老年原发性高血压疾病患者健康状况评价及护理需求

目的:探讨老年原发性高血压疾病患者健康状况评价及护理方法与效果。方法:将120例老年原发性高血压患者平分为两组,对照组给予常规性社区护理,护理组在此基础上寻找了更多的心理护理干预方法。结果:干预前两组生存质量得分差异无统计学意义(P>0.05),3个月后,两组生存质量都有明显提高,但是护理组的提高程度明显高于对照组(P<0.05)。干预前两组收缩压比较差异无统计学意义(P>0.05),干预后护理组收缩压低且差异都具有统计学意义(P<0.05)。结论:老年原发性高血压疾病患者健康状况一般不太好,积极地护理干预能够改善患者的生活质量,降低血压,值得推广应用。

观察联用缬沙坦、硝苯地平治疗原发性高血压疾病的临床效果

目的对联用缬沙坦、硝苯地平治疗原发性高血压疾病的临床效果进行探讨。方法研究中对照组用缬沙坦治疗,观察组用缬沙坦+硝苯地平治疗;详细整理患者各项临床数据后作回顾性分析。结果治疗后观察组临床各症状积分低、临床治疗效果优,与对照组比较,差异有统计学意义(P<0.05)。结论原发性高血压疾病患者接受缬沙坦+硝苯地平治疗的效果显著,可使其临床体征显著改善,血压水平亦随之充分降低。

基于病证结合及组合分类器的原发性高血压合并心血管疾病风险预测模型构建

原发性高血压发病率高,易引发心血管疾病。从目前国内外原发性高血压合并心血管疾病风险预测模型的研究现状出发,进而阐述模型的研究方法,指出中医证候因素参与模型构建。选择具有原发性高血压合并心血管疾病风险的人群,将西医生化指标与中医证候因素结合,构建基于组合分类器的病证结合原发性高血压合并心血管疾病风险预测模型,为该病早期防治提供依据。

血清补体1q、同型半胱氨酸及脂联素水平在老年原发性高血压并发心血管疾病风险评估中的价值

目的 通过分析血清补体1q(C1q)、同型半胱氨酸(Hcy)及脂联素(APN)的水平,探讨这些指标在老年原发性高血压并发心血管疾病风险评估中的价值。方法 选择2020年3月至2022年3月西安交通大学附属三二〇一医院收治的原发性高血压并发心血管疾病患者154名作为高血压并心血管疾病组,另选取同期于本院收治的高血压患者151例为单纯高血压组,同期体检健康者152例为对照组,观察三组及原发性高血压并发心血管疾病患者高风险与低风险组血清Hcy、APN、C1q水平,分析影响老年原发性高血压并发心血管疾病风险的相关因素。结果 APN、C1q水平:高血压并心血管疾病组<单纯高血压组<对照组μg/mL,Hcy水平:高血压并心血管疾病组>单纯高血压组>对照组,差异有统计学意义(P<0.05);高风险组的血清APN、C1q水平分别为(12.34±2.87)mg/L、(164.47±8.65)μg/mL,低于低风险组的(25.69±1.25)mg/L、(171.39±9.26)μg/mL,Hcy水平为(24.78±4.74)mg/L,高于低风险组的(17.54±2.85)mg/L,差异有统计学意义(P<0.05);收集所有研究者基线资料、生化指标,经非条件多因素logistic回归模型分析得,吸烟史、糖尿病史、高血压史、体重指数、病理分级、危险度的分层、Hcy、APN、C1q为原发性高血压并发心血管疾病风险的独立危险因素(P<0.05)。结论 血清Hcy、APN、C1q水平在评估老年原发性高血压并发心血管疾病风险方面具有较高的价值,有望作为老年原发性高血压并发心血管疾病中的生物标志物。

Study on the Effect of Simvastatin on Left Ventricular Mass and Endothelial Function and the Relationship between Their Changes in the Patients with Essential Hypertension

