心血管疾病严重威胁着人民的身心健康,在心血管危险因素中,原发性高血压(EH)的患病率最高,全球25岁以上人群EH患病率达40%,其危害性及致残性也最高[1].青年人群一旦发病对其身心健康会造成严重伤害,因此及时预防EH的发生具有重要意义.

Objective To investigate the influencing factors for masked hypertension. Methods Among 10 040 patients who received treatment in the Department of Cardiology of General Hospital of Beijing Military Area Command Affiliated to Southern Medical University from January 2010 to April 2015,we consecutively selected 250 hypertensive patients(hypertension group),250 MH patients( MH group)and 250 normal hypertensive patients( control group). General data and laboratory indexes were collected,and the influencing factors for MH were investigated by multivariate logistic regression analysis. Results The three groups were significantly different in gender,BMI and the proportion of patients with family history of hypertension(P< 0. 05),but were not significantly different in average age,the proportion of patients with smoking history and the proportion of patients with history of alcohol consumption(P > 0. 05). The three groups were not significantly different in FPG,HDL,BUN and potassium ion level(P > 0. 05),but were significantly different in the levels of TC,TG,LDL,UA,Cr and ALT(P <0. 05). MH patients with different family history of hypertension were not significantly different in average age( P > 0. 05). Multivariate logistic regression analysis showed that BMI and the family history of hypertension had significant influence on MH. Conclusion BMI and the family history of hypertension are influencing factors for MH. Therefore,the screening of patients with high BMI and the family history of hypertension should be emphasized.

Objective: To investigate the impact for family history of hypertension on masked hypertension (MH) morbidity with relevant cardiac damage. Methods: Our research included in 3 groups: MH group, n=250 consecutive patients treated in our hospital from 2010-01 to 2015-04, Hypertension group, n=250 and Control group, n=250 subjects with normal blood pressure. The family history of hypertension, general clinical information, routine biochemical indexes and the findings of echocardiography were studied and compared among different groups. Results: ① There were 70 (28%) patients with family history of hypertension in MH group, 87 (34.8%) in Hypertension group and 26 (10.4%) in Control group. The ratio of family history of hypertension in MH group was higher than Control group, P<0.001, while it was similar between MH group and Hypertension group, P>0.05. Logistic regression analysis presented that family history of hypertension and body mass index were positively related to the morbidities of MH (r=1.468, r=0.173) and hypertension (r=1.195, r=0.086). ② Compared with Control group, MH group had increased left ventricular mass index (85.64 ± 17.7) g/m2 vs (80.50 ± 15.53) g/m2 and the maximum blood flow velocity of aortic valve (115.74 ± 16.54) cm/s vs (112.40±14.21) cm/s, all P<0.05. In MH group, compared with those without family history of hypertension, the patients with&nbsp;family history had the higher left ventricular mass index (89.22 ± 19.08) g/m2 vs (84.25 ± 16.99) g/m2 and the maximum blood flow velocity of aortic valve (119.19 ± 14.97) g/m2 vs (114.39 ± 16.96) g/m2, all P<0.05. Conclusion: The subjects with family history of hypertension had the higher risk of MH morbidity with more severe cardiac damage.

Objective To explore the changes of blood pressure and its influence factors in primary hypertension patients during submaximal exercise.Methods 82 patients with primary hypertension ( hypertension group) and 54 normal subjects (normal control group) were enrolled from December 2014 to July 2015. Changes of blood pressure with primary hypertension during submaximal exercise were measured. Multiple regression analysis was used to analyze relationship between systolic pressure during submaximal exercise with blood pressure before exercise, pulse pressure, and brachial-ankle pulse wave velocity (baPWV).Results Compared with normal control group, systolic pressure during submaximal exercise in hypertension group was higher (190±13.2 mmHgvs. 136.7 ±15.3 mmHg,P<0.05), with higher rising range (39.0±12.1 mmHgvs. 21.7±10.4 mmHg,P<0.05). Multiple stepwise regression analysis result showed that pre-exercise systolic blood pressure, baPWV and pulse pressure were related to systolic blood pressure during submaximal exercise (P<0.05).Conclusion In primary hypertension patients, blood pressure change during submaximal exercise is higher than normal subjects. Pre-exercise systolic blood pressure, baPWV and pulse pressure were related to systolic blood pressure during submaximal exercise.

