依达拉奉注射液联合甘油果糖治疗高血压性脑出血的临床疗效

目的:探讨依达拉奉联合甘油果糖治疗高血压性脑出血的临床疗效。方法:根据患者的意愿将120例高血压性脑出血患者分成观察组(56例)和对照组(64例)。对照组患者给予依达拉奉联合甘露醇治疗;观察组患者采用依达拉奉联合甘油果糖治疗15d。观察两组患者治疗后临床疗效、神经功能恢复评分及肾功能损害情况。结果:1观察组患者治疗后总有效率为73.21%(41/56),明显高于对照组患者总有效率35.9%(25/64),差异有统计学意义(P0.05);2治疗后两组患者的NIHSS评分均低于治疗前,治疗后观察组患者NIHSS评分为(4.29±5.6)明显低于对照组患者评分(7.09±4.9),差异均有统计学意义(P0.05);3治疗后观察组患者肾功能损害情况评分明显低于对照组患者,差异有统计学意义,(P0.05)。结论:采用依达拉奉联合甘油果糖治疗高血压性脑出血患者,疗效确切且不良反应少,值得临床推广应用。     

小骨窗微创手术治疗高血压脑出血患者的疗效

目的:分析小骨窗微创手术在高血压脑出血患者的临床效果。方法:选取我院收治的高血压脑出血患者200例,按照治疗方式的不同分为观察组100例,对照组100例,观察组采用小骨窗微创手术治疗,对照组采用传统开颅手术治疗,对两组疗效及预后进行对比。结果:两组患者的术后残留血肿量较术前明显减少,差异有统计学意义(P0.05),观察组术后残留血肿量(10.3±2.8)m L,对照组术后残留血肿量(11.1±3.0)m L,两组之间术后血肿残留量比较,差异无统计学意义(P0.05)。观察组手术时间(92.8±15.5)分钟,对照组手术时间(125.4±16.1)分钟,观察组手术时间明显短于对照组,差异有统计学意义(P0.05)。观察组住院时间(15.8±5.2)天,对照组住院时间(24.1±5.8)天,观察组住院时间明显短于对照组,差异有统计学意义(P0.05)。再出血率比较:观察组治疗后再出血率3.0%,对照组治疗后再出血率8.0%,观察组出血率明显低于对照组,差异有统计学意义(P0.05)。NDS及ADL比较:两组治疗后NDS及ADL均优于治疗前,差异有统计学意义(P0.05)。观察组NDS及ADL均显著优于对照组,差异有统计学意义(P0.05)。GCS比较:两组评分差异无统计学意义(P0.05)。结论:小骨窗微创手术可以改善患者的预后,可显著提高高血压脑出血治疗效果。     

烟酰胺经调控p38MAPK信号通路对高血压脑出血大鼠的脑保护作用机制分析

摘要 目的：探讨烟酰胺经调控p38MAPK信号通路对高血压脑出血大鼠的脑保护作用机制。方法：选择48只SD大鼠,随机选择12只作为假手术组,其余36只进行高血压脑出血造模,对比4组大鼠的血肿体积、左扭转比率、神经功能变化、出血脑组织p-p38MAPK、p38MAPK蛋白表达、烟酰胺腺嘌呤二核苷酸、凋亡诱导因子含量及脑组织含水量。结果：与模型组相比,尼莫地平组、烟酰胺组的血肿体积明显缩小;与烟酰胺组相比,尼莫地平组的血肿体积明显缩小（P<0.05）;与干预前相比,干预后烟酰胺组、尼莫地平组的血肿体积明显缩小,模型组的血肿体积明显增多（P<0.05）。与模型组相比,假手术组、尼莫地平组、烟酰胺组的向左扭转比率、p-p38MAPK/p38MAPK、烟酰胺腺嘌呤二核苷酸明显较高,脑组织含水量、凋亡诱导因子含量明显较低;与烟酰胺组相比,尼莫地平组、假手术组的左扭转比率、p-p38MAPK/p38MAPK、烟酰胺腺嘌呤二核苷酸明显较高,脑组织含水量、凋亡诱导因子含量明显较低;与尼莫地平组相比,假手术组的左扭转比率、p-p38MAPK/p38MAPK、烟酰胺腺嘌呤二核苷酸明显较高,脑组织含水量、凋亡诱导因子含量明显较低（P<0.05）。结论：在高血压脑出血大鼠中,p38MAPK介导的细胞凋亡途径会加剧高血压脑出血的脑损伤,烟酰胺会经过抑制p38MAPK信号通路减轻高血压脑出血后的脑损伤。     

Prediction of the incidence of spontaneous intracerebral hemorrhage from meteorological data