Objective:To study the effect of Simvastatin on the left ventricular mass and endothelial function and to investigate the relationship between their changes in the patients with essential hypertension(EH). Methods: 50 patients with hypertension without severe complication were divided into two groups in a randomized,controlled and single blind trial.Group I(n=25)were given Simvastatin and hydragogue for 12 weeks while Group Ⅱ were given hydragogue during the same time.We detected the left ventricular mass and the brachial artery dilatation induced by reactive hyperemia(DIRH)or nitroglycerin(DING)respectively with ultrasonography in all patients before and after treatment.25 normal subjects without any treatment were taken as the control. Results:The left ventricular mass index(LVMI)was higher in the two groups of patients[(133.61±31.02)g/m 2;(118.04±39.62)g/m 2]than that in the control(88.79±22.73)g/m 2 before treatment(P<0.01,0.000 1,respectively)while the blood pressure was higher.The DIRH was lower in the two groups of patients(5.93±2.24)%;(6.54±3.16)%than that in the control(13.09±2.99)%,P<0.000 1.There was no significantly differences in age,serum concentrations of total cholesterol,triglyceride,sugar,blood pressure or the DING between two groups of patients and the control(P>0.05).And there was no significant difference in the all variables between group Ⅰ and group Ⅱ before treatment.After treatment the LVMI decreased[(133.61±31.02)g/m 2 VS(91.07±16.01)g/m 2,P<0.01]and the DTRH increased[(5.93±2.24)% VS(13.53±2.38)%,P<0.01]in the patients of group Ⅰ while there was no significant change in LVMI and DIRH in the patients of group Ⅱ.The blood pressure in the two groups of patients was decreased to the normal.Compared with group Ⅱ,the changes of LVMI and DIRH was higher in patients of group Ⅰ though the serum concentrations of total cholesterol,triglyceride or sugar were not significantly different.No significant change in serum concentrations oftotal cholesterol,triglyceride or sugar was found during treatment in the two groups of patients.Analysis showed that the LVMI correlated with DIRH and the change of LVMI correlated better with the change of DIRH(r=-0.56;0.69,P<0.000 1,respectly). Conclusions: The increase of left ventricular mass was related with endothelial dysfunction in essential hypertension.Being independent of the changes of serum concentrations of total cholesterol,triglyceride or sugar and blood pressure,Simvastatin could inhibit the increase of left ventricular mass and improve endothelial function.

Serum adiponectin concentrations in patients with essential hypertension

Objective: To explore the serum levels of adiponectin in patients with essential hypertension and the relation between adiponectin and blood pressure. Methods: Forty-five cases with essential hypertension and 43 healthy control subjects have been taken fasting blood samples for measurements of plasma glucose, plasma lipids, insulin, C-peptide, thyroid hormones, TNF-α, leptin and adiponectin. Glucose tolerance was assessed by 75-g oral glucose tolerance test. Results: The concentrations of adiponectin in cases with essential hypertension were significantly lower than those in the control group (4.15 ± 1.99 vs 7.04 ± 3.13 mg/ml, P = 0.000). Pearson relation analysis showed that serum adiponectin concentrations were negatively and significantly correlated with body-mass index ( r = - 0. 274, P = 0. 038), total cholesterol (r= -0.257, P = 0.048)in control groups, while adiponectin concentrations were negatively and significantly correlated with systolic blood pressure (r = - 0.356, P = 0.016), triglyceride ( r = - 0.367, P = 0.013), tumor necrosis factor-alpha ( r = -0.298, P = 0.047) and triiodothyronine( r = -0.317, P = 0.034) in essential hypertension group. Multiple regression analysis showed that body-mass index was the independent factor to adiponectin levels, and SBP and TNF-αwere adiponectin independent factors in the essential hypertension group. Conclusion: The serum adiponectin concentrations are significant lower in patients with essential hypertension, and there is negative and significantly correlation between adiponectin and blood pressure.