目的 探讨基础低血压状态者血压升高后出现临床症状的意义.方法 选择我院心内科就诊的基础低血压状态者36例(基础低血压状态组)及正常血压者70例(正常血压组).观察基础低血压状态组出现临床症状与血压的关系,并比较2组间肱踝脉搏波传导速度(baPWV)和颈总动脉内膜中层厚度(IMT)的差异.结果 基础低血压状态组年轻时血压为(88.3±3.8/58.3±3.8)mm Hg(1 mm Hg=0.133 kPa),出现临床症状时血压为(127.5±5.7/74.8±8.7)mm Hg,予以非药物降压治疗后,血压下降(8.8±3.1/5.6±3.5)mm Hg,临床症状消失;基础低血压状态组和正常血压组的baPWV和IMT比较有显著差异[baPWV(13.3±1.3)m/s vs (12.4±0.9)m/s,P＜0.01;IMT(0.95±0.2)mm vs (0.84±0.12)mm,P＜0.01].结论 基础低血压状态者血压升高一定程度,虽然未达到140/90mm Hg,已出现临床症状和一定程度的血管改变,通过非药物降压治疗后可明显改善临床症状.

中国疾病预防控制中心（CDC）近期公布的一项横断面研究显示，2010年中国成年人高血压患病率高达33.5%，估计患病人数达3.3亿，45万人死于高血压[1]。研究者于2010年在我国凋查了98548名18岁以上居民，结果显示，调查对象中有37461例高血压患者，高血压患病率为38.0%，我国成年人平均收缩压（SBP）为130.8 mmHg（1 mmHg=0.133 kPa），舒张压（DBP）为80.4 mmHg，远高于2002年（平均SBP和DBP分别为120.0 mmHg和76.0 mmHg）和2004年水平（平均SBP和DBP分别为120.9 mmHg和76.3 mmHg）[2]。研究结果提示我国高血压防治工作任重道远。

Objective To study the evolution of D-dimer in coronary artery reperfusion following AMI and its significance .Methods Eighty AMI patients admitted to our hospital from 2001 to 2010 were divided into group A (n=29) ,group B(n=30) ,and group C (n=21) .The therapeutic effect was assessed according to their coronary angiography .Serum D-dimer level was measured before and 1 ,2 ,4 ,8 ,24 ,48h after treatment .Serum CK-MB and troponin I levels were also meas-ured .Thrombogen time and thromboplastin time were recorded .Patients in group A received in-travenous thrombolysis treatment with recombinant tissue activator and those in groups B and C received intravenous normal saline drip .Results The serum CK-MB and troponin I levels were significantly higher in 3 groups following AMI .The serum D-dimer level was significantly higher ingroupAthaningroupCat 1,2,4,8h(4.31±0.94mg/L vs0.89±0.12mg/L,5.21±1.06 mg/Lvs1.55±0.43mg/L,7.56±1.53mg/Lvs0.93±0.12mg/L,4.33±0.99mg/Lvs0.61± 0 .17 mg/L ,P<0 .05 ,P<0 .01) ,in group B than in group C at 1 and 2 h (3 .69 ± 0 .86 mg/L vs 0.89 ± 0 .12 mg/L ,2 .39 ± 0 .66 mg/L vs 1 .55 ± 0 .43 mg/L ,P<0 .05 ,P<0 .01) ,and in group A than in group B at 2 ,4 ,8 ,24 h (P<0 .05 ,P<0 .01) .No significant difference in serum D-dimer level was found in group C at the same time points .Conclusion The serum D-dimer level is sig-nificantly different in AMI patients when they receive thrombolysis and autolysis treatment for coronary artery reperfusion ,and can thus be used as an indicator of thrombolysis .