目的 研究老年人原发性高血压合并轻度认知功能障碍的相关性.方法 入选符合标准的老年原发性高血压患者170例,根据动态血压监测结果分为晨峰血压(MBPS)组和非MBPS组.收集受试者的病史,检测血压、体质量指数、空腹血糖、血脂、血清胱抑素C(Cys-C),并用蒙特利尔认知评估(MoCA)量表作为认知功能的测评工具.结果 两组患者性别、年龄、体质量指数、空腹血糖、血脂水平差异均无统计学意义(P＞0.05),而血清Cys-C水平、MoCA评分差异有统计学意义(P＜0.05).多元logistic逐步回归分析结果表明,血清Cys-C水平与MoCA评分结果呈负相关(OR=2.326,P=0.017),由此推测血清Cys-C水平可能是老年人原发性高血压合并轻度认知功能障碍的独立危险因素.结论 血清Cys-C水平联合MBPS可更好地评估老年人原发性高血压的轻度认知功能障碍.

[目的]研究社会支持与脑血管病病人生活质量的相关性.[方法]采用社会支持评定量表(SSRS)对100例脑血管病病人及60名健康正常人的社会支持进行评定,采用Barthel指数(BI)和抑郁自评量表(SDS)对100例脑血管病病人的生活质量进行评定,分析脑血管病病人的社会支持与生活质量的相关性.[结果]脑血管病病人获得的社会支持低于与正常对照组,差异有统计学意义(P＜0.05);社会支持与脑血管病病人的BI评分呈正相关(r=0.851,P＜0.05),与SDS评分呈负相关(r =-0.796,P＜0.05).[结论]社会支持与脑血管病病人的生活质量密切相关,在护理过程中要重视病人的社会支持,以提高其生活质量.

Objective:To explore the influence of diabetic self-management education on blood glucose control and inflammatory factor levels in inpatients with diabetes mellitus (DM).Methods:A total of 168 DM patients,who hospitalized in department of endocrinology in 163rd hospital of Chinese PLA from Jun 2012 to Jun 2013,were ran-domly divided into self-management education group (self-management group,n=88)and routine health education group (routine management group,n = 80).Self-management group received self-management education course namely AADE7TM ,provided by full-time DM health education staff,including healthy eating,being active,monito-ring,taking medication,problem solving,healthy coping and reducing risks,while routine management group re-ceived routine DM health education.Blood glucose control,changes of levels of myeloperoxidase (MPO),tumor necrosis factor-α(TNF-α)and intercellular adhesion molecule-1 (ICAM-1)were examined before and after interven-tion.Results:Compared with before intervention,there were significant reductions in levels of fasting blood glucose (FBG),postprandial blood glucose (PBG)and glycosylated hemoglobin (HbA1c)in both groups after interventions (P <0.05 all).Compared with routine management group,there were significant reductions in levels of FBG [(7.1 ±1.3)mmol/L vs.(6.0±1.1)mmol/L],PBG [(9.5±1.6)mmol/L vs.(8.8±1.4)mmol/L]and HbA1c [(7.9 ±1.5)% vs.(7.2±1.1)%]in self-management group,P <0.05 all.Before discharge,there were significant de-crease in inflammatory factor levels in both groups compared with before intervention (P < 0.05 all).Compared with routine management group after intervention,there were significant decrease in inflammatory factor levels [TNF-α:(201.0±57.3)pg/ml vs.(100.7±49.2)pg/ml,ICAM-1:(25.2±3.6)ng/ml vs.(18.2±2.9)ng/ml]&nbsp;in self-management group,P < 0.05 both.Conclusion:Self-management education provided by full-time diabetic health education staff is superior to routine diabetic health education method in controlling blood glucose and decrea-sing inflammatory factor levels,indicating it can improveβcell function and relieve insulin resistance.

Objective:To study the of psychological intervention on hospital patients with post-stroke depression.Methods:A total of 198 cases with onset of stroke in 12 h were assessed by Hamilton depression scale(HAMD,24 items),in which 89 cases with HAMD score 17 minutes were regard as study object,and randomly divided into experimental group and the control group,Both groups received conventional drug treatment for stroke and general health education.The experimental group received psychological intervention,once a day,45 minutes time,continued for 2 weeks on the base of routine therapy.HAMD total score decreased by 50% or more regard as the effect standard,the efficacy of intervention was determined after 2 weeks intervention.Results: Two weeks later,the HAMD of experimental group of patients with post-stroke depression were significantly decreased,and less than that of control group [(10.5±3.3)∶(15.8±3.5),P0.05].Conclusion:Positive psychological intervention can effectively improve the depression symptoms in patients with post-stroke.