骨痛症状、改善骨密度、提高生活质量,效果显著。

Plasma Hemoglobin Was Decreased in Elderly With Primary Hypertension and/or Type 2 Diabetes Complicated With End-stage Renal Disease

Objectives To study the change in plasma hemoglobin concentration in elderly patients with primary hypertension and/or type 2 diabetes complicated with end-stage renal disease （ESRD） determined by estimated glomerular filtration rate. Methods Two hundred and thirty cases of Chinese patients aged 60 years or older with primary hypertension and/or type 2 diabetes complicated with chronic kidney disease were enrolled in the study. Patients with chronic kidney disease were divided into ESRD group with estimated glomemlar filtration rate less than 15 mL . min^-1.1.73 m^-2 （7.80 ± 3. 14 mL. min^-1 . 1.73 m^-2） and non-ESRD group with estimated glomerular filtration rate 15 mL.min^-1 . 1.73 m^-2（29. 76 ± 12. 90 mL.min^-1 . 1.73 m^-2） or higher. The plasma hemoglobin concentration was compared between the above two groups retrospectively. Results There was significant decrease in plasma hemoglobin concentration in ESRD group compared with non-ESRD group （74.4 ± 22. 5 g/L vs 100. 8 ± 23.0 g/L, P 〈 0. 05 ）. After stratification by sex, there was also significant decrease in plasma hemoglobin concentration both in male and female of ESRD groups compared with their respective non-ESRD groups（77. 2±22. 0 g/L vs 104. 9 ±20. 7 g/L; 69. 7 ±22. 8 g/L vs 96.4± 24.8 g/L, P 〈 0. 05, respectively）. Plasma hemoglobin concentration was positively related to estimated glomerular filtration rate significantly in patients with ESRD （ P 〈 0. 05 ）. Conclusions Plasma hemoglobin concentration is decreased significantly, and is positively related to estimated glomerular filtration rate significantly in elderly patients with primary hypertension and/or type 2 diabetes complicated with ESRD determined by estimated glomerular filtration rate.