目的 对比观察罗哌卡因及布比卡因应用于患有妊娠期高血压的产妇行剖宫产时腰麻联合硬膜外麻醉的临床效果。方法 将103例择期行剖宫产手术的妊娠期高血压患者随机分为罗哌卡因组51例及布比卡因组52例分别采用对应药物进行麻醉,研究两组阻滞效果、心血管系统变化情况及不良反应发生情况。结果 两组间麻醉镇痛效果及优良率比较,差异没有统计学意义(P>0.05)。罗哌卡因组感觉及运动阻滞起效时间较布比卡因组长,运动阻滞恢复时间较布比卡因组短(P<0.05)。心血管系统变化情况比较,麻醉5min、10min时两组收缩压及平均动脉压均降低,但布比卡因组波动更大,两组间比较差异显著(P<0.05),心率及血氧饱和度比较无差异(P>0.05)。罗哌卡因组不良反应出现时间较布比卡因组晚,同时其不良反应发生率较布比卡因组低(χ²=4.1599,P<0.05)。结论 罗哌卡因及布比卡因在阻滞时间上略有差异,麻醉镇痛效果相当,但鉴于妊高症产妇本身心血管系统存在基础问题,运用罗哌卡因对心血管系统的影响较小,安全性更高,更值得推荐使用。

目的 对硝苯地平缓释片治疗高血压合并糖尿病的疗效分析。方法 运用随机对照的方法,选择2012年1月—2014年8月在我社区医院就诊的220例高血压合并糖尿病患者,将其分为观察组与对照组,每组各取110例,将全部患者的血糖等各项指标控制在常规范围,观察组服用硝苯地平缓释片,对照组采用常规疗法。一个疗程(8周)进行对比,检测血压、血糖项目,观测临床治疗效果。结果 服用药物后,两组血压均有降低(P<0.05),观察组临床总有效率98.18%,对照组有效率86.36%,观察组比对照组有明显的控制疗效。两组统计数据差异有统计学意义(P<0.05)。结论 硝苯地平缓释片治疗高血压合并糖尿病方面有疗效,无明显的治疗副作用,值得临床推广使用。

目的 探讨压力管理对改善中年高血压患者生活质量的效果。方法 采用便利抽样法,把首次在我院住院的中年高血压患者115例按时间段分为实验组60例和对照组55例,对照组给予常规护理,实验组采用压力管理干预,分住院期和出院后康复期两阶段进行。使用抑郁自评量表和SF-36量表分别在出院前和出院后1个月进行测评。结果 干预后实验组患者抑郁标准分降低,SF-36量表各维度分及总分升高,与对照组比较差异均有统计学意义(P＜0.05)。结论 对中年高血压患者实施有针对性、整体性、延续性和激励性的压力管理,可提高其生活质量。

Objective To explore the influence of stress management on the improvement of quality of life of middle-aged patients with hypertension. Methods According to convenience sampling, 115 middle-aged patients with hypertension who were the first time admitted to our hospital were divided, on the basis of different periods, into the test group (60 patients) and the control group (55 patients). The control group was accepted normal nursing, while the test group was accepted the stress management intervention that performed during hospitalization and after patients discharged from the hospital. Both groups were assessed, by using self-rating depression scale and SF-36 scale, before discharging from hospital and one month after discharging from hospital. Results After the intervention, the test group experienced reductions in depression standard score and increases in dimension scores and total scores of SF-36 scale.compared with those of the control group, these changes had statistical significant (P＜0.05). Conclusion Selective, integrated, continuous and stimulating stress management can help middle-aged patients with hypertension to improve the quality of life.

