心理护理对心脏病患者护理效果的影响

目的探究临床上心理方面的护理对于心脏病病患的护理疗效,总结对心脏病病患的心理护理的临床经验,扩大其应用。方法随机2013年3月至2015年3月的50例心脏病病患,回顾性的分析对其进行心理方面的护理过程,对其在心理护理前后的疗效进行对比,主要为对病患的满意度调查,分为满意、良好、不满意3种,并对心理护理前后的满意程度进行对比。结果对病患给予心理护理前的满意程度为72%,对病患给予心理护理后的满意程度为98%。P<0.05,表示护理前后具有显著的统计学差异。结论心脏病是当前非常常见的一种疾病,会严重影响病患的生命财产安全,临床上对于病患精心的心理当面的护理具有非常重大的意义。实践证明:对心脏病病患实施一定程度上的必要的心理护理,能够降低病患的心理负担,有效的提高护理工作中的质量。

Prevalence and incidence of interatrial block in global population and in different clinical situations

The high prevalence of interatrial block （IAB） is widely neglected due to its frequent underdiaguosis. Its prevalence depends mainly on age and also on the presence of associ- ated heart disease. In patients without structural heart dis- ease, it is mainly an elderly condition. This is particularly true for advanced IAB, rarely found in global population before 65 years but with prevalence of 8% in the 70＇s and 25% in centenarians,tll When studying prevalence data of this condition, three factors should be taken into account in order to interpret differences that are frequently related with the methodology used （Table 1, Figure 1）.

Does high altitude increase risks of the elderly patients with coronary artery disease？

Objective To assess the effect of altitude hypoxia on the elderly patients with coronary artery disease （CAD）. Methods Three subject groups were surveyed during their train trip on the highest railroad the Qinghai-Tibet Railway： 22 elderly individuals with documented CAD, 20 healthy elderly controls, and 20 healthy young controls, all of whom from Beijing near the sea level （76 m）, Survey questions addressed clinical features of their healthy conditions and aspects of their coronary disease. The baseline study was performed at Xining at an altitude of 2261m, and then during acute exposure to altitudes of 2808 m, 4768m, 5072 m and 4257 m by train for 24 hours. Resting pulse rate, blood pressure, oxygen saturation, electrocardiograph （ECG）, and cardiac work estimated by the heart rateblood pressure double product were obtained five times in each subject at different altitudes. Results On arrival to altitudes between 4768 m and 5072 m, the older passengers, especially those with preexisting coronary disease, had higher HR, higher BP, and lower SaO2, as well as more frequent abnormalities on ECG, as compared to the younger healthy subjects. As compared with the healthy elderly controls, incomplete right bundle branch block, left ventricular hypertrophy, and ST segment depression were more frequently seen in the elderly coronary patients （P〈0.01）. Cardiac work in group 1 was increased by 13% 12 hours after arrival to altitudes between 2808 m and 5072 m. Oxygen saturation decreased significantly with the altitude increasing by train ascent but improved after inhalation of oxygen. Most of the older subjects tolerated their sojourn at high altitude well except one who developed angina repeatedly with a significant ST segment depression. Conclusions Coronary events and ECG signs of myocardial ischemia are rare in elderly individuals with CAD who travel from sea level to moderate altitudes of 1500m to 2800 m. Patients with CAD who are well compensated at sea level generally tolerate this moderate altitude well. However, it would be prudent for patients with CAD going to altitude above 3000 m. The patients should consult their physician before undertaking a trip to such altitude （J Geriatr Cardio12009; 6：137-141）.

Diabetes onset before or after the age of 65 does it affect the progression of renal and cardiovascular diseases in the elderly patient？

Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chronic kidney disease than non-diabetic elderly patients and the risk of these complications increases with patient age, duration of the dia- betes and glycated hemoglobin values. Besides the known classical factors of renal disease progression,

Trends in the prevalence of heart diseases over a ten-year period from single-center observations based on a large echocardiographic database

There is a paucity of data regarding trends in the incidence of heart disease in China during recent years. Using a large echocardiography database in our center, we analyzed trends in the prevalence of several common heart diseases from Dec. 2003. This study retrospectively analyzed the echocardiographic database in our Department from 2003 to 2012. A total of 385 682 cases were included in the study. The prevalence of rheumatic heart disease decreased over the 10-year period, from 4.04% in 2003 to 3.06% in 2012 （P〈0.01）. Infective endocarditis also decreased, from a mean prevalence of 0.37% in July 2003 to 0.27% in Dec. 2008 （P〈0.001）. The prevalence of hy- pertrophic cardiomyopathy, which includes 20% apical hypertrophic cardiomyopathy and 20% hypertrophic obstructive cardiomyopathy, was about 1.8%. The prevalence of the three most common adult congenital heart diseases （CHDs） decreased by about 10% from July 2003 to Dec. 2008 （all P〈0.001）. The prevalence of moderate pulmonary arterial hypertension （PAH） or left ventricular systolic dysfunction （LVSD） decreased during the 10-year period （P〈0.001）, but there was no change in the prevalence of severe PAH or LVSD （P〉0.05）. The present study indirectly demonstrates that the prevalence of several common heart diseases in China has declined in recent years.