<strong>Objective:</strong> Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to ...<strong>Objective:</strong> Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to evaluate autonomic nervous function. <strong>Patients and Method:</strong> 48 patients with dysuria after cervicothoracic SCI were selected. Before, during and after imaging urodynamic examination with slow filling in supine position, blood pressure and ECG were monitored simultaneously. The symptoms of sweating, shivering, headache, flushing and chills were observed and recorded. The study of the relationship among the changes of blood pressure, heart rate and urodynamic indexes and the above symptoms was analyzed. <strong>Results:</strong> They were divided into three groups: group A (no obvious abnormality), group B (hyperactivity) and group C (hypoactivity) according to their BP, HR and existing the symptoms or not. <strong>Conclusion:</strong> The incidence of autonomic dysfunction in the high level SCI patients with dysuria was very high (79.17%), most of them were hyperactivity, and a few were low function. The changes of SBP and DBP in the hypoactivity group all appeared an increasing and then declining trend, while the change of HR in the low function one was lower than normal and decreased continuously. The main inducements of AD are neurogenic detrusor overactivity, detrusor sphincter dyssynergia, elevated abdominal pressure and abnormal bladder sensitivity. The asymptomatic patients had a higher occurrence rate (43.75%). Only by imaging urodynamic examination with slow filling and synchronous blood pressure monitoring, can autonomic nervous function of the patients be evaluated safely, objectively, early and accurately.展开更多
Objective To evaluate the safety and efficacy of early high intensity blood purification for severe wasp venom poisoning with acute kidney injury(AKI).Methods We retrospectively analyzed 120 patients[(47±14)year,...Objective To evaluate the safety and efficacy of early high intensity blood purification for severe wasp venom poisoning with acute kidney injury(AKI).Methods We retrospectively analyzed 120 patients[(47±14)year,F/M=68/52]with severe wasp venom poisoning(creatine kinase>20,000 IU/L;lactic展开更多
目的:探讨妊娠期高血压孕妇血压昼夜节律变化及其与肾损伤的关系研究。方法:将2018年1月至2019年12月江苏省溧阳市人民医院妇产科收治的108例诊断为妊娠期高血压的孕妇作为研究对象,根据血压昼夜节律变化将孕妇分为杓型组(n=31)、非杓型...目的:探讨妊娠期高血压孕妇血压昼夜节律变化及其与肾损伤的关系研究。方法:将2018年1月至2019年12月江苏省溧阳市人民医院妇产科收治的108例诊断为妊娠期高血压的孕妇作为研究对象,根据血压昼夜节律变化将孕妇分为杓型组(n=31)、非杓型组(n=36)、反杓型组(n=41)。比较不同血压昼夜节律变化患者24 h动态血压监测参数、肾功能和肾早期损伤指标水平。分析24 h动态血压监测参数与肾功能及肾损伤指标相关性及其对妊娠期高血压孕妇早期肾损伤的预测价值。结果:非杓型和反杓型患者24 h平均收缩压(24 h SBP)和夜间平均收缩压(nSBP)高于杓型,非杓型白天平均收缩压(dSBP)高于杓型,反杓型24 h平均舒张压(24 h DBP)和夜间平均舒张压(nDBP)高于杓型,反杓型nSBP和nDBP高于非杓型(P<0.05);非杓型和反杓型患者血肌酐(Scr)、血清胱抑素-C(Cys-C)、同型半胱氨酸(Hcy)和尿微量白蛋白(mALB)水平高于杓型,反杓型高于非杓型(P<0.05);dDBP和24 hDBP与Scr呈负相关关系,nDBP与Scr呈正相关关系(P<0.05);24 h DBP、dDBP和nDBP与估计肾小球滤过率(eGFR)呈负相关关系(P<0.05);24 h SBP、24 h DBP、dSBP、dDBP、nSBP和nDBP与Cys-C、Hcy和mALB均呈正相关关系(P<0.05);夜间平均血压对妊娠期高血压孕妇早期肾损伤的预测价值较高(AUC:0.854;95%CI:0.726~0.982)。结论:妊娠期高血压孕妇血压昼夜节律以非杓型和反杓型为主,夜间平均血压变化对早期肾损伤的预测价值较高,24 h动态血压监测有助于妊娠期高血压孕妇血压的评估以及早期肾损伤的预测。展开更多
