Objective To develop a nationally acceptable blood pressure(BP)reference standards for the diagnosis and evaluation of hypertension in children and adolescents in China.Methods The current study was based on the data ...Objective To develop a nationally acceptable blood pressure(BP)reference standards for the diagnosis and evaluation of hypertension in children and adolescents in China.Methods The current study was based on the data from eleven large-scale cross-sectional BP surveys in China's Mainland since 2001,the survey sites were representative of national geographical distribution including four municipalities(Beijing,Shanghai,Tianjin,Chongqing)and seven provinces(Hunan,Liaoning,Hebei,Zhejiang,Guangxi,Xinqiang and Guangdong).The surveys which met the following selection criteria were involved to form the reference population sample and pooled database:1)Subjects were Han nationality and their ages were from 3 to 18 years old;2)BP levels were measured by auscultation using standard sphygmomanometer and recorded as Korotkoff phase 1(SBP),Korotkoff phase 4(DBP-K4)and/or Korotkoff phase 5(DBP-K5);3)All surveyors were trained before investigations and standard quality control was implemented throughout the BP measuring process;4)Basic variables,except BPs,were at least included but not limited to age,sex,nationality,height and weight.Totally 112 227 subjects(56 912 males accounting for 50.7%)were enrolled in the reference population sample in this study.SPSS 13.0 software was used to do the descriptive statistical analysis.Centile curves for SBP,DBP-K4 and DBP-K5 were drawn by sex using LMS method.Z scores of Height and BMI were calculated based on the data from the Chinese National Survey on Constitution and Health(CNSCH)in schoolchildren in 2005 to evaluate the nutrition status and development level of the reference population.Results The reference population had an optimal representation of Chinese Han children and adolescents.The resulting curves provided specific cut off points based on age and sex for the diagnosis of high normal BP,hypertension and severe hypertension,respectively.Given the best approach for blood pressure measurement in children and adolescents remained controversial,especially on the choice of K4 or K5展开更多
目的探索缺血性卒中静脉溶栓病人,出现颅内出血转化的危险因素。方法收集分析2018年1月1日至2019年11月30日在皖南医学院弋矶山医院接受静脉溶栓治疗的123例急性脑梗死临床资料。溶栓24 h后采用头颅CT检查。将病人分为出血转化组(n=25)...目的探索缺血性卒中静脉溶栓病人,出现颅内出血转化的危险因素。方法收集分析2018年1月1日至2019年11月30日在皖南医学院弋矶山医院接受静脉溶栓治疗的123例急性脑梗死临床资料。溶栓24 h后采用头颅CT检查。将病人分为出血转化组(n=25)和非出血转化组(n=98)。对比两组年龄、性别、吸烟史、饮酒史、溶栓前后病人收缩压和舒张压变化,发病到病人接受静脉溶栓治疗的时间,溶栓前后美国国立卫生研究院卒中量表(NIHSS)评分变化等,明确脑梗死病人行溶栓治疗后出血转化的危险因素。结果两组在性别、烟酒史、发病到接受溶栓治疗时间等基线数据上差异无统计学意义(P>0.05);出血转化组与非出血组在发病年龄[(71.64±10.56)岁比(63.85±12.42)岁]、溶栓前NIHSS评分[11(6,14.5)分比7(4,12)分]、溶栓后2 h NIHSS评分[11(3,14.5)分比5(2,9)分],出血转化组均大于非出血组(P<0.05)。但是出血转化组溶栓前后NIHSS评分差值低于非出血组[0(0,2)分比1(0,4)分,P<0.001]、溶栓前收缩压出血转化组较高[(160.88±20.24)mmHg比(150.79±21)mmHg,P=0.033],出血转化组溶栓前后收缩压变化值大于非出血转化组[(34.88±22.51)mmHg比(24.58±16.56)mmHg,P=0.011]。logistic逐步回归分析提示年龄较大、溶栓前后收缩压差值、溶栓前后NIHSS评分变化值是脑梗死病人溶栓治疗后出血转化的危险因素(P>0.05)。溶栓前后收缩压变化值和NIHSS评分变化值均对病人愈后有显著影响(P>0.05)。结论静脉溶栓后NIHSS评分变化值小、溶栓后收缩压变化值大是出血转化的危险因素。尤其是高龄病人,应充分考虑到病人血压情况和神经功能缺损程度等变化因素,并采用合适的干预手段、积极预防出血转化的发生。展开更多
