摘要:目的:研究高血压病患者过氧化物酶体增殖物激活受体(PPAR)γ2基因Pro12Ala多态性与血糖水平之间的关系。方法:纳入177名原发性高血压患者,其中空腹血糖(FBG)lt;5.6 mmol/L组65例, FBG≥5.6 mmol/L组112例,收集一般资料;分别测定空腹及餐后2小时血糖、胰岛素;对PPARγ2 基因Pro12Ala多态性与各临床变量的关系进行研究。结果:FBGlt;5.6 mmol/L组和FBG≥5.6 mmol/L组Pro和Ala等位基因频率分别为0.333,0.034及0.602,0.031;PP和PA基因型频率分别为0.299,0.068及0.571,0.062;无AA型纯合子。以体重指数(BMI)分层后,BMIlt;25组内,FBG与PPARγ2基因型相关（P=0.029)。以基因型分组比较,PA组空腹血糖水平和胰岛素抵抗指数都低于PP组(Plt;0.05)。结论:成都地区高血压患者PPARγ2基因Pro12Ala多态性与空腹血糖水平相关,且携带Ala基因者空腹血糖水平较低,胰岛素抵抗较轻,推测该突变可能有减轻高血压病患者胰岛素抵抗,改善糖代谢异常的作用。Abstract: Objective:To study the association between the Pro12Ala polymorphism in peroxisome proliferatorsactivated receptorγ2 ( PPARγ2 ) gene and blood glucose levels in patients with primary hypertension. Methods：The Pro12Ala polymorphism in PPARγ2 was determined by polymerase chain reactionrestriction fragment length polymorphism (PCRRELP) in 177 subjects with primary hypertension of the Han people in Chengdu of China, including 65 subjects with fasting blood glucose (FBG)lt;5.6 mmol/L and 112 subjects with FBG≥5.6 mmol/L; the clinical characteristics including height, weight, OGTT(0h and 2h) of the subjects were detected and the realationship between the Pro12Ala polymorphism and the clinical characteristics were analysed. Results: The allele frequencies in the group with FBGlt;5.6 mmol/L and FBG≥5.6 mmol/L were 0.333, 0.602 for Pro and 0.034, 0.031 for Ala. The genotype frequencies were 0.299, 0.571 for PP and 0.068, 0.062 for PA, and there was no AA. In the group with BMIlt;25, the Pro12Ala polymorphism was associated with FBG （P=0.029). the Ala allele had a negative relationship to the FPG and insulin resistance index (IRI) (Plt;0.05).Conclusion: The data showed that the Pro12Ala polymorphism was associated with FBG., and The allele Ala probably had benefits to glycometabolic disturbance in patients with primary hypertension by declining insulin resistance.
高血压是我国重点防治的心血管疾病, 血压的控制率备受关注。在一些血压控制不良的患者中睡眠呼吸暂停是导致顽固性高血压的重要原因。以睡眠过程中反复、频繁出现呼吸暂停和低通气为特点的睡眠呼吸暂停低通气综合征( sleep apneahypopnea syndrome, SAHS) 自20 世纪80 年代以来也受到广泛关注, 临床和基础研究取得了迅速发展。目前, 多项临床、流行病学和基础研究证实SAHS可以导致和/ 或加重高血压, 与高血压的发生发展密切相关。
【摘要】 目的 探讨高血压危象评估和处理原则及对高血压危象急诊处理的指导意义。 方法 依据高血压危象评估和处理原则对2008年1月-2009年12月期间收治的160例高血压危象患者进行诊断和治疗。结果 160例高血压危象患者中,高血压急症134例,高血压亚急症26例。高血压急症中,以心脑血管病变为主,包括脑卒中、急性冠脉综合征和急性左侧心力衰竭。依据高血压危象评估和处理原则进行急诊处理,能够对高血压危象进行准确评估和有效处理,减少诊治失误,降低死亡率并改善预后。结论 有关高血压危象的评估和处理原则能够指导高血压危象的急诊处理,取得良好的预后。【Abstract】 Objective To investigate the principles of evaluation and management of hypertensive crises in order to guide emergency clinical practice for better managements and prognosis. Methods One hundred and sixty patients with hypertensive crises admitted to our department from January 2008 to December 2009 had been diagnosed and treated. Results There were 134 patients with hypertensive emergencies (HE) and 26 patients with hypertensive urgencies(HU)in accordance with those principle. Cardiocerebralvascular diseases were the main symptom of HE including stroke, acute coronary syndrome and acute left ventricular failure. According to those principles,the emergency management was carried out, accuracy evaluation and effective management of hypertensive crises could reduce wrong diagnosis and treatment,decrease mortality and improve prognosis. Conclusion The principle of evaluation and management of hypertensive crises could guide the emergency management of hypertensive crises and obtain better prognosis．
Objective To assess the effectiveness and safety of irbesartan for hypertensive patients with hyperuricaemia. Methods The databases such as The Cochrane Library (Issue 2, 2010), MEDLINE (by the end of April 2010), SCI (by the end of April 2010), CBM (by the end of April 2010) and CNKI (by the end of April 2010) were searched to collected randomized controlled trails (RCTs) on irbesartan for hypertensive combined with hyperuricaemia. Studies were screened according to the inclusion and exclusion criteria; data were extracted; the methodological quality was evaluated; and meta-analyses were conducted by using RevMan 5.0.0 software. Results Nine studies involving 977 patients were included. The results of meta-analyses showed that compared with the control group, irbesartan was superior in decreasing serum uric acid (SUA) (MD=57.12, 95%CI 16.08 to 98.15, P=0.006); it was similar in controlling blood pressure (Systolic pressure: MD= –0.24, 95%CI –2.19 to 1.71, P=0.81; Diastolic pressure: MD=0.46, 95%CI –1.58 to 2.50, P=0.66), and lower in the incidence rate of adverse reaction (RR=0.07, 95%CI 0.02 to 0.24, P=0.000 1). Conclusion The study suggests that irbesartan is effective and safe to control blood pressure and decrease serum uric acid for hypertensive patients with hyperuricaemia. But because all nine included studies are graded C in quality, the conclusion still needs to be further verified by long-term, large scale and high quality studies.
Studies of evidence-based medicine have provided much important evidence, clarified problems, and guided the clinical practice in the treatment of renal diseases. As examples, several therapeutic problems in renal hypertension, renal anemia and low protein diet for the patients with chronic kidney disease are discussed in this paper.
目的:研究替米沙坦对合并高血压的阵发性房颤患者转复为窦性心律后复发的影响。方法: 选择84例合并高血压的阵发性房颤患者,随机分成观察组及对照组,观察组降压药使用替米沙坦,对照组使用氨氯地平,两组均使用胺碘酮复律,随访2年,观察两组患者的疗效及超声心动图(左房内径)变化。结果:观察组治疗合并高血压的阵发性房颤复发率显著低于对照组。结论:替米沙坦联合抗心律失常药物,能有效防止房颤复发,维持窦性心律。