We analyzed the relationship between the incidence of spontaneous intracerebral hemorrhage (ICH) and various meteorological data (daily atmospheric air pressure, air temperature, precipitation, humidity, presence of typhoons, occurrence of the rainy season, wind velocity, and wind direction) for patients at Teraoka Memorial Hospital in Shin-ichi Town, Japan, from January 1, 2001 to December 31, 2003. All data were analyzed by contingency table analysis and multivariate regression analysis. From January 1, 2002 to December 31, 2003, we identified high-risk ICH days as those days for which the preceding 3 days mean recorded air pressure of 1,015 hPa or more and then conducted a statistical comparison of the incidence of ICH on high-risk ICH days with that on the other days. Our subjects were 164 patients with ICH. The relative risk of high-risk ICH days is 1.46 (Fisher’s exact test, p = 0.04). Mann–Whitney’s U-tests indicate ICH tends to occur on days with lower maximum air temperature. Multivariate logistic regression analysis revealed that 3 incidences influence the occurrence of intracerebral hemorrhage (p < 0.01 each): (1) days associated with 4-day periods of mean air pressure in excess of 1,015 hPa; (2) days during which a typhoon was approaching; and (3) days with west or southwest wind . Detailed examination of meteorological data indicates a relationship with the incident rate of ICH.     

Marker-assisted selection of a neuro-behavioural trait related to behavioural inhibition in the SHR strain,an animal model of ADHD

The search for the molecular bases of neuro-behavioural traits in Spontaneously Hypertensive Rats (SHR), an animal model of Attention Deficit Hyperactivity Disorder (ADHD), led to the discovery of two quantitative trait loci related to the locomotor activity in the centre of the open field. In the present study, rats from an F2 intercross between the SHR and Lewis strains were selected with markers on the basis of their genotype at these two loci. We obtained a 'high line' in which rats have the alleles increasing the trait, and a 'low line' with the lowering alleles. In activity cages with a dim light, the low line was more active than the high line. The reverse was found in the open field, and the inhibition of locomotor activity in the low line (as compared to the high line) was directly related to the aversiveness of the situation (larger in the centre than in the periphery, and in high light than in low light), and was more intense in males than in females. This inhibition is not attributable to a classical 'anxiety' factor as measured in the elevated plus maze, in which the open arms behaviours were not different between the lines. The high line also showed a deficit in prepulse inhibition of the acoustic startle reflex. The present data show that the two loci previously described in a SHR × Lewis intercross as related to the activity in the centre of the open field are indeed involved in a behavioural inhibition trait. The marker-based selected lines described here are unique tools for the study of the neurobiological bases of this trait and the molecular foundations of its variability of genetic origin.     

卡托普利与心痛定治疗高血压急症的疗效观察

目的以卡托普利舌下含服治疗高血压急症,并与心痛定舌下含服治疗对照。方法卡托普利２５ｍｇ舌下含服治疗高血压急症６０例为治疗组,６０例用心痛定１０ｍｇ舌下含服作对照组。结果卡托普利组用药１５ｍｉｎ即开始有显著的降压作用（Ｐ＜０．００１）,３０ｍｉｎ、６０ｍｉｎ、１２０ｍｉｎ后疗效更显著（Ｐ＜０．００１）。心痛定组用药１５ｍｉｎ血压无显著下降（Ｐ＞０．０５）。３０ｍｉｎ、６０ｍｉｎ、１２０ｍｉｎ,血压明显下降（Ｐ＜０．００１）,两组比较,卡托普利组降压作用明显（Ｐ＜０．００１）。结论卡托普利舌下含服是治疗高血压急症较迅速、有效、安全的降压方法,无明显不良反应。     

脑心通胶囊联合神经生长因子治疗高血压脑出血的疗效及对血清IL-6、MMP-9、S100B水平的影响

目的:研究脑心通胶囊联合神经生长因子治疗高血压脑出血的疗效及对血清白介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)、S100B水平的影响。方法:选取2015年8月至2016年7月本院收治的88例高血压脑出血患者,根据患者入院顺序分为观察组和对照组,44例每组。对照组使用神经生长因子治疗,观察组使用脑心通胶囊联合神经生长因子进行治疗。比较两组患者临床疗效,治疗前后GCS、GOS评分、血清IL-6、MMP-9、S100B水平的变化。结果:治疗后,观察组临床总有效率显著高于对照组(P0.05)。两组患者治疗后GCS、GOS评分均较治疗前明显升高(P0.05),血清IL-6、MMP-9、S100B水平均较治疗前显著降低(P0.05),且观察组的GCS、GOS评分显著高于对照组(P0.05),血清IL-6、MMP-9、S100B水平明显低于对照组(P0.05)。所有患者用药期间均未发生药物不良反应。结论:脑心通胶囊联合神经生长因子治疗高血压脑出血的疗效肯定,且能有效降低患者血清IL-6、MMP-9、S100B水平,安全性高。     

Association between circulating angiotensin-converting enzyme 2 and cardiac remodeling in hypertensive patients

