目的 探索社区原发性高血压(高血压)患者血清尿酸浓度与无创中心动脉反射波增强指数(central arterial reflected wave augmentation index,cAIx)的关系.方法 2017年4月至12月于广东社区连续入组923例高血压人群,所有参与者均接受问卷调查、体格检查和cAIx、血清尿酸浓度和血脂浓度检测.采用Pearson相关和多变量线性回归分析尿酸浓度与cAIx的关系.结果 Pearson相关分析表明尿酸与cAIx呈正相关(r=0.273,P<0.001).在调整年龄、性别、吸烟、饮酒、体质量指数、血压、血脂、心率、血糖、合并疾病和用药史后,多变量线性回归表明尿酸浓度与cAIx独立相关(β=0.192,95％CI:0.15～0.24,P<0.001).结论 在高血压患者中血清尿酸浓度与cAIx密切相关,升高的尿酸浓度可能是cAIx升高的独立危险因素.

目的 探索社区青中年人群血清谷氨酰转肽酶浓度与动脉硬化的关系.方法 本研究是一个横断面研究,所有年龄18～65岁的参与者均于2014年1月至2016年12月来自广东社区,且均采集人口信息学及完善体格检查、血糖、血脂、肝酶和脉搏波传导速度检测,根据肱踝脉搏波传导速度将入选者分为动脉硬化(≥1400 cm/s)组和正常组(<1400 cm/s).采用多变量逻辑回归、分层和交互作用分析入选人群谷氨酰转肽酶浓度与动脉硬化的关系.结果 共入选865人,其中男性和动脉硬化人数分别为54(26.60％)和367(42.43％)例,平均年龄、谷氨酰转肽酶浓度与肱踝脉搏波传导速度分别为(50.11±8.67)岁,(25.38±24.09)IU/L和(1398.72±221.43)cm/s.动脉硬化组人群谷氨酰转肽酶浓度明显高于正常组,差异有统计学意义[(29.00±26.80)IU/L vs.(22.71±21.52)IU/L,P<0.001].当谷氨酰转肽酶作为连续变量时,在调整年龄、吸烟、肾功能、性别、血脂、饮酒、体质量指数、收缩压、空腹血糖、原发性高血压(高血压)和糖尿病后,谷氨酰转肽酶与动脉硬化密切相关(OR=1.34,95％CI:1.05～1.71,P=0.0202);当谷氨酰转肽酶作为分类变量时,以第一分位作为对照,第二、三和四分位与动脉硬化的关系分别为OR=1.67(95％CI:0.99～2.83,P=0.0560)、OR=2.14(95％CI:1.23～3.73,P=0.0068)和OR=2.31(95％CI:1.29～4.15,P=0.0050)(趋势P=0.006).各亚组中也表明谷氨酰转肽酶与动脉硬化密切相关,且与各亚组变量无交互作用.结论 青中年人群中血清谷氨酰转肽酶浓度与肱踝脉搏波传导速度密切关系,是动脉硬化的独立危险因素.

目的 探讨老年高血压人群臂间血压差异增大的相关因素.方法 本研究为横断面研究,对广东省东莞市寮步镇参与2013年1月1日—12月31日年度体检的4744例老年原发性高血压患者进行调查,测量双臂肱动脉血压并计算臂间血压差异.通过单因素线性回归和多因素线性回归统计分析影响臂间血压差异的相关因素.结果 单因素线性回归分析显示,收缩压和舒张压为影响臂间血压差异的相关因素(P<0.001).多因素线性回归分析显示,随着收缩压升高(β=0.069,P<0.001)或舒张压下降(β=-0.030,P<0.001),臂间收缩压差异升高;随着年龄增大(β=0.031,P<0.001)、收缩压下降(β=-0.020,P<0.001)、舒张压升高(β=0.119,P<0.001)、心率减慢(β=-0.015,P=0.001)、总胆固醇下降(β=-0.259,P=0.009)、高密度脂蛋白胆固醇升高(β=0.533,P=0.005)、吸烟(β=0.321,P=0.043),臂间舒张压差异升高.结论 影响老年高血压人群臂间血压差异增大的相关因素为收缩压、舒张压、心率、血脂水平和吸烟.

