1.7 按血压昼夜节律分类 可分为：①杓型（dippers）高血压，夜间血压（主要为收缩压和平均动脉压）均值较白天均值下降＞10％；②浅（非杓型（shallow or non－dippers）高血压，夜间血压均值较白天均值下降≤10％；③反杓型（reverse－dippers）高血压，夜间血压均值较白天均值增高≥10％；④超（深）杓型（extreme－dippers）高血压，夜间血压均值较白天均值下降＞20％。
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YANG Li-gang, LI Fei.The 242nd Hospital of Shenyang, Shenyang 110034,China
【Abstract】 Objective To explore the announcements in operation of hypertensive cerebral hemorrhage to improve and increase exist quality.Methods Totally 65 cases of severe hypertensive cerebral hemorrhage were selected and operation was done in our hospital from January 2006 to June 2008. GOS score standard and retrospective study was carried out to patients followed up for six mouths.Results There were 8 cases losing visit. Among 57 cases followed up, 10 cases （5 scores） were good, 23 cases （4 scores） were light imcomplete, 12 cases （3 scores） were severe imcomplete, 4 cases （2 scores） were plants existing and 8 cases （1 score） were died.Conclusion The indication is precise control in operation, the opportunity is selected in time in operation, modus operandi is selected correctly, surgical technic is controlled perfectly, as well as active obviate to cure postoperative complications. It is important to improve and increase the patient prognosis.
【Abstract】 The testing method of ACE inhibitory activities was studied, and the antihypertensive peptides were derived from mytilus coruscus, then the ACE inhibitory activities were studied on different conditions; the antihypertensive effects were tested by SHR-feeding method. The results were as follows: the antihypertensive peptide had strong ACE inhibitory activities, the ACE inhibitory ratio was 88.08%, and the antihypertensive effect was obvious in 2 to 6 hours, the average reduced breadth is 16～28mmHg.
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2.1.2.3 体重因素 国内外流行病学研究表明,约60%的肥胖者合并患有原发性高血压,肥胖使患高血压的危险性增加2～6倍。体重每增加10kg,收缩压升高2～3mmHg,舒张压升高1～3mmHg。在控制了其他危险因素后,体重指数（body mass index ,BMI.2g/m2 ）BMI每增加一个单位，高血压发病的相对危险增加约10%,BMI≥24者,其发病率为BMI<24者的2～3倍［18］。
【Abstract】The hypertension to become our country most common cardiovascular disease. Our country adult hypertension prevalence rate is 18.8%, compared with 1991, in 2002 our country hypertension prevalence rate rose 31%, the hypertension has been sick the population to increase approximately 70000000, affects the first factor which our country population always died. At present, the hypertension has become in the global scope the significant public health question. Therefore, launches the hypertension in view of the community crowd preventing and controlling is the hygienic work urgent matter, but determined the science effective preventing and controlling hypertension the health education knowledge, is very important work.
【Key words】Hypertension; Control; Health education knowledge
缺失Vav2蛋白的老鼠其血压较高，通过分析这些老鼠，Xosé Bustelo等人发现，Vav2信号通路在正常情况下，与NO引发的血管壁平滑肌的松弛有关。Vav2信号通路与Rac1 和Pak1蛋白的激活有关。如果Vav2-缺陷型老鼠Pak1蛋白没有被激活，将导致磷酸二酯酶-5(phosphodiesterase type 5)过量表达，与此一致，Vav2缺陷型老鼠用磷酸二酯酶-5抑制剂处理过，也会导致其血压下降。
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Abstract： Objective To explore the causes that influence the medicinetaking compliance in the management of the patients with primary hypertension. Methods A total of 1,490 patients with primary hypertension were investigated by questionnaire including the medicinetaking compliance, educational level and personal income.Results The medicinetaking compliance was associated with educational level and personal income. Conclusion The medicinetaking compliance in the patients with primary hypertension is based on education and income, so guidance by medical workers and financial support by family ought to be stressed on.