Background Hypertension is a common disease of the cardiovascular system. So far, the pathogenesis of primary hypertension remains unclear. The elaboration of its pathogenesis is an important topic in the field which ...Background Hypertension is a common disease of the cardiovascular system. So far, the pathogenesis of primary hypertension remains unclear. The elaboration of its pathogenesis is an important topic in the field which calls for urgent resolution. The aim of this study was to probe into the metabolic imbalance of homocysteine （Hcy） and hydrogen sulfide （H2S） in children with essential hypertension, and its significance in the pathogenesis of essential hypertension. Methods Twenty-five children with essential hypertension and 30 healthy children with normal blood pressure were enrolled in the study. The medical history was investigated and a physical examination was conducted on the subjects. Plasma Hcy content was examined by fluorescence polarization immunoassay （FPIA）. The plasma H2S level was detected by a modified method with a sulfide electrode. Data were presented as mean＋standard deviation. The t test was applied to the mean values of both groups. Pearson linear correlation analysis was applied to the plasma Hcy and H2S as well as to the systolic pressure against the plasma H2S/Hcy ratio. Results Plasma Hcy, an intermittent metabolite of the endogenous methionine pathway, was markedly increased but plasma H2S, a final product of this pathway was significantly decreased in hypertensive cases when compared with normal subjects （（Hcy： （12.68±9.69） μmol/L vs （6.62±4.79） μmol/L （t=2.996, ,P〈0.01）; H2S： （51.93±6.01） μ/L vs （65.70±5.50） μmol/L） （t=-8.670, ,P〈0.01））. The ratio of plasma H2S/Hcy in children with hypertension was 5.83±2.91, while that of the control group was 11.60 ± 3.30, and the difference is significant with a t=-6.610 and P〈0.01. A negative correlation existed between plasma Hcy and H2S concentrations, r=-0.379, P〈0.05. And a negative correlation was found between systolic blood pressure and the plasma H2S/Hcy ratio, r=-0.687, P〈0.05. Conclusion There was a metabolic imbalance of homocysteine and hydrogen sulfide in essential hy展开更多
