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        west china medical publishers
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        find Author "王斯" 9 results
        • 心血管疾病合并慢性腎臟病的血壓管理

          在心血管疾病的患者中,慢性腎臟病的患病率顯著高于自然人群。當心血管疾病合并慢性腎臟病時,患者心血管事件的發生及死亡風險明顯增加。其中,高血壓是很重要的一項危險因素。慢性腎臟病患者的血壓較普通高血壓患者更難控制。現根據國內外最新研究進展,對心血管疾病合并慢性腎臟病的血壓管理問題作一綜述,主要包括如何選擇最佳的血壓靶標及如何選用合理的藥物兩方面。

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        • 心房顫動發病機制的研究進展

          心房顫動(房顫)是臨床上常見的心律失常,具有很高的致殘率及致死率。房顫及其并發癥對人類健康造成了巨大的危害,且發病率及患病率逐年升高。了解房顫的發病機制,有助于房顫的預防及治療。近年來,對房顫的發病機制主要集中在電重構、結構重構、炎癥及基因遺傳等方面,現將其研究進展作一闡述。

          Release date:2016-09-08 09:14 Export PDF Favorites Scan
        • 中介素在心血管系統的研究進展

          【摘要】 中介素(intermedin,IMD)又稱腎上腺髓質素2,是降鈣素基因相關肽超家族的一員。IMD能夠無選擇性作用于降鈣素受體樣受體/受體活化修飾蛋白復合物,通過受體復合物上G蛋白的變構,激活下游的效應酶及離子通道,再進一步發揮生物學效應。IMD的作用廣泛,其對血管的作用主要包括血管生成作用、外周血管擴張作用、中樞升壓作用及抗血管鈣化作用;其對心臟的作用主要包括正性肌力作用、正性頻率作用、抗心肌肥厚的作用等。

          Release date:2016-09-08 09:26 Export PDF Favorites Scan
        • Changes of Thyroid Hormone Receptor Activity in Patients with Hypertensive Non-valvular Atrial Fibrillation

          目的 研究高血壓非瓣膜心房顫動患者甲狀腺激素受體(TR)的活性差異,以探討此類患者心房顫動發生發展的可能機制。 方法 2008年1月-2010年1月序貫收集103例高血壓非瓣膜心房顫動患者的相關資料(48例陣發性心房顫動、55例持續性心房顫動),并收集50例單純高血壓患者。收集各組患者的相關人口學數據及檢查結果,并采用放射性分析技術測定各組患者外周血淋巴細胞及淋巴細胞核TR的活性,主要包括平衡解離常數(Kd)及最大結合容量(MBC)。 結果 心房顫動患者淋巴細胞TR的Kd較單純高血壓患者小(越小表示與甲狀腺激素的親和力越高),且持續性心房顫動患者的Kd較陣發性心房顫動患者更小(0.77 ± 0.43、1.02 ± 0.41,P<0.001);心房顫動患者淋巴細胞TR的MBC較單純高血壓患者小(越小表示受體總量越少),且持續性心房顫動患者TR的MBC較陣發性心房顫動患者更小(36.10 ± 12.40、65.22 ± 30.90,P<0.001)。淋巴細胞核TR的Kd及MBC也存在類似情況。簡單相關分析提示左房直徑與淋巴細胞TR的Kd及MBC呈負相關,另外,調整相關指標后偏相關分析也提示左房直徑與Kd及MBC呈負相關(Kd:r=?0.296,MBC:r=?0.448;P均<0.01);淋巴細胞核TR的Kd及MBC也存在類似情況。 結論 高血壓非瓣膜心房顫動患者中,TR的總量減少,并且持續心房顫動組低于陣發心房顫動組;甲狀腺激素與受體的親和力在心房顫動患者中升高,且持續心房顫動組高于陣發心房顫動組。另外,還發現TR的Kd和MBC與左房直徑均呈負相關。這些改變可能是高血壓非瓣膜心房顫動患者心房顫動發生及維持的一種重要機制。

          Release date:2016-09-08 09:13 Export PDF Favorites Scan
        • The Relationship between Antioxidant Activity of Hyper Density Lipoprotein and Microalbuminuria in Patients with Hypertension