目的 研究社区无动脉粥样硬化性心血管病史人群血清尿酸浓度与肱-踝脉搏波传导速度(brachial anklepulse wave velocity,baPWV)的关系.方法 本研究是一个横断面研究,2015年6月至2017年12月在广东社区连续入选18岁以上人群,均接受人口问卷调查、体格检查、尿酸浓度和baPWV检查,根据尿酸浓度进行四分位分组,并根据baPWV检查结果分为动脉硬化组(baPWV≥1400 cm/s)和正常组(baPWV<1400 cm/s).采用单变量和多变量逻辑回归分析尿酸浓度与baPWV和动脉硬化的关系.结果 共入选907例[男589(64.94％)]研究对象,年龄(50.97±9.36)岁,其中动脉硬化患者400例(44.10％).动脉硬化患者尿酸浓度显著高于正常人,差异有统计学意义[(4.56±1.24)mg/dL vs.(4.03±1.21)mg/dL,P<0.001].当以尿酸作为连续变量时,在调整年龄、性别、体质量指数、收缩压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、C-反应蛋白、吸烟、饮酒、高血压和糖尿病后,尿酸浓度(OR=3.75,95％CI:1.54～9.14,P=0.004)与动脉硬化密切相关;当尿酸作为分类变量时,以第一分位作为对照,多变量调整后第二、三和四分位与动脉硬化的危险度分别为2.47(95％CI:1.36～4.50,P=0.003),2.80(95％CI:1.35～5.85,P=0.006)和4.85(95％CI:1.79～13.16,P=0.002)(趋势P<0.001).结论 社区无动脉粥样硬化性心血管病史人群血清尿酸浓度与baPWV密切相关,可能是动脉硬化的独立危险因素.

目的 总结该院在新型冠状病毒肺炎流行期间药物临床试验受试者随访经验,为国内医院药物临床试验受试者随访管理提供参考.方法 秉持受试者及临床试验从业人员安全第一的理念,严格遵守伦理原则及药物临床试验管理规范,迅速制定工作指引,利用信息化手段加强各部门协调沟通、人员培训,针对不同项目随访及受试者特点,改革随访方式,优化随访流程,落实随访细节,及时收集真实、准确的临床数据保障临床试验顺利开展.结果 受试者及临床试验从业人员无新型冠状病毒感染,口罩佩戴率、流行病史筛查率、环境及医疗用品消毒率均为100％,受试者超出随访窗口期58例,失访6例,失访率为1.4％,用药依从性为98.5％.结论 新型冠状病毒肺炎流行期间系统化、精细化、个性化的随访管理策略切实保障了药物临床试验质量.突发疫情对药物临床试验部门应对突发事件的能力及相关应急预案的制订和实施提出了更高的要求.

Objectives To explore the relationship between number of coronary lesion and major adverse cardiovascu?lar event(MACE)in patients with coronary artery disease during the one year antiplatelet therapy in China. Methods Prospective registration study of patients with definitive diagnosis of coronary artery disease and received antiplatelet therapy that came from 107 tertiary hospitals among 31 provinces and autonomous regions between November 2012 and December 2014 in China was carried out. Relationship between number of coronary lesion and MACE in patients with coronary artery disease received antiplatelet therapy during the one year follow-up period was analyzed by Multiariable Logistic regression analysis. Results A total of 12 118 patients were analyzed,the cumulative incidence of MACE were 541(12.7%),551(14.8%)and 754(18.2%)among one lesion,two lesions and multivessel lesions,respectively (P<0.05). Multiariable Logistic regression analysis showed that multivessel lesions was an independent risk factors for MACE(OR=1.17,95%CI:1.09-1.24,P<0.001). Conclusions The more multivessel lesions of patients with coronary artery disease received antiplatelet therapy are,the higher incidence of MACE is during the one year follow-up period.

Objectives To study the association between lipid comprehensive index and incidence of coronary heart artery disease (CHD) in elderly patients. Methods All the 150 elderly patients with chest pain by coronary angiography examination were from Guangdong Provincial People`s Hospital between June 2016 to June 2018. They were divided into CHD group and none CHD group based on the results of coronary angiography. They were divided into normal group,single lesion group,double vessels lesion group and multiple vessels lesion group according to the degree of coronary artery stenosis. Fasting blood glucose,serum concentration of lipid,renal function,blood pressure and lipid comprehensive index were measured,and the univariate and multivariate Logistic regression were used for analyzing the related factors with incidence of CHD in elderly patients. Results There were total of 150 elderly patients with data integrity,age was(76.13± 4.56)years,including 35 none CHD patients and 115 CHD patients. Patients in single vessel lesion group,double vessels lesion group and multiple vessels lesion group were 67,38,10, respectively. There were significant differences in systolic blood pressure and lipid comprehensive index among groups (P<0.05). The univariate Logistic regression showed that lipid comprehensive index(OR=1.91,95% CI:1.12-3.20, P<0.001) was a risk factor for elderly patients with CHD. Further multiple Logistic regression analysis showed that lipid comprehensive index(OR=1.59,95%CI:1.21-2.99,P=0.002)was still a risk factor for elderly patients with CHD. Conclusions Lipid comprehensive index correlates with CHD in elderly patients,and is a risk factor for elderly patients with CHD.