目的比较不同收缩压、不同降压方案对老年高血压脑出血（HICH）患者预后的影响。方法选取2011年2月—2015年6月在西安市东郊第一职工医院内科住院的老年HICH患者541例,按照入院时收缩压将患者分为A组（收缩压〈180 mm Hg）179例、B组（...目的比较不同收缩压、不同降压方案对老年高血压脑出血（HICH）患者预后的影响。方法选取2011年2月—2015年6月在西安市东郊第一职工医院内科住院的老年HICH患者541例,按照入院时收缩压将患者分为A组（收缩压〈180 mm Hg）179例、B组（收缩压为180~200 mm Hg）227例和C组（收缩压〉200 mm Hg）135例;按照降压方案不同将患者分为非强化降压组309例和强化降压组232例。比较不同收缩压患者入院时脑血肿体积、脑水肿体积、美国国立卫生研究院卒中量表（NIHSS）评分及发病90 d改良Rankin量表（mRS）评分;比较不同降压方案及强化降压组不同收缩压患者入院时和治疗后7 d脑血肿体积、脑水肿体积及发病90 d mRS评分。结果 B组和C组患者入院时脑血肿体积大于A组,入院时NIHSS评分及发病90 d mRS评分高于A组（P〈0.05）;C组患者入院时脑血肿体积大于B组,脑水肿体积大于A组,发病90 d mRS评分高于B组（P〈0.05）。入院时非强化降压组与强化降压组患者脑血肿体积、脑水肿体积比较,差异无统计学意义（P〉0.05）;治疗后7 d强化降压组患者脑血肿体积、脑水肿体积小于非强化降压组,发病90 d mRS评分低于非强化降压组（P〈0.05）。强化降压组不同收缩压患者入院时脑血肿体积、脑水肿体积比较,差异无统计学意义（P〉0.05）;B组和C组患者治疗后7 d脑血肿体积、脑水肿体积大于A组,C组患者发病90 d mRS评分高于A组（P〈0.05）。结论入院时收缩压较高的老年HICH患者病情更严重、预后更差,强化降压较非强化降压能更有效地改善患者病情严重程度及预后,且收缩压较低的老年HICH患者强化降压效果更佳。展开更多
目的 探讨亚临床甲状腺功能减退（亚临床甲减）与收缩压水平的关系,为高血压防治和病因探索提供证据.方法 检索国内外各类大型数据库中近11年发表的有关亚临床甲减与收缩压水平关系的文献,采用Meta分析方法,利用Stata11软件评价亚临床...目的 探讨亚临床甲状腺功能减退（亚临床甲减）与收缩压水平的关系,为高血压防治和病因探索提供证据.方法 检索国内外各类大型数据库中近11年发表的有关亚临床甲减与收缩压水平关系的文献,采用Meta分析方法,利用Stata11软件评价亚临床甲减与收缩压水平之间的关系.计算加权均数差（WMD）及其95%CI,Begg＇s检验法和Egger＇s检验法评价发表性偏倚.结果 （1）亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.04mmHg,95%CI：0.64～3.45,P＜0.05）.（2）亚组分析显示,在促甲状腺激素（TSH）均数差值＜7 mU/L组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.33 mm Hg,95%CI：0.60～4.06,P＜0.05）,在TSH均数差值＞7mU/L组,则无统计学意义;在亚洲组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.62mmHg,95%CI：1.69～3.55,P＜0.05）,而在欧洲组差异无统计学意义;在社区收集组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.77 mm Hg,95%CI：1.61～3.93,P＜0.05）,而在医院收集组差异无统计学意义;在横断面研究组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.77 mm Hg,95%CI：1.61～3.93,P＜0.05）,而病例对照研究组的差异无统计学意义.（3）Begg＇s检验法和Egger＇s检验法检验均无统计学意义（P＞0.05）,所以没有显著的发表偏倚.结论 亚临床甲减和收缩压水平升高有明显相关性.亚临床甲减是否为收缩压水平升高的危险因素之一,还有待进一步大样本的前瞻性研究证实.积极治疗亚临床甲减,对高血压的预防和治疗有一定意义.展开更多
文摘Objective To develop a nationally acceptable blood pressure(BP)reference standards for the diagnosis and evaluation of hypertension in children and adolescents in China.Methods The current study was based on the data from eleven large-scale cross-sectional BP surveys in China's Mainland since 2001,the survey sites were representative of national geographical distribution including four municipalities(Beijing,Shanghai,Tianjin,Chongqing)and seven provinces(Hunan,Liaoning,Hebei,Zhejiang,Guangxi,Xinqiang and Guangdong).The surveys which met the following selection criteria were involved to form the reference population sample and pooled database:1)Subjects were Han nationality and their ages were from 3 to 18 years old;2)BP levels were measured by auscultation using standard sphygmomanometer and recorded as Korotkoff phase 1(SBP),Korotkoff phase 4(DBP-K4)and/or Korotkoff phase 5(DBP-K5);3)All surveyors were trained before investigations and standard quality control was implemented throughout the BP measuring process;4)Basic variables,except BPs,were at least included but not limited to