          ObjectiveTo discuss the relationship between microalbuminuria (MAU) and antioxidant activity of plasma hyper density lipoprotein (HDL) in hypertensive patients, and investigate whether MAU could be a predictor of HDL antioxidant activity. MethodFrom December 2007 to March 2009, sixty consecutive primary hypertensive patients from the inpatient and outpatient departments of West China Hospital and Sichuan Electric Power Central Hospital were included in the study, and 30 healthy volunteers served as controls. MAU, plasma HDL and paraoxonase (PON1) activity were tested. ResultsPON1 activity was lower in hypertensive patients than the controls (P<0.05), and this degree of decline was positively related to MAU (P<0.05). ConclusionMAU reflects PON1 activity in hypertensive patients and can be a predictor to judge plasma HDL function in patients with hypertension.

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        • Relationship between Blood Lipids Level and Homeostasis Model Assessment-Insulin Resistance in Elder People in Chengdu

          【摘要】 目的 探討成都市成華區中老年人群血脂水平、分布特點及其與胰島素抵抗指數(HOMA-IR)的關系。 方法 2007年5月在此區中老年(50~79歲)人群中隨機抽取672人進行心血管危險因素研究調查,對其血脂水平及HOMA-IR進行統計分析。 結果 人群當中①女性各血脂項目的水平均比男性高,其中總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)的差異有統計學意義(Plt;0.05);②三酰甘油(TG)升高的比例較高,其中男性為30.0%,女性為27.6%;大部分人群HDL-C、低密度脂蛋白膽固醇(LDL-C)水平處于合適范圍,HDL-C降低的比例為6.0%,LDL-C升高的比例為7.3%;③隨著TG水平的升高、HDL-C 水平的降低,HOMA-IR呈升高趨勢;LDL-C水平的升高,HOMA-IR呈升高趨勢,僅在女性人群中差異有統計學意義(Plt;0.05),在男性人群中差異無統計學意義;④TG與HOMA-IR呈正相關,相關系數為0.185(P=0.000);HDL-C與HOMA-IR呈負相關,相關系數為-0.145(P=0.000)。LDL-C與HOMA-IR呈正相關,相關系數為0.099(P=0.010)。 結論 TG增高是成都市成華區中老年人群的顯著特點,女性HDL-C比男性高;血脂紊亂與胰島素抵抗相關。【Abstract】 Objective To investigate the relationship between blood lipids level and homeostasis model assessment-insulin resistance (HOMA-IR) in elder people in Chengdu. Methods In May 2007, 672 people aged from 50 to 79 years in Chengdu were recruited by random sampling methods for the survey of cardiovascular risk factors. The blood lipids level and HOMA-IR were statistically analyzed. Results ① The serum total cholesterol (TC) and high density lipoprotein chole sterol (HDL-C) were obviously higher in women than those in men (Plt;0.05). ② Triacylglycerol (TG) increased in 30.0% of men and 27.6% of women; HDL-C and low density lipoprotein cholesterin (LDL-C) in most of the involved people were appropriate. ③ HOMA-IR increased as the TG level increased and HDL-C decreased; HOMA-IR increased as the LDL-C level increased, which was significant in the females (Plt;0.05). ④ HDL-C was positively correlated with HOMA-IR (r=-0.145, P=0.000); LDL-C was positively correlated with HOMA-IR (r=0.099, P=0.010). Conclusion The increase of hypertriglyceridemia was the most frequent type of the dislipidemia in the elder people in Chengdu; HDL-C level is higher in women than in men. Dyslipidemia is correlated with insulin resistance.

          Release date:2016-09-08 09:24 Export PDF Favorites Scan
        • Investigation on the Antihypertensive Therapy for Hypertension Patients in Wuhou District Communities in Chengdu City

          ObjectiveTo investigate on the antihypertensive therapy for hypertension patients in Wuhou District communities in Chengdu city and assess whether they have complied with the hypertension treatment guidelines. MethodsIn a survey of 1 539 community people, we selected 337 hypertensive patients who had detailed high blood pressure medication records. ResultsThe main characteristics of community hypertension treatment included higher proportions of single-drug therapy (70.3%), and traditional compound preparation (13.9%). Calcium channel blockers (CCB) and beta blockers were most commonly used in the dual step-down scheme (39.7%), while CCB, angiotensin converting enzyme inhibitors and beta blockers were mostly used in step-down triple combination. The control rate was 46.7% after antihypertensive drug treatment in the community. ConclusionIt is necessary to carry out hypertension education, strengthen the training of doctors at the basic level with hypertension prevention and control guidelines to improve the rates of treatment and control of hypertension.

