n-3PUFA对高脂SHR 大鼠血压及血浆游离脂肪酸谱的影响

目的:观察高饱和脂肪酸及n-3多不饱和脂肪酸饮食后对自发性高血压大鼠血压、静息心率、体重、血脂、血糖及游离脂肪酸谱的影响。方法:选择8周龄雄性自发性高血压大鼠(SHR)30只和同龄对照大鼠(WKY)30只,随机分为6组:SHR、WKY普通饲料组各10只,SHR、WKY高脂组各10只,SHR、WKY高脂加鱼油饮食组各10只,持续喂养至16周龄。干预期间每两周测定血压和体重,干预前后测定静息心率、血脂、血糖及血浆游离脂肪酸谱。结果:(1)血压和静息心率的变化:SHR大鼠高脂饮食组较普食组血压水平显著性增高,而高脂加鱼油饮食组较高脂饮食组血压水平显著性减低;WKY大鼠高脂饮食组较普食组血压水平显著性增高,而高脂加鱼油饮食组较高脂饮食组血压水平显著性减低;SHR大鼠高脂饮食组较普食组静息心率显著性增高(P=0.007),而高脂加鱼油饮食组较高脂饮食组静息心率有下降趋势,但差异无显著性(P=0.125),WKY大鼠静息心率各组间无明显差异。(2)血浆游离脂肪酸谱:与WKY大鼠比较,SHR大鼠中亚麻酸(Linolenic acid,ALA)、花生四烯酸(Linoleic Acid,AA)与n-6多不饱和脂肪酸(n-6 polyunsaturated fatty acids,n-6PUFA含量增高,高脂饮食增加了饱和脂肪酸(Saturated fatty acid,SFA),有显著差异(P0.05),高脂鱼油组二十二碳六烯酸(Docosahexaenoic acid,DHA)及二十碳五烯酸(Docosapentaenoic acid,EPA)增加导致n-3多不饱和脂肪酸(n-3 polyunsaturated fatty acids,n-3PUFA)含量增加(P0.05),SHR大鼠高脂鱼油组亚油酸(Linoleic Acid,LA)、AA含量减低(P0.05)。结论:膳食补充n-3PUFA可能通过影响交感神经活性和血浆脂肪酸谱的组成而改善高饱和脂肪酸所致SHR大鼠的血压升高。     

Isolation of a plasma protein elevated during hypertension in the rat

Plasma from male rats contains a protein that is elevated during essential hypertension. This protein, termed hypertension associated protein (HAP), can be detected as a peptide that has a molecular weight of 14,000 daltons on high resolution SDS-gradient polyacrylamide gels. The native protein has now been isolated by elution from DEAE-Sepharose, carboxymethyl cellulose and by gel permeation on Ultrogel AcA44. The procedure yields 102 mg of highly purified protein from 5 ml (250 mg) of plasma in 72 h. The native protein has a molecular weight of 28,000 daltons.     

Relationships among alterations in renal membrane sodium transport,renin and aminopeptidase M activities in genetic hypertension

Rats of the Milan Hypertensive Strain (MHS) may be considered a useful model for understanding the genetic molecular mechanism underlying a primary form of hypertension in at least a subgroup of patients. Many differences between MHS and its normotensive control strain (MNS) were found at the organ, cellular and biochemical level. In the present investigation renal cell membrane proteins (BBMV) were analysed by two-dimensional electrophoresis and a difference between MHS and MNS was shown in a polypeptide of 32 kDa, subsequently identified as the C-terminal fragment of aminopeptidase M (APM). The activity of the enzyme was higher in MHS. Genetic relationships between this enzyme and the other biochemical cellular abnormalities of MHS, namely sodium transport in BBMV and renin activity in kidney cortex were investigated in MHS, MNS and in two inbred recombinant strains. This analysis showed that faster sodium transport, low kidney levels of renin and hypertension, but not differences in two-dimensional electrophoretic pattern and in aminopeptidase M activity, cosegregated in recombinant strains. These results are consistent with the hypothesis that the faster sodium transport can be considered a primary cellular abnormality responsible for hypertension in MHS and that the aminopeptidase difference is not involved in the cellular abnormalities.     