age,sex,nationality,height and weight.Totally 112 227 subjects(56 912 males accounting for 50.7%)were enrolled in the reference population sample in this study.SPSS 13.0 software was used to do the descriptive statistical analysis.Centile curves for SBP,DBP-K4 and DBP-K5 were drawn by sex using LMS method.Z scores of Height and BMI were calculated based on the data from the Chinese National Survey on Constitution and Health(CNSCH)in schoolchildren in 2005 to evaluate the nutrition status and development level of the reference population.Results The reference population had an optimal representation of Chinese Han children and adolescents.The resulting curves provided specific cut off points based on age and sex for the diagnosis of high normal BP,hypertension and severe hypertension,respectively.Given the best approach for blood pressure measurement in children and adolescents remained controversial,especially on the choice of K4 or K5
文摘目的探索缺血性卒中静脉溶栓病人,出现颅内出血转化的危险因素。方法收集分析2018年1月1日至2019年11月30日在皖南医学院弋矶山医院接受静脉溶栓治疗的123例急性脑梗死临床资料。溶栓24 h后采用头颅CT检查。将病人分为出血转化组(n=25)和非出血转化组(n=98)。对比两组年龄、性别、吸烟史、饮酒史、溶栓前后病人收缩压和舒张压变化,发病到病人接受静脉溶栓治疗的时间,溶栓前后美国国立卫生研究院卒中量表(NIHSS)评分变化等,明确脑梗死病人行溶栓治疗后出血转化的危险因素。结果两组在性别、烟酒史、发病到接受溶栓治疗时间等基线数据上差异无统计学意义(P>0.05);出血转化组与非出血组在发病年龄[(71.64±10.56)岁比(63.85±12.42)岁]、溶栓前NIHSS评分[11(6,14.5)分比7(4,12)分]、溶栓后2 h NIHSS评分[11(3,14.5)分比5(2,9)分],出血转化组均大于非出血组(P<0.05)。但是出血转化组溶栓前后NIHSS评分差值低于非出血组[0(0,2)分比1(0,4)分,P<0.001]、溶栓前收缩压出血转化组较高[(160.88±20.24)mmHg比(150.79±21)mmHg,P=0.033],出血转化组溶栓前后收缩压变化值大于非出血转化组[(34.88±22.51)mmHg比(24.58±16.56)mmHg,P=0.011]。logistic逐步回归分析提示年龄较大、溶栓前后收缩压差值、溶栓前后NIHSS评分变化值是脑梗死病人溶栓治疗后出血转化的危险因素(P>0.05)。溶栓前后收缩压变化值和NIHSS评分变化值均对病人愈后有显著影响(P>0.05)。结论静脉溶栓后NIHSS评分变化值小、溶栓后收缩压变化值大是出血转化的危险因素。尤其是高龄病人,应充分考虑到病人血压情况和神经功能缺损程度等变化因素,并采用合适的干预手段、积极预防出血转化的发生。
基金the Key Science andTechnology Program of Beijing (No. H030930030530 and No. H030930030031)National Natural Science Foundation of China (No. 30425010 and No. 30630031)Major Basic Research Project of China (No. 2006CB503807).
文摘Background Hypertension is a common disease of the cardiovascular system. So far, the pathogenesis of primary hypertension remains unclear. The elaboration of its pathogenesis is an important topic in the field which calls for urgent resolution. The aim of this study was to probe into the metabolic imbalance of homocysteine （Hcy） and hydrogen sulfide （H2S） in children with essential hypertension, and its significance in the pathogenesis of essential hypertension. Methods Twenty-five children with essential hypertension and 30 healthy children with normal blood pressure were enrolled in the study. The medical history was investigated and a physical examination was conducted on the subjects. Plasma Hcy content was examined by fluorescence polarization immunoassay （FPIA）. The plasma H2S level was