目的:探讨美托洛尔联合氯沙坦钾氢氯噻嗪治疗重症心力衰竭(简称心衰)的临床效果及对B型脑钠肽水平的影响.方法:选取医院2018年2月至2020年12月收治的92例重症心力衰竭患者,按照随机数字表法分为对照组和观察组,每组46例.对照组予以美托洛尔治疗,观察组采用美托洛尔联合氯沙坦钾氢氯噻嗪治疗.比较两组临床疗效,治疗前后美国纽约心脏病学会(NYHA)心功能分级、B型脑钠肽(BNP)水平、左心室射血分数(LVEF)、左室收缩末期内径(LVSd)、左室舒张末期内径(LVDd)及药物不良反应发生率.结果:治疗后,观察组总有效率为95.65％,高于对照组的82.61％(P<0.05);两组NYHA心功能分级均优于治疗前,且观察组优于对照组(P<0.05);治疗后,两组BNP、LVSd、LVDd水平均较治疗前降低(P<0.05),LVEF水平较治疗前升高(P<0.05),且观察组BNP、LVSd、LVDd水平均低于对照组(P<0.05),LVEF水平高于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05).结论:采用美托洛尔联合氯沙坦钾氢氯噻嗪治疗重症心衰患者可有效改善患者心功能,降低BNP水平,明显提高治疗效果,且安全性较高.

目的：探究胱抑素 C 与缺血性脑卒中相关性。方法我院2012-03-2014-03急诊留观或神经内科收治的50例缺血性脑卒中患者(研究组)以及在我院同期进行体检的50例正常人(对照组)为研究对象。分析2组患者的危险因素及血清胱抑素 C 水平；胱抑素 C 与其他相关危险因子的相关性,分析胱抑素 C 与上述危险因素是否存在正相关性,了解胱抑素C 与缺血性脑卒中的关系。结果2组患者的性别和三酰甘油差异无统计学意义(P >0.05)；年龄、升高、体质量、BMI、血压、血糖、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和胱抑素 C 比较差异均有统计学意义(P <0.05)；研究组患者的性别、吸烟史、身高、体质量、BMI,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等与胱抑素 C 无相关性(P >0.05)；患者收缩压、血糖水平以及年龄与胱抑素 C 存在相关性(P <0.05),且患者收缩压、血糖水平升高、年龄与胱抑素 C 呈正相关；对胱抑素 C 与缺血性脑卒中的相关性进行分析结果显示,胱抑素 C 与缺血性脑卒中有相关性且胱抑素 C 是影响患者患有缺血性脑卒中的独立因素(P <0.05)。结论胱抑素 C 与缺血性脑卒中有相关性,且与缺血性脑卒中的收缩压、血糖水平及年龄因素有正相关性,能够用于临床患者缺血性脑卒中的早期诊断,对预防、治疗具有重大意义,且具有一定的社会效益、经济效益,具有推广前景。

目的：对血同型半胱氨酸（ Hcy）对2型糖尿病患者并发脑梗死产生的影响进行分析探讨，为今后的临床诊治与预防工作提供可靠的参考依据。方法：抽取我院2011年9月-2013年9月收治的56例确诊2型糖尿病合并脑梗死患者、56例单纯2型糖尿病患者以及60例同期在我院进行体检的健康体检者，对其展开血Hcy、C反应蛋白（ CRP）水平检测，并对比分析各组患者的检测结果。结果：糖尿病合并脑梗死组、单纯2型糖尿病组患者的血Hcy、CRP水平较健康对照组发生明显升高（ P＜0．05），且前者检测结果高于后者（P＜0．05）。结论：在2型糖尿病患者中，Hcy水平的增加会对脑梗死的发生产生显著影响，为诱发动脉粥样硬化的主要危险因素，值得关注。

选取我院急诊科收治的80例急症急性左心心力衰竭患者随机分为观察组和对照组各40例，观察两组患者临床治疗效果、心率、血压变化。结果观察组疗效明显优于对照组，两组患者治疗前后心率、血压等均有明显改善，观察组患者改善情况明显优于对照组，P<0.05，有统计学意义。在急诊重症急性左心心力衰竭患者时，在常规治疗的基础上采用呼吸机治疗有助于改善患者体征，促进患者康复，提高临床治愈率。

Objective To investigate the relationship between Cys C and ischemic stroke. Methods 126 ischemic stroke patients who had treatment from November 2012 to November 2013 in our hospital were selected as experimental group.Among them, 105 cases had hypertension and 25 cases haddiabetes mellitus. 30 healthy persons with similar age and sex as experimental group were selectedas control group. And 20 cases Diabetes mellitus group, 40 cases hypertension patients and 20 cases coronary heart disease patients were also selected for this study.Cys C and ischemic stroke related measures such as blood pressure and blood sugar levels were determined in the two groups. The relationship between Cys C and ischemic stroke related measures was analyzed. Results Compared with control group,the Cys C level of experimental group at the onset of disease, after the onset of the disease and after treatment was increased significantly(P 0.05). Ischemic stroke patients with hypertension or diabetes had significant higher Cys C level than that of the patients with only high blood pressure, coronary heart disease or simple diabetes(P 0.05). Logistic regression analysis showed that hypertension and Cys C are independent risk factor of ischemic stroke. Cys C level in ischemic stroke patients was positively correlate with systolic blood pressure(r=0.593,P0.05), blood glucose level(r=0.534,P0.05)and the age(r=0.568,P0.05). Conclusions Cys C level can assist in the diagnosis of ischemic cerebral apoplexy. In patients with cerebral apoplexy. Therefore increase inblood pressure and blood glucose levels and together with the increase of Cys C level may alert for the occurrence of ischemic cerebral apoplexy.

Objective To explore the clinical values of serum procalcitonin in community acquired pneumonia in aged patients.Meth-ods We selected 40 community acquired pneumonia patients admitted in the First People’s Hospital of Zhaoqing from March 201 2 to September 201 3 as the observation group.CRP was measured by using immunity-turbidity method;PCT was determined by Brahms PCT-Q and WBC was counted in serial blood samples from 40 patients with community acquired pneumonia and 20 healthy people.Re-sults Taking CRP≥1 0 mg·L-1 as accurate rate,the sensitivity,specificity,accuracy were 78.3%,63.1%,76.4% ,respectively;taking PCT≥0.3 μg·L-1 as the standard,the sensitivity,specificity,accuracy were 84.2%,90.3%,86.9%,respectively;taking WBC>1 0 ×1 09 ·L-1 as the standard,the sensitivity,specificity,accuracy were 47.5%,84.3%,70.7%,respectively.Serum CPR and PCT scores,the percentage of neutrophils and WBC in the control group were significantly lower than those in the observation group(P<0.05).Conclusions The levels of CRP,PCT and WBC count show a significant correlation with the diagnosis of CAP and PCT have higher sensitivity and specificity in the diagnosis of CAP.The level of PCT can be used as a severity index to evaluate the elderly com-munity-acquired pneumonia.