目的探讨老年心房颤动合并稳定性冠心病患者抗栓治疗的效果。方法本研究为回顾性队列研究。选择我院自2014年1月至2017年1月收治的老年心房颤动合并稳定性冠心病的患者的临床资料，根据抗栓治疗方案将患者分为两组：双联抗血小板抗栓组...目的探讨老年心房颤动合并稳定性冠心病患者抗栓治疗的效果。方法本研究为回顾性队列研究。选择我院自2014年1月至2017年1月收治的老年心房颤动合并稳定性冠心病的患者的临床资料，根据抗栓治疗方案将患者分为两组：双联抗血小板抗栓组（阿司匹林＋氯吡格雷，简称DT组）和华法林加单一抗血小板抗栓组（华法林＋阿司匹林，或华法林＋氯吡格雷，简称WS组）。随访12个月，评估两组患者抗栓治疗的安全性（出血风险）和有效性（不良心脑血管事件）。结果329例患者入选本研究。其中男性173例，平均年龄为（70.1±9.3）岁。DT组82例，WS组247例。WS组患者的年龄、2型糖尿病、血CK-MB水平和血栓风险均明显高于DT组（均P〈0.05），但两组的抗栓治疗时间、出血风险、冠状动脉情况和术后24 h CK-MB峰值差异无统计学意义（均P〉0.05）。平均随访（11.7±1.5）个月后两组出血发生率差异无统计学意义（P〉0.05）。此外，两组间的主要不良心脑血管事件发生率差异无统计学意义（P〉0.05），DT组缺血性脑卒中发生率有增加趋势，但差异无统计学意义（P〉0.05）。结论老年房颤合并稳定性冠心病患者支架治疗术后联合应用华法林加单一抗血小板药物抗栓治疗安全、有效，且有降低缺血性脑卒中的趋势，但需更多研究证实。展开更多
Objective The study will explore effects of the autoantibodies against AT1 receptor and angiotensin Ⅱ on the refractory hypertension. Methods Seventy-seven patients (46 men and 31 women) with essential hypertension w...Objective The study will explore effects of the autoantibodies against AT1 receptor and angiotensin Ⅱ on the refractory hypertension. Methods Seventy-seven patients (46 men and 31 women) with essential hypertension were divided into groups of refractory hypertension (RH) and hypertension (HT) according to the 1999 WHO-ISH Guidelines for the Management of Hypertension. Forty normotensives (22 men) were recruited as controls. The mean age was 54. 3±13 years old in RH group, 53. 5±9 years old in HT group and 51. 2±11. 9 years old in normotensives (NT) group. The mean blood pressure was 154. 2±9. 4/98. 4± 8. 2 mmHg in RH group and 130. 1±7. 6/80. 5±6. 7 mmHg in HT group after combination drug therapy of hypertension for 4 weeks. Blood pressure in NT group was 120. 8±11. 7/76. 4 ± 7. 2 mmHg. The epitope of the 2nd extracellular loops of AT1 receptor was synthesized and used as antigens to screen the autoantibodies by ELISA. Plasma angiotensin (Ang) II were examined by a radioimmunoassay. Results The autoantibodies against AT1 receptor were positive in 18 (46. 15 %) patients with RH, in 4 (10. 5 % ) hypertension and in 3 (7. 5 % ) normotensives, P < 0. 01. Ang Ⅱwas 57. 01±52. 63 pmol/L in patients with RH. Both the autoantibodies positive and the Ang Ⅱ increasing were 4 (10. 3 % ) cases, both normal were 7 (17. 9 % ) cases, the autoantibodies positive or Ang II increasing was all of 14 (35. 9 % ) cases (x2 = 0. 09, P>0. 05) . There was no relationship between the autoantibodies against AT1 receptor and the angiotensin Ⅱ in refractory hypertension. Conclusion The autoantibodies against AT1 receptor and Ang Ⅱ might be two independent factors in developing of refractory hypertension. The findings suggest that AT1 receptor an-tagnist used in the treatment of refractory hypertension might have an important value.展开更多
文摘目的探讨老年心房颤动合并稳定性冠心病患者抗栓治疗的效果。方法本研究为回顾性队列研究。选择我院自2014年1月至2017年1月收治的老年心房颤动合并稳定性冠心病的患者的临床资料，根据抗栓治疗方案将患者分为两组：双联抗血小板抗栓组（阿司匹林＋氯吡格雷，简称DT组）和华法林加单一抗血小板抗栓组（华法林＋阿司匹林，或华法林＋氯吡格雷，简称WS组）。随访12个月，评估两组患者抗栓治疗的安全性（出血风险）和有效性（不良心脑血管事件）。结果329例患者入选本研究。其中男性173例，平均年龄为（70.1±9.3）岁。DT组82例，WS组247例。WS组患者的年龄、2型糖尿病、血CK-MB水平和血栓风险均明显高于DT组（均P〈0.05），但两组的抗栓治疗时间、出血风险、冠状动脉情况和术后24 h CK-MB峰值差异无统计学意义（均P〉0.05）。平均随访（11.7±1.5）个月后两组出血发生率差异无统计学意义（P〉0.05）。此外，两组间的主要不良心脑血管事件发生率差异无统计学意义（P〉0.05），DT组缺血性脑卒中发生率有增加趋势，但差异无统计学意义（P〉0.05）。结论老年房颤合并稳定性冠心病患者支架治疗术后联合应用华法林加单一抗血小板药物抗栓治疗安全、有效，且有降低缺血性脑卒中的趋势，但需更多研究证实。
文摘Objective The study will explore effects of the autoantibodies against AT1 receptor and angiotensin Ⅱ on the refractory hypertension. Methods Seventy-seven patients (46 men and 31 women) with essential hypertension were divided into groups of refractory hypertension (RH) and hypertension (HT) according to the 1999 WHO-ISH Guidelines for the Management of Hypertension. Forty normotensives (22 men) were recruited as controls. The mean age was 54. 3±13 years old in RH group, 53. 5±9 years old in HT group and 51. 2±11. 9 years old in normotensives (NT) group. The mean blood pressure was 154. 2±9. 4/98. 4± 8. 2 mmHg in RH group and 130. 1±7. 6/80. 5±6. 7 mmHg in HT group after combination drug therapy of hypertension for 4 weeks. Blood pressure in NT group was 120. 8±11. 7/76. 4 ± 7. 2 mmHg. The epitope of the 2nd extracellular loops of AT1 receptor was synthesized and used as antigens to screen the autoantibodies by ELISA. Plasma angiotensin (Ang) II were examined by a radioimmunoassay. Results The autoantibodies against AT1 receptor were positive in 18 (46. 15 %) patients with RH, in 4 (10. 5 % ) hypertension and in 3 (7. 5 % ) normotensives, P < 0. 01. Ang Ⅱwas 57. 01±52. 63 pmol/L in patients with RH. Both the autoantibodies positive and the Ang Ⅱ increasing were 4 (10. 3 % ) cases, both normal were 7 (17. 9 % ) cases, the autoantibodies positive or Ang II increasing was all of 14 (35. 9 % ) cases (x2 = 0. 09, P>0. 05) . There was no relationship between the autoantibodies against AT1 receptor and the angiotensin Ⅱ in refractory hypertension. Conclusion The autoantibodies against AT1 receptor and Ang Ⅱ might be two independent factors in developing of refractory hypertension. The findings suggest that AT1 receptor an-tagnist used in the treatment of refractory hypertension might have an important value.