detected by a modified method with a sulfide electrode. Data were presented as mean＋standard deviation. The t test was applied to the mean values of both groups. Pearson linear correlation analysis was applied to the plasma Hcy and H2S as well as to the systolic pressure against the plasma H2S/Hcy ratio. Results Plasma Hcy, an intermittent metabolite of the endogenous methionine pathway, was markedly increased but plasma H2S, a final product of this pathway was significantly decreased in hypertensive cases when compared with normal subjects （（Hcy： （12.68±9.69） μmol/L vs （6.62±4.79） μmol/L （t=2.996, ,P〈0.01）; H2S： （51.93±6.01） μ/L vs （65.70±5.50） μmol/L） （t=-8.670, ,P〈0.01））. The ratio of plasma H2S/Hcy in children with hypertension was 5.83±2.91, while that of the control group was 11.60 ± 3.30, and the difference is significant with a t=-6.610 and P〈0.01. A negative correlation existed between plasma Hcy and H2S concentrations, r=-0.379, P〈0.05. And a negative correlation was found between systolic blood pressure and the plasma H2S/Hcy ratio, r=-0.687, P〈0.05. Conclusion There was a metabolic imbalance of homocysteine and hydrogen sulfide in essential hy
文摘目的比较不同收缩压、不同降压方案对老年高血压脑出血（HICH）患者预后的影响。方法选取2011年2月—2015年6月在西安市东郊第一职工医院内科住院的老年HICH患者541例,按照入院时收缩压将患者分为A组（收缩压〈180 mm Hg）179例、B组（收缩压为180~200 mm Hg）227例和C组（收缩压〉200 mm Hg）135例;按照降压方案不同将患者分为非强化降压组309例和强化降压组232例。比较不同收缩压患者入院时脑血肿体积、脑水肿体积、美国国立卫生研究院卒中量表（NIHSS）评分及发病90 d改良Rankin量表（mRS）评分;比较不同降压方案及强化降压组不同收缩压患者入院时和治疗后7 d脑血肿体积、脑水肿体积及发病90 d mRS评分。结果 B组和C组患者入院时脑血肿体积大于A组,入院时NIHSS评分及发病90 d mRS评分高于A组（P〈0.05）;C组患者入院时脑血肿体积大于B组,脑水肿体积大于A组,发病90 d mRS评分高于B组（P〈0.05）。入院时非强化降压组与强化降压组患者脑血肿体积、脑水肿体积比较,差异无统计学意义（P〉0.05）;治疗后7 d强化降压组患者脑血肿体积、脑水肿体积小于非强化降压组,发病90 d mRS评分低于非强化降压组（P〈0.05）。强化降压组不同收缩压患者入院时脑血肿体积、脑水肿体积比较,差异无统计学意义（P〉0.05）;B组和C组患者治疗后7 d脑血肿体积、脑水肿体积大于A组,C组患者发病90 d mRS评分高于A组（P〈0.05）。结论入院时收缩压较高的老年HICH患者病情更严重、预后更差,强化降压较非强化降压能更有效地改善患者病情严重程度及预后,且收缩压较低的老年HICH患者强化降压效果更佳。
文摘目的 探讨亚临床甲状腺功能减退（亚临床甲减）与收缩压水平的关系,为高血压防治和病因探索提供证据.方法 检索国内外各类大型数据库中近11年发表的有关亚临床甲减与收缩压水平关系的文献,采用Meta分析方法,利用Stata11软件评价亚临床甲减与收缩压水平之间的关系.计算加权均数差（WMD）及其95%CI,Begg＇s检验法和Egger＇s检验法评价发表性偏倚.结果 （1）亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.04mmHg,95%CI：0.64～3.45,P＜0.05）.（2）亚组分析显示,在促甲状腺激素（TSH）均数差值＜7 mU/L组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.33 mm Hg,95%CI：0.60～4.06,P＜0.05）,在TSH均数差值＞7mU/L组,则无统计学意义;在亚洲组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.62mmHg,95%CI：1.69～3.55,P＜0.05）,而在欧洲组差异无统计学意义;在社区收集组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.77 mm Hg,95%CI：1.61～3.93,P＜0.05）,而在医院收集组差异无统计学意义;在横断面研究组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.77 mm Hg,95%CI：1.61～3.93,P＜0.05）,而病例对照研究组的差异无统计学意义.（3）Begg＇s检验法和Egger＇s检验法检验均无统计学意义（P＞0.05）,所以没有显著的发表偏倚.结论 亚临床甲减和收缩压水平升高有明显相关性.亚临床甲减是否为收缩压水平升高的危险因素之一,还有待进一步大样本的前瞻性研究证实.积极治疗亚临床甲减,对高血压的预防和治疗有一定意义.