目的 研究血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性与新疆地区维吾尔族(维族)、汉族人群原发性高血压(EH)的关系。方法 采用聚合酶链反应(PCR)检测此两类人群104例原发性高血压(病例组、EH)及102例健康人群(对照组、NT)血中ACE基因16号内含子的I/D多态性。统计各基因型频率、等位基因频率,并采用Logistic回归分析剔除混杂因素后ACE基因I/D多态性与EH的关系。结果 两族人群的EH组与NT组D等位基因频率及基因型频率差异均没有统计学意义(P>0.05)。但经Logistic回归分析校正各种混杂因素后,两族人群EH的发病率与ACE基因(I/D)多态性相关(P<0.05)。结论 ACE基因I/D多态性可能为新疆地区维族、汉族EH的易感因素。

Objective To investigate whether the insertion deletion(I/D) polymorphism in the angiotensin converting enzyme(ACE) gene is associated with essential hypertension(EH) in Uighur and Han population of Xinjiang. Methods The study covered 104 hypertension patients (EH) and 102 normotensive controls (NT). The variant of ACE I/D was determined by polymorphism chain reaction (PCR). Logistic was used to analyze the ACE I/D polymorphism compared with ACE genotype. Results There was no significant difference between the EH and NT group about the genotype frequency and allele frequency(P>0.05). Using logistic regression analysis, adjusted for confounding factor, there was a relationship between EH and ACE gene I/D polymorphism(P<0.05). Conclusion The results suggest that the I/D polymorphism of ACE gene is associated with the EH in the Uighur and Han people of Xinjiang.

目的 检测年轻原发性高血压病患者(≤40岁)血清中D-二聚体(D-Dimer)、超敏C反应蛋白(CRP)的表达水平并观察两者的相关性。方法 收集原发性高血压病的年轻患者40例作为观察组,无高血压病等心脑血管疾病的社区居民40例作为对照组,晨起空腹抽血,电化学发光法测定血清D-Dimer、CRP表达量,同时行Pearson检验分析两者关联性。结果 观察组血清D-Dimer、CRP表达量较对照组均升高(P＜0.05),结果存在统计学意义;观察组D-Dimer、CRP阳性率较对照组均升高(P＜0.05);且两者相关,相关系数r=0.71,P＜0.01。结论 年轻原发性高血压病患者血清D-Dimer及CRP的表达量较无高血压病居民提高,且D-Dimer与CRP在机体内的表达存在相关性,上述两种血清标记物作为高血压疾病发生、发展评价指标的相关价值值得探究。

Objective To detect the serum D-Dimer and C-reactionprotein expression levels in essential hypertension patients and observe the correlation between both of them. Methods 40 young essential hypertension patients as observer group; and 40 persons without hypertension as control group. After taking the fasting blood, the serum level of D-Dimer and CRP was detected using electrochemiluminescence method. Simultaneously, the correlation of D-Dimer with CRP was tested using Pearson correlation coefficient. Results The serum level of D-Dimer and CRP was higher in young essential hypertension patients than those in the control group. And the difference was statistically significant (P<0.05). In 80 patients, the serum levels of D-Dimer and CRP were significantly correlated, and correlation coefficient r=0.71, there was significant difference (P<0.01). Conclusion D-Dimer and CRP are significantly increased in the serum of advanced young essential hypertension patients. And the serum level of D-Dimer is significantly correlated with the serum level of CRP in young essential hypertension patients. D-Dimer as an indicator of essential hypertension after review of the value worthy of further study.

目的 探讨社区老年高血压病人直立性低血压的药物影响。方法 通过对辖区内897例社区老年高血压病人开展体检,将年轻老年和老老年高血压两组分为直立性低血压组和非直立性低血压组两组。分析降压药物对社区老年高血压病人直立性低血压的影响。结果 OH组的降压药物使用率稍高于非OH组的降压药物使用率,经统计分析P>0.05。OH组联合两种以上及联合三种以上降压药物使用率略高于非OH的药物使用率, P>0.05。利尿剂OH发生率稍高于其他组的OH发生率,P>0.05。结论 社区老年高血压OH的发病可能与目前常用的5大类降压药物无关。