Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.
Objective To investigate the pathological spectrum of hypertensive retinopathy. Methods Systemic hypertension was produced experimentally in SD rats by partially constricting the right renal artery and removing the left kidney.The eyes obtained from hypertensive animals at 2 weeks,1,2,4months were examined by means of light microscopy,immunohistochemical staining,electron microscopy and histochemical electron microscopy and compared with the control group. Results 1.From 2 months after surgery,thickening of retinal capillary basement membrane(RBM)became apparent.2.From then on,RBM showed an increased staining reaction for type Ⅳcollagen and laminin,while staining reaction of RBM for fibronectin in hypertensive rats was negative at any stages.The number of anionic sites within the RBM was gradually reduced following the development of hypertension and it was definitely decreased at 4 months. 3.A few deteriorated endothelial cells were lifted focally from the RBM with subendothelial swelling in retinal vessels at 2 weeks,and the pericytes exhibited edema and deterioration at 4 months. Conclusions Detachment of the endothelial cells from the RBM,thickening of the RBM companied with the reduction of anionic sites and deterioration of pericytes may be responsible for hypertensive retinopathy. (Chin J Ocul Fundus Dis, 1999, 15: 163-166)
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.
Objective To observe the effects of valsartan/ hydrochlorothiazide and valsartan on left ventricular thickness and the left ventricular diastolic function in patients with essential hypertension and left ventricular hypertrophy and impaired left ventricular diastolic function. Methods 56 patients of essential hypertension with left ventricular hypertrophy and impaired left ventricular diastolic function were randomized into two randomized double-blind groups, valsartan/hydrochlorothiazide (HCTZ) 80/12.5 mg o.d were gave to A group and valsartan 80 mg o.d were gave to B group. The dosage would be doubled in patients whose SDBP ≥ 12 kPa or SSBP ≥ 18.7 kPa after 4 weeks. Treatment lasted for 6 months. Result At the end of 6 months, valsartan/ hydrochlorothiazide and valsartan significantly reduced BP from baseline (Plt;0.01), there was significant difference in reducing BP between the two groups (Plt;0.05). Indexes of left ventricular diastolic function (IVST, LVPWT, LVMI) significantly decreased (Plt;0.01). LVEF increased significantly (Plt;0.01). There was significant difference in IVST, LVPWT, LVMI and LVEF between two groups (Plt;0.05). Conclusion Valsartan/ hydrochlorothiazide (HCTZ) can not only decrease blood pressure effectively, but also can significantly improve left ventricular hypertrophy and left ventricular diastolic function.
ObjectiveTo explore and compare the therapeutic effects of neuro-endoscopic and craniotomic hematoma evacuation for hypertensive hematomas in the basal ganglia region. MethodsEighty-six patients with hypertensive hematomas in the basal ganglia regions treated between January 2010 and September 2014 were divided into neuro-endoscopy and craniotomy groups randomly with 43 in each. Hematoma was removed directly under neuro-endoscope in the endoscopic group, while it was removed under the operating microscope in the craniotomy group. The average operation bleeding amount, residual hematoma after operation, hematoma evacuation rate, the changes of National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI) scores before operation, 1 and 3 months after operation were compared between the two groups. All data were analyzed statistically. ResultsThe average amount of operation bleeding was (127±26) mL, postoperative residual hematoma was (6±4) mL, and the hematoma clearance rate was (86±9)% in the neuro-endoscopy group, while those three numbers in the craniotomy group were respectively (184±41) mL, (11±6) mL, and (72±8)%, with all significant differences (P < 0.05). The NIHSS and BI scores were not significantly different between the two groups before surgery (P > 0.05). Seven days, one month and three months after surgery, the NIHSS score was significantly lower, and the BI score was significantly higher in the neuro-endoscopy group than the craniotomy group (P < 0.05). ConclusionNeuro-endoscopic surgery for hypertensive hematomas in basal ganglia region is proved to have such advantages as mini-invasion, direct-vision, complete clearance and good neural function recovery after surgery, which is a new approach in this field.