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        • Relationship between blood pressure variability and pulse wave velocity in patients with hypertension

          Objective To explore the best mode of blood pressure monitoring by comparing the correlation of deferent kinds of blood pressure variability with arterial stiffness. Methods This study was conducted among 140 hypertensive patients in Wuhou Strict, Chengdu. Baseline data was collected including demographic data, biochemical examination and brachial-ankle pulse wave velocity (baPWV) measurement and so on. A consecutive home blood pressure was also gained by the individuals themselves and the clinical blood pressure was also recorded during the visit. The correlation between baPWV and the blood pressure variability were tested. Results The blood pressure variability measured at home in the morning was independently correlated with baPWV (r=0.313, P=0.011), the blood pressure variability measured at home in the evening was also independently correlated with baPWV (r=0.241, P=0.042), and day-to-day morning blood pressure variability measured at home was correlated with baPWV (r= 0.269, P=0.030). The correlation of month-to-month blood pressure variability and blood pressure variability gained at clinic room with baPWV was not significant (P>0.05). Conclusion In the monitoring of blood pressure variability in hypertensive patients, the blood pressure variability monitoring at home is better than that at the clinic room; and monitoring in the morning is better than that in the evening.

          Release date:2017-06-22 02:01 Export PDF Favorites Scan
        • An Analysis of the Relationship between Pulse Pressure, Pulse Pressure Index and Hyperuricemia in Middle-aged and Aged Residents in Chengdu

          【摘要】 目的 分析成都地區中老年居民脈壓(pulse pressure, PP)及脈壓指數(pulse presure index,PPI)與高尿酸血癥(hyperuricemia,HUA)的關系。 方法 利用2007年5月代謝綜合征研究調查資料(共1 061人),依據PP[≤60 mm Hg(1 mm Hg=0.133 kPa)、gt;60 mm Hg]和PPI(≤0.450、gt;0.450)將人群分為正常組及增高組,分析兩組人群尿酸水平及HUA患病率,采用單因素回歸及logistic回歸分析PP及PPI與HUA關系。 結果 ①PP/PPI增高組血漿尿酸水平明顯高于PP/PPI正常組,差異有統計學意義(P=0.000)。②PP/PPI增高組HUA患病率明顯高于PP/PPI正常組,差異有統計學意義(P=0.026、0.027)。③單因素回歸和logistic回歸分析皆提示PP及PPI與HUA呈正相關。 結論 成都地區PP及PPI與血漿尿酸水平關系密切,PP/PPI增高可能是HUA的危險因素。【Abstract】 Objective To evaluate the relationship between pulse pressure (PP), pulse pressure index (PPI) and hyperuricemia (HUA) among middle-aged and aged residents in Chengdu. Methods Based on the level of PP [≤60 mm Hg (1 mm Hg=0.133 kPa),gt;60 mm Hg] and PPI (≤0.450,gt;0.450), We divided the 1 061 middle-aged or aged people into normal PP/PPI group and augmented PP/PPI group. All patients came from the survey for metabolic syndrome study in May 2007. We analyzed the distribution of serum uric acid (UA) and HUA, and analyzed the relationship between PP, PPI and HUA by using single-factor and logistic regression analysis. Results The index of UA in the augmented PP/PPI groups was higher than that in the normal groups with a significant difference (P=0.000). The prevalence of HUA in the augmented PP/PPI groups was statistically higher than that in the normal groups (P=0.026, 0.027). Single-factor and logistic regression analysis showed that PP and PPI were both positively correlated to HUA. Conclusion The abnormalities of PP and PPI are closely related to metabolism disorder in Chengdu, and high level of PP or PPI is probably risk factors for HUA.

          Release date:2016-09-08 09:26 Export PDF Favorites Scan
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