A comparison of the cutaneous microvascular properties of the Spontaneously Hypertensive rat and the Wistar-Kyoto rat

The Spontaneously Hypertensive rat (SHR) and its non-hypertensive companion strain, the Wistar-Kyoto (WKY) rat, provide an excellent comparative model to permit study of the differential properties of cutaneous microvascular beds. We explored the possibility that chronically elevated vascular pressures in the SHR rat might affect the microvascular constitution of the skin. We measured skin blood flow at the back and at the paw of a group of 20-week-old WKY rats and a contrast group of SHR rats. We then performed skin biopsies at these two locations and used the NIH Image program to count and measure the size of capillaries, arterioles, and venules. We also determined microvascular density as percentage of total tissue area. At basal temperature, skin blood flow was similar in the two rat strains at both the back and paw. Heat induced vasodilatation resulted in a 50% increase in blood flow at the back, reaching the same level in the two rat groups. However, at the paw site, thermal stimulation resulted in significantly greater flow (39.3 +/- 3.1 ml/100 gm tissue per min) in the SHR rats than the WKY rats (28.6 +/- 1.9 ml/100 gm tissue per min, P < 0.05). The ratio of systemic arterial pressure to skin blood flow was computed as an index of vascular resistance to flow. At basal temperature, this index was 50% greater for the SHR rats at both skin sites. At 44 degrees C, the resistance index decreased at both sites in both rat groups but was still approximately 50% higher at the back of the SHR than the WKY rats. In contrast, the resistance index at 44 degrees C at the paw site fell to the same level in both the SHR and WKY rats. There were twice as many capillaries at the back of the WKY rats than at the back of the SHR rats (9.2 +/- 2.0 per mm2 vs. 4.7 +/- 1.2 per mm2, P < 0.05). Expressed as a percentage of total tissue area, the capillary density at the back in the WKY rats was 0.064 +/- 0.010% as compared to 0.034 +/- 0.008% in the SHR rats (P < 0.05). There were five times more arterioles at the paw compared to the back in both rat groups with no significant difference between the groups. We measured the diameter of the lumen and the thickness of the wall of each arteriole and computed their ratio as an index of possible media hypertrophy. There were minimal differences seen in these parameters between the two rat groups at the back and paw sites. The venular density was significantly higher at the paw than at the back in both rat groups with no significant difference between them. Reduced capillary density at the back of the SHR rats may be a developmental adaptation to high blood pressure. Such a reduction in the pathways of blood flow may help account for increased flow resistance at that site, independent of arteriolar vasoconstriction.     

73例老年高血压脑出血外科手术方法的疗效比较

目的：观察比较三种手术方法治疗老年高血压脑出血的临床疗效及安全性。方法：采取回顾性分析对2008年6月至2012年9月期间在我院接受手术治疗的73例患者,比较手术方式的优劣。结果：采用ADL分级评价治疗效果,神经内镜结合小骨窗组的临床疗效优于立体定向组和大骨瓣开颅血肿清除术组,有统计学差异（P〈0．05）。结论：神经内镜结合小骨窗治疗老年性高血压性脑出血疗效优于立体定向手术和大骨瓣开颅血肿清除术组,值得在脑出血临床治疗中推广应用。     

老年高血压性脑出血相关预后影响因素回顾性分析

目的：回顾性分析高血压性脑出血患者影响预后的各因素之间的关系的相关性,以及各因素对脑出血患者预后的影响。方法：回顾性分析我院2009年1月-2012年7月间接受治疗的老年高血压性脑出血患者147例,其中男：86例,女：61例;年龄60．83岁,平均（69．6±5．7）岁;高血压病程8-23年,平均（9．7±1．6）年。分析老年高血压性脑出血患者发病至就诊时间、入院就诊时的临床表现、患者的意识状态、出血位置及出血量、语言功能障碍、肢体运动功能障碍,以及患者的预后转归等因素与预后的相关性。结果：老年高血压性脑出血治疗后,总有效率为67．7％;在诸多预后因素中：意识状态、出血量、出血位置,以及是否破入脑室等因素与预后具有相关性,具有统计学意义（P〈0．05）。结论：老年高血压性脑出血的预后与意识状态、出血量、出血位置相关,根据临床症状对脑出血患者采取积极的治疗措施,对脑出血患者的预后有重要的意义。     

早期康复护理对肠内营养治疗的高血压颅内出血患者预后的影响

目的：研究早期康复护理对肠内营养治疗的高血压颅内出血患者预后的影响。方法：选取2010年1月-2012年10月间入院诊治的高血压颅内出血并应用肠内营养支持治疗的患者120例,随机分为实验组（60例）和对照组（60例）。,对照组应用常规护理办法,实验组在其基础上应用早期康复护理,随访1年后观察两组患者预后的生活质量情况、GCS（格拉斯哥昏迷指数）评分以及并发症的发生情况。结果：随访1年后,实验组的生活质量显著高于对照组（P〈0．05）;护理干预前两组患者的GCS评分无差异,护理干预后实验组的GCS评分显著高于对照组（P〈0．05）;实验组在肺部感染、下肢静脉血栓、肩手综合征等并发症的发生例数均显著低于对照组（P〈0．05）。结论：针对肠内营养支持治疗的高血压颅内出血患者应用早期康复护理可有效改善患者的昏迷程度、预防并发症,有助于提高患者的生活质量。     