Perioperative management of 58 hypertensive patients suffering from surgical disease is reported. We emphasize that before operation the blood pressure should be adequately controlled, and heart function promoted. It is safer that the diastolic pressure is controlled under 14 kPa before operation. During operation we strictly observe the change of the blood pressure and manage it in time. Analgesic and antihypertensive agents are used after operation.
ObjectiveTo explore the prevalence and risk factors of hypertension in Anyue County from June 2011 to June 2013. MethodsUsing stratfied random cluster sampling method, 5 391 people over 15 years of age were selected from 3 residential areas and 3 natural villages to finish a questionnaire and blood pressure measurement. ResultsThe total prevalence rate of hypertension in Anyue County was 18.77%. The prevalence rates of hypertension in urban areas and rural areas were 21.75% and 16.20%, and the difference was significant (χ2=27.120, P<0.001). In both urban and rural areas, the prevalence rate of hypertension increased with age (χ2=475.634, P<0.001; χ2=394.026, P<0.001). The percentages of awareness, treatment and control in Anyue County were 31.30%, 24.41%, and 9.09%. The percentages of awareness, treatment and control in urban areas were 40.15%, 33.70%, and 11.23% and were 20.68%, 13.65%, and 6.61% in rural areas. There were significant differences in the percentages of awareness, treatment and control between urban and rural areas (χ2=44.475, P<0.001; χ2=54.861, P<0.001; χ2=8.202, P=0.004). The logistic regression analysis showed that age (OR=1.061, P<0.001), diabetes (OR=1.550, P<0.001), hyperlipemia (OR=2.372, P<0.001) and smoking (OR=1.335, P<0.001) were the risk factors for hypertension; and it showed that high level of education was a protective factor for hypertension (OR=0.755, P<0.001). ConclusionBecause of high prevalence and low percentages of awareness, treatment and control in Anyue County, the prevention and control situation of hypertension are grim. We should focus on the control of smoking, blood lipid and blood glucose.
高血壓是我國重點防治的心血管疾病, 血壓的控制率備受關注。在一些血壓控制不良的患者中睡眠呼吸暫停是導致頑固性高血壓的重要原因。以睡眠過程中反復、頻繁出現呼吸暫停和低通氣為特點的睡眠呼吸暫停低通氣綜合征( sleep apneahypopnea syndrome, SAHS) 自20 世紀80 年代以來也受到廣泛關注, 臨床和基礎研究取得了迅速發展。目前, 多項臨床、流行病學和基礎研究證實SAHS可以導致和/ 或加重高血壓, 與高血壓的發生發展密切相關。
ObjectiveTo explore the regional and urban-rural disparities in the hypertension incidence of Chinese adults. MethodsBased on the data from the China Health and Nutrition Survey (CHNS), as well as the consumption level and altitude data from the National Bureau of Statistics and government official website, a robust multilevel Poisson regression was performed to explore the regional and urban-rural disparities in the hypertension incidence of Chinese adults, according to data and design types. ResultsAccording to the inclusion and exclusion criteria, 11 579 subjects and totaling 50 957 lines of data were enrolled. The 24 years follow-up results indicated that the crude incidence density of hypertension was 37.08/1 000 person years, with 40.51/1 000 person years for males and 34.13/1 000 person years for females. The robust multilevel Poisson regression results indicated that, by adjusting the high-level factors such as time, the proportion of the community mainly engaged in agricultural labor, and the consumption level of subjects, as well as sociodemographic characteristics such as age and gender, the Middle (RR=1.20, 95%CI 1.04 to 1.39), Northeast (RR=1.25, 95%CI 1.03 to 1.52), and Eastern (RR=1.25, 95%CI 1.05 to 1.48) China had a higher risk of developing hypertension than the Western China. The risk of hypertension in urban area was lower than that in rural area (RR=0.87, 95%CI 0.77 to 0.96). ConclusionThe incidence density of hypertension in China is relatively high, and male is higher than female. The incidence of hypertension in the Western China is lower than that in the Middle, Northeast and Eastern China, and urban area is lower than rural area.