Correlation of three grades with carotid atherosclerotic plaque by the ultrasound in middle-aged patients with hypertension

Objective:To explore the correlation of different hypertension grades with carotid atherosclerotic plaque in middle-aged patients with hypertension.Methods:A total of 300 patients with primary hypertension who were admitted in the Cardiology Department and Neurology Department of our hospital from January, 2015 to September, 2016 were included in the study and divided into 3 groups with 100 cases in each group according to the hypertension grade criteria. Moreover, 100 normal individuals who came for physical examinations were served as the control group. TCD was used to detect MCA, ACA, PCA, VA1, and BA. CDFI was used to detect CCA, ICA, ECA, and VA2. EDV, PSV, PI, and RI were detected, respectively. The nitrate reductase colorimetric method was used to detect NO, MDA, and SOD.Results:PSV and EDV in the internal carotid artery system in patients with hypertension were significantly reduced (P<0.05), while PI and RI were significantly increased (P<0.05);moreover, with the increasing of hypertension grading, PSV and EDV were gradually reduced, while PI and RI were increased. PSV and EDV in the vertebral artery system in patients with hypertension were significantly reduced (P<0.05), while PI and RI were significantly increased (P<0.05);moreover, with the increasing of hypertension grading, PSV and EDV were gradually reduced, while PI and RI were increased. SOD and NO in patients with hypertension were significantly lower than those in the control group (P<0.05), while MDA was significantly higher than that in the control group (P<0.05);moreover, with the increasing of hypertension grading, SOD and NO were gradually reduced, while MDA was gradually increased.Conclusions: TCD in combined with CDFI can make a comprehensive evaluation of hemodynamic indicators of intracranial and extracranial vessels in patients with hypertension, and is of great significance in the early detection of intracranial and extracranial arteriosclerosis.

Effect of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia

Objective To evaluate effects of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2diabetes and combined hyperlipidemia.Methods Totally80 elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia were treated with Atorvastatin(10 mg/d)for 12 weeks.Fasting plasma levels

The study of the correlation between serum uric acid and insulin resistance in middle-aged and elderly hospitalized patients with type 2 diabetes

Objective To study the relationship between serum uric acid and insulin resistance in type 2 diabetic patients.Methods A total of 728 middle-aged and elderly type 2 diabetic patients were recruited and the anthropometric,clinical and biochemical parameters and

急性高容血液稀释对老年心脏手术病人脑氧合功能的影响

目的 观察急性高容性血液稀释 (AHHD)对老年心脏手术病人脑氧合功能的影响并探讨其可能的作用机制。方法 2 4例冠状动脉搭桥术 (CABG)的病人 ,ASAⅠ～Ⅱ级 ,随机分为老年扩容组、未扩容组和中青年扩容组。扩容组诱导时 1小时内经颈内静脉推注 6 %贺斯溶液 1 0ml/kg ,同时静注硝酸甘油 0 5μg·kg- 1 ·min- 1 。分别于术前、诱导后 5分钟、扩容止及主动脉插管时监测血液动力学指标 ,测定动、静脉血乳酸浓度 ,脑血氧饱和度 (SjvO2 ) ,脑血氧分压 (PjO2 )和脑血流速率。结果 (1 )老年扩容组的PAP较术前显著增高 (P <0 0 5) ,但与其他两组相比无显著差异。 (2 )未扩容组的SjvO2 ,CBF/CMRO2 在主动脉插管时较术前显著降低 (P <0 0 1 ) ,与扩容组相比也显著减少 (P<0 0 5) ;而老年扩容组SjvO2 较术前及另外两组均显著增加 (P <0 0 5) ,CBF/CMRO2 无明显变化。(3)脑血流速率在中青年扩容组病人均显著高于另外两组 (P <0 0 5)。 (4)脑乳酸净生成量 (ADVL)三组间无显著差异 (P >0 0 5)。结论 AHHD对老年手术病人脑氧合功能具有一定的保护作用。