老年高血压脑出血的微创治疗分析

目的：探讨微创手术与传统开颅手术治疗高血压脑出血的手术效果。方法：回顾性分析自2005年5月至2009年7月期间开颅手术39例和微创手术治疗44例高血压脑出血的疗效,比较两种方式的优劣。结果：开颅手术组和微创手术组均获得了较好的疗效,两者相比未见有明显的差剐。结论：微创手术组和开颅手术比较未见明显的疗效差异,微创手术手术简单,创伤面积小,费用较低,患者耐受性好,值得推广。     

血清脑钠肽、25-羟维生素D、半乳糖凝集素-3与妊娠期高血压疾病患者左心室舒张功能的相关性及对妊娠结局的影响

摘要 目的：探讨妊娠期高血压疾病（HDP）患者血清脑钠肽（BNP）、25-羟维生素D[25(OH)D]、半乳糖凝集素-3 （Gal-3）与左心室舒张功能的相关性,并分析其对患者妊娠结局的影响。方法：选择2019年6月至2021年12月我院收治的HDP患者114例纳入研究组,其中妊娠期高血压组39例,轻度子痫前期组44例,重度子痫前期组31例,另选择同期在我院产检的健康孕妇30例作为对照组。比较各组血清BNP、25(OH)D、Gal-3及左心室舒张功能,分析患者血清BNP、25(OH)D、Gal-3与左心室舒张功能的相关性。根据妊娠结局将患者分为妊娠结局良好组65例、妊娠结局不良组49例,收集两组患者临床资料,应用单因素分析和多因素Logistic回归分析 HDP患者妊娠结局不良的影响因素。结果：各组血清BNP、25(OH)D、Gal-3水平比较差异有统计学意义（P<0.05）,HDP患者随疾病严重程度的升高血清BNP、Gal-3水平逐渐升高,25(OH)D水平逐渐降低。各组左心室舒张早期充盈峰速度（E峰）、左心室舒张晚期充盈峰速度（A峰）、E/A比较差异有统计学意义（P<0.05）。Pearson相关分析显示,HDP患者血清BNP、Gal-3水平与E峰、E/A呈负相关（P<0.05）,与A峰呈正相关（P<0.05）,血清25(OH)D水平与E峰、E/A呈正相关（P<0.05）,与A峰呈负相关（P<0.05）。多因素Logistic回归分析显示：收缩压≥158.02 mmHg、舒张压≥104.32 mmHg、血清BNP≥406.42 ng/L、血清25(OH)D≤14.94 μg/L、血清Gal-3≥16.17 ng/mL是HDP妊娠结局不良的危险因素（P<0.05）。结论：HDP患者血清BNP、Gal-3水平异常升高、25(OH)D水平异常降低均为HDP患者妊娠结局不良的危险因素,三者水平与患者左心室舒张功能相关,检测三者水平有助于对患者妊娠结局的临床判断。     

传统开颅手术、显微镜下微创手术治疗基底节区高血压脑出血的临床疗效分析

目的:观察和比较传统开颅手术、显微镜下微创手术治疗基底节区高血压脑出血的临床疗效及安全性。方法:选择2011年10月至2016年1月在我院进行手术治疗的基底节区高血压脑出血患者320例,根据手术方式分为两组,每组160例患者。A组患者接受传统开颅血肿清除术,B组患者接受显微镜下小骨窗血肿清除术,比较两组患者的手术情况、临床疗效、术后生活质量的变化和不良反应的发生情况。结果:B组患者手术时间、ICU时间以及住院时间均较A组显著缩短(P0.05),术中失血量、CSS评分以及术后24 h的血肿量显著低于A组(P0.05),术后1个月临床总有效率显著高于A组(P0.05)。随访6个月期间,B组生活质量显著优于A组(P0.05),术后肺部感染、再次出血的发生率均显著低于A组(P0.05)。结论:显微镜下行小骨窗血肿清除术治疗基底节区高血压脑出血的临床疗效显著优于传统开颅血肿清除术,且创伤较小,可有效缩短手术时间,提高手术安全性。