目的 探讨血压控制对慢性肾病老年患者病情进展的影响,为其临床研究提供可参考依据。方法共纳入160例诊断为慢性肾病的高血压老年患者作为研究对象,根据慢性肾病分期分为G3a组、G3b组、G4组,比较3组差异,并随访观察1年,根据病情是否进...目的 探讨血压控制对慢性肾病老年患者病情进展的影响,为其临床研究提供可参考依据。方法共纳入160例诊断为慢性肾病的高血压老年患者作为研究对象,根据慢性肾病分期分为G3a组、G3b组、G4组,比较3组差异,并随访观察1年,根据病情是否进展分为进展组与未进展组,筛选出影响病情进展的危险因素。同时按收缩压水平分为A组（〈120 mm Hg）、B组（121-130 mm Hg）、C组（131-140 mm Hg）及D组（〉140mm Hg）,分析不同收缩压患者的生存情况。结果 160例慢性肾病患者中,G3a期56例,占35.0%;G3b期60例,占37.5%;G4期44例,占27.5%。随慢性肾病分期的升高,肾小球滤过率（GFR）、血红蛋白（Hb）及碳酸氢根（HCO3-）水平逐渐降低,而尿蛋白及收缩压逐渐升高,差异有统计学意义（〈0.05）。随访1年,160例患者中有24例患者进展,占15.0%。进展组GFR、Hb及HCO3-水平低于未进展组,但尿蛋白、年化GFR下降率及收缩压高于未进展组,差异有统计意义（〈0.05）;多因素分析发现b GFR低、随访期间收缩压高是影响慢性肾病进展的独立危险因素（〈0.05）。生存情况比较发现,D组患者慢性肾病生存最差,其次为A组患者,B组患者生存最好。结论 老年慢性肾病肾损伤风险增加与收缩压水平之间有相关性,对于老年患者需要制定合理的血压管理方案,以期降低老年慢性肾病患者的死亡风险。展开更多
文摘<strong>Objective:</strong> Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to evaluate autonomic nervous function. <strong>Patients and Method:</strong> 48 patients with dysuria after cervicothoracic SCI were selected. Before, during and after imaging urodynamic examination with slow filling in supine position, blood pressure and ECG were monitored simultaneously. The symptoms of sweating, shivering, headache, flushing and chills were observed and recorded. The study of the relationship among the changes of blood pressure, heart rate and urodynamic indexes and the above symptoms was analyzed. <strong>Results:</strong> They were divided into three groups: group A (no obvious abnormality), group B (hyperactivity) and group C (hypoactivity) according to their BP, HR and existing the symptoms or not. <strong>Conclusion:</strong> The incidence of autonomic dysfunction in the high level SCI patients with dysuria was very high (79.17%), most of them were hyperactivity, and a few were low function. The changes of SBP and DBP in the hypoactivity group all appeared an increasing and then declining trend, while the change of HR in the low function one was lower than normal and decreased continuously. The main inducements of AD are neurogenic detrusor overactivity, detrusor sphincter dyssynergia, elevated abdominal pressure and abnormal bladder sensitivity. The asymptomatic patients had a higher occurrence rate (43.75%). Only by imaging urodynamic examination with slow filling and synchronous blood pressure monitoring, can autonomic nervous function of the patients be evaluated safely, objectively, early and accurately.