BackgroundAngiotensin-converting enzyme 2 (ACE2) plays a vital role in the pathogenesis of hypertension-induced cardiac remodeling and exhibits cardioprotective properties in hypertensive animal models. Evidence that ACE2 is an important regulator of hypertensive cardiac remodeling in humans has not been addressed directly yet.MethodsA total of 161 patients with essential hypertension and 47 age- and sex-matched normotensive healthy subjects were consecutively recruited. Serum concentration levels of ACE2 were determined by enzyme-linked immunosorbent assay. Cardiac structural and functional parameters were measured by echocardiography.ResultsSerum ACE2 concentrations were higher in hypertensive patients compared to healthy subjects (170.31 [83.50–707.12] pg/ml in patients versus 59.28 [39.71–81.81] pg/ml in healthy subjects, P < 0.001). After adjustment for confounders, including age, sex, body mass index, snoring, smoking, duration of hypertension, comorbidities, medication use, mean arterial pressure and N-terminal pro-brain natriuretic peptide, serum ACE2 concentrations were positively correlated with left atrial diameter, left ventricular end-diastolic diameter and left ventricular mass in hypertensive patients. Moreover, multiple regression analyses adjusting for covariates revealed that serum ACE2 concentrations were also independently associated with left ventricular ejection fraction and late diastolic filling velocities of the mitral inflow.ConclusionsThis study reveals an elevated serum concentration of ACE2 and independent associations between serum ACE2 and echocardiographic parameters in hypertensive patients.     

间苯三酚联合拉贝洛尔治疗妊娠高血压疾病的疗效研究

目的:研究间苯三酚联合拉贝洛尔治疗妊娠高血压疾病的临床效果及可能机制。方法:选择2015年12月-2018年12月我院收治的180例妊娠高血压疾病患者,并将其根据入院的顺序,随机数字表法均分为两组,每组90例。对照组静脉滴注间苯三酚200 mg,连续给药7 d,观察组联合静脉滴注拉贝洛尔100 mg,当患者的血压降至目标期值后,将给药方法改为口服拉贝洛尔片,每次50 mg,每天3次,直至分娩前。比较两组胎盘早剥、产后出血、胎儿窘迫、剖宫产、低体重儿以及新生儿窒息的发生情况,治疗前后的收缩压(Systolic blood pressure,SBP)、平均动脉压(Mean arterial pressure,MAP)、舒张压(Diastolic blood pressure,DBP)以及血清半胱氨酸蛋白酶抑制剂C(Serum cysteine protease inhibitor C,Cys-C)、高迁移率蛋白-1(High mobility protein-1,HMGB1)、同型半胱氨酸(Homocysteine,Hcy)水平的变化。结果:治疗后,观察组的总有效率为92.22%,明显高于对照组(74.44%,P0.05);观察组的胎盘早剥率、产后出血率、胎儿窘迫发生率、剖宫产率、低体重儿率以及新生儿窒息率均明显低于对照组(P0.05);两组治疗后的SBP、MAP和、DBP、血清Hcy、HMGB1和Cys-C水平均较治疗前明显降低(P0.05),且观察组以上指标均明显低于对照组(P0.05)。结论:间苯三酚联合拉贝洛尔能显著降低妊娠高血压不良分娩结局的发生率,控制血压效果理想,其作用机制可能与降低患者血清Hcy、HMGB1和Cys-C水平有关。     

甲基多巴联合酚妥拉明治疗妊娠期高血压的临床疗效及安全性研究

目的:研究甲基多巴联合酚妥拉明治疗妊娠期高血压的临床疗效及安全性。方法:选择2015年1月～2017年12月我院收治的妊娠期高血压疾病患者210例,并将其随机分为两组。对照组静脉滴注酚妥拉明治疗,每次20 mg,每天1次;观察组联合口服甲基多巴,每次250 mg,每天3次。比较两组的治疗有效率,妊娠情况及治疗前后的收缩压(SBP)、平均动脉压、舒张压(DBP)和尿素氮(BUN)、血肌酐(Cr)、β2微球蛋白(β2-MG)和尿微量清蛋白(MA)水平的变化。结果:治疗后,观察组的有效率明显高于对照组(P0.05);观察组的产后出血、胎盘剥落、子痫前期、羊水栓塞先兆以及剖宫产发生率均明显低于对照组(P0.05)。两组治疗后的SBP、MAP和DBP均较治疗前明显降低(P0.05),且观察组SBP、MAP和DBP明显低于对照组(P0.05)。两组治疗前后的Cr、BUN水平相比均无明显的差异(P0.05),两组治疗后的血清β2-MG和MA水平均较治疗前明显降低(P0.05),且观察组以上指标明显低于对照组(P0.05)。两组的不良反应发生情况相比差异无统计学意义(P0.05)。结论:甲基多巴联合酚妥拉明治疗妊娠期高血压的临床效果明显优于单用酚妥拉明治疗,其可以更有效控制血压,改善患者肾功能,且安全性较高。