国产Amplatzer封堵器介入治疗中老年房间隔缺损的中远期疗效观察

目的评价国产Amplatzer封堵器介入治疗中老年房间隔缺损(ASD)的中远期临床疗效及安全性。方法 2007年1月～2011年5月共118例中老年ASD,男28例,女90例,年龄40～79岁,平均(52.7±9.2)岁,经临床、心电图、X线及经胸超声心动图(TTE)检查诊断为ASD继发孔型,TTE测不同切面ASD的最大直径6～38 mm,平均(23±4)mm。根据ASD边缘情况,分为中央型(42例)及边缘不足型(76例),边缘不足型分为前缘(主动脉缘)不足型(65例)、后缘(主动脉对侧缘)不足型(2例)、房顶缘不足型(4例)、二尖瓣缘不足型(5例)。其中单孔ASD 114例,多孔ASD 4例。均成功行介入治疗。手术后1、3、6、12个月及每年分别行心电图、X线胸片、TTE随访,以上病例随访时间最短6个月,最长4年。结果 118例均1次封堵成功,技术成功率100%,所用国产Amplatzer封堵器直径为10～42 mm,平均(27.2±7.1)mm。术中、术后无重要并发症。随访X线胸片显示肺血较术前减少,心胸比率不同程度缩小。术后1个月和3个月(全组118例)超声心动图显示右房内径(RAD)及右室内径(RVD)、肺动脉收缩压(PASP)较封堵前明显缩小(P<0.05);术后6个月(全组118例)、术后1年(101例)、术后2年(67例)、术后3年(36例)、术后4年(14例)超声心动图随访显示右房及右室内径、肺动脉收缩压进一步缩小(P<0.01)。所有患者中远期随访均健康生存,无封堵器介入治疗相关远期严重并发症,无因ASD而再次接受治疗者。结论国产Amplatzer封堵器介入治疗中老年ASD具有操作简单、创伤小、安全且技术成功率高、住院时间短等优点,中远期疗效明确,并发症少。

老年男性住院患者营养状况的调查

目的调查老年男性住院患者的营养状况及其影响因素,为老年男性住院患者合理进行营养支持提供参考。方法便利选取解放军总医院综合外科、肾内科、内分泌科、消化内科、神经内科、心内科、呼吸内科7个科室的老年男性住院患者共149例,测量体质量指数(body mass index,BMI),并分析与科室、进餐方式及年龄等的关系。结果老年男性住院患者低体质量(营养不良)发生率为14.1%,超重发生率为19.5%,肥胖发生率为46.9%。不同科室间BMI差异无统计学意义(P>0.05);不同进餐方式(鼻饲患者或正常进餐)及年龄段的患者BMI差异有统计学意义(P<0.05)。结论老年男性住院患者超重和肥胖的发生率高于营养不良发生率;因此,一方面要从总体上控制老年患者的超重问题,另一方面根据患者进餐方式与年龄段的特点加强特殊人群的营养支持。

老年病人对待死亡的心理分析及心理护理

老年病人对待死亡的心理分析及心理护理（０３０００１）中国人民解放军第二六四医院王春华关键词老年病人，死亡，心理反应，分析ＰｓｙｃｈｏｌｏｇｉｃａｌＡｎａｌｙｓｉｓｏｎＧｅｒａｔｉｃＰａｔｉｅｎｔ＇ｓＰｏｉｎｔｏｆＶｉｅｗａｂｏｕｔＤｅａｔｈａｎｄＰｓ...

人工全肘关节置换治疗五例伴严重骨质疏松的肱骨远端粉碎性骨折

目的探讨人工全肘关节置换术治疗伴严重骨质疏松的肱骨远端粉碎性骨折的近期临床疗效。方法2006年4月-2007年10月,采用骨水泥半限制型假体对5例伴严重骨质疏松的肱骨远端粉碎性骨折患者行人工全肘关节置换。男2例,女3例;年龄50～76岁。均为摔伤。闭合骨折4例;开放骨折1例,Gustilo分型为Ⅱ型。骨折根据AO分型:C1型2例,C2型2例,C3型1例。骨质疏松Barnett指数为0.40～0.45。伤后至手术时间4～18d,平均7.2d。术后第2天开始康复锻炼。结果手术时间120～180min,平均150min;出血量150～250mL,平均200mL。术后切口均Ⅰ期愈合,术后早期无相关并发症发生。5例术后均获随访,随访时间19～36个月,平均24.5个月。术后4个月肘关节屈曲平均141.6°,伸直平均6.5°,外展角平均10.2°;旋前平均81.7°,旋后平均73.8°。双上肢长度相差<1.5cm,手指与腕关节屈曲及背伸肌力正常。X线片示假体位置良好,无松动、脱位。根据Mayo肘关节功能评分标准:优1例,良3例,中1例,优良率为80%。结论人工全肘关节置换是治疗伴严重骨质疏松肱骨远端粉碎性骨折的有效方法之一,但必须严格掌握手术适应证和术中操作技巧。