文摘Objective To evaluate the safety and efficacy of early high intensity blood purification for severe wasp venom poisoning with acute kidney injury(AKI).Methods We retrospectively analyzed 120 patients[(47±14)year,F/M=68/52]with severe wasp venom poisoning(creatine kinase>20,000 IU/L;lactic
文摘目的:探讨妊娠期高血压孕妇血压昼夜节律变化及其与肾损伤的关系研究。方法:将2018年1月至2019年12月江苏省溧阳市人民医院妇产科收治的108例诊断为妊娠期高血压的孕妇作为研究对象,根据血压昼夜节律变化将孕妇分为杓型组(n=31)、非杓型组(n=36)、反杓型组(n=41)。比较不同血压昼夜节律变化患者24 h动态血压监测参数、肾功能和肾早期损伤指标水平。分析24 h动态血压监测参数与肾功能及肾损伤指标相关性及其对妊娠期高血压孕妇早期肾损伤的预测价值。结果:非杓型和反杓型患者24 h平均收缩压(24 h SBP)和夜间平均收缩压(nSBP)高于杓型,非杓型白天平均收缩压(dSBP)高于杓型,反杓型24 h平均舒张压(24 h DBP)和夜间平均舒张压(nDBP)高于杓型,反杓型nSBP和nDBP高于非杓型(P<0.05);非杓型和反杓型患者血肌酐(Scr)、血清胱抑素-C(Cys-C)、同型半胱氨酸(Hcy)和尿微量白蛋白(mALB)水平高于杓型,反杓型高于非杓型(P<0.05);dDBP和24 hDBP与Scr呈负相关关系,nDBP与Scr呈正相关关系(P<0.05);24 h DBP、dDBP和nDBP与估计肾小球滤过率(eGFR)呈负相关关系(P<0.05);24 h SBP、24 h DBP、dSBP、dDBP、nSBP和nDBP与Cys-C、Hcy和mALB均呈正相关关系(P<0.05);夜间平均血压对妊娠期高血压孕妇早期肾损伤的预测价值较高(AUC:0.854;95%CI:0.726~0.982)。结论:妊娠期高血压孕妇血压昼夜节律以非杓型和反杓型为主,夜间平均血压变化对早期肾损伤的预测价值较高,24 h动态血压监测有助于妊娠期高血压孕妇血压的评估以及早期肾损伤的预测。
文摘目的 探讨血压控制对慢性肾病老年患者病情进展的影响,为其临床研究提供可参考依据。方法共纳入160例诊断为慢性肾病的高血压老年患者作为研究对象,根据慢性肾病分期分为G3a组、G3b组、G4组,比较3组差异,并随访观察1年,根据病情是否进展分为进展组与未进展组,筛选出影响病情进展的危险因素。同时按收缩压水平分为A组（〈120 mm Hg）、B组（121-130 mm Hg）、C组（131-140 mm Hg）及D组（〉140mm Hg）,分析不同收缩压患者的生存情况。结果 160例慢性肾病患者中,G3a期56例,占35.0%;G3b期60例,占37.5%;G4期44例,占27.5%。随慢性肾病分期的升高,肾小球滤过率（GFR）、血红蛋白（Hb）及碳酸氢根（HCO3-）水平逐渐降低,而尿蛋白及收缩压逐渐升高,差异有统计学意义（〈0.05）。随访1年,160例患者中有24例患者进展,占15.0%。进展组GFR、Hb及HCO3-水平低于未进展组,但尿蛋白、年化GFR下降率及收缩压高于未进展组,差异有统计意义（〈0.05）;多因素分析发现b GFR低、随访期间收缩压高是影响慢性肾病进展的独立危险因素（〈0.05）。生存情况比较发现,D组患者慢性肾病生存最差,其次为A组患者,B组患者生存最好。结论 老年慢性肾病肾损伤风险增加与收缩压水平之间有相关性,对于老年患者需要制定合理的血压管理方案,以期降低老年慢性肾病患者的死亡风险。