Key words： primary hypertension; medicinetaking compliance; data gathering
（1）开展健康教育：健康教育是预防和控制高血压病的基础和前提。正确的健康信念，有利于提高患者的服药依从性。护理人员通过个别咨询、书面健康处方指导、团体健康大课堂指导、滚动屏幕宣教，提高患者对高血压的危险因素、并发症、预后、规范药物治疗的重要意义等知识的认识，促进高血压的有效控制。（2）建立良好医患关系：医患合作可提高服药依从性。医护人员尊重、体谅、理解病人，病人信任医护人员，有利于提高其服药依从性。（3）饮食指导：教育患者要有合理的膳食结构：①低盐：每日限钠盐的摄入量，一般控制在5～6 g 以下；②补充钙盐、钾盐以及水果；③减少脂肪摄入，忌食油炸食物和动物内脏,脂肪量应控制在总热量的25%以下，适当补充鱼蛋白；④戒烟。（4）促进家庭和社会的支持有着积极的作用：家庭和社会的支持对患者起督促作用，也可以是对良好遵医行为所获得良好效果的正反馈反应。（5）行为治疗措施：①行为监测：要求患者记录服药日记、病情自我观察记录等；②刺激与控制：将患者的服药行为与日常生活习惯联系起来，如设置闹钟提醒服药的时间；③强化行为：当患者依从性好时给予肯定，反之给予批评。（6）改善医疗环节： 改善医疗的各个环节,包括向患者交代治疗程序、用药量、治疗方法及复诊时间，这样可提高患者的依从性。
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【Abstract】Along with the age growth senior citizen in the physiological function and the biochemistry responded on has had the corresponding change, therefore has also had the change to the medicine response and in vivo process, to the medicine sensitive enhancement, responded not good compares the young adults to display obviously generally.Therefore, to the senior citizen reasonable, safe and the effective use medicine research appears extremely importantly.Cardiovascular disease is one of senior citizen's common diseases, pays attention to the question in view of senior citizen's hypertension and heart disease medication, the brief analysis is as follows.
【Key words】Senior citizen; Cardiovascular disease; Sensitivity; Responded not good
据10-5月26日刊JAMA上的一则研究披露，大约有50%的高血压患者的血压得到了充分的控制，从而达到了Healthy People 2010的目标，但是在美国的高血压发病率在最近几年中却没有下降。
根据文章等背景资料：“一项来自National Health and Nutrition Exami-nation Survey (NHANES) 2005-2006的初步的报告说，高血压是一种流行性的疾病，它影响到在美国的大约6500万人，该数字与根据美国人口所得出的估计值相符。鉴于高血压的流行率及其对健康结果的影响，有数项全国性的创制案研发出了有关的治疗计划、指南和政策以推动对高血压的预防、发现/注意、治疗和控制。” 对高血压的控制（定义为收缩压的数值低于140 mm Hg，而舒张压的数值低于90 mm Hg）从NHANES II (1976-1980)的10%增加到了NHANES II (1999-2000)时的31%。 Healthy People 2010的目标是在美国的高血压人口中，有50%的人的血压得到控制。
Medical University of South Carolina, Charleston的Brent M. Egan, M.D.及其同僚检查了综合了所有成年人的以及按年龄、族裔/种族、性别所划分的次级组中成年人的高血压流行率、人们对高血压的注意、治疗及控制的变化，其观察的时间段为NHANES 1988-1994 及1999-2008期间的5个为期2年的时段，其中的患者包括了4万2856名年龄在18岁以上的成年人，他们代表了美国人口的一个样本。高血压被定义为收缩压至少140 mm Hg及舒张压至少90 mm Hg，他们自我报告使用了抗高血压药物，或两者兼有。
【参考文献】
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【Abstract】 Objective To probe into the influence of hypertension history to cerebrovascular hemodynamic parameters in elderly. Methods 2 321 individuals aged 65～80 year were selected from a cohort. Participants were divided into 2 groups according to hypertension history in baseline. 1 168 cases with history of hypertension were defined as hypertension case group and 1 153 cases without history of hypertension were defined as control group. Differences and distribution of cerebrovascular hemodynamic parameters between 2 groups were compared. Results The cerebrovascular hemodynamic parameters synthesized scores in case and control groups were 59.61±31.68 and 80.73±25.30(P<0.01). The abnormal rates of the score(<75 points) in 2 groups were 59.5% and 30.3%(P<0.01). Kinematic parameters in case group were significantly lower than those in control group. However, dynamic parameters as well as exposure rates of history of heart disease, obese and family history of stroke in case group were significantly higher than those in control group (P<0.01). Conclusions There is significant influence of hypertension history to cerebrovascular hemodynamic in elderly and it may increase the risk of stroke.
【参考文献】
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“服用钙通道阻滞药的病人再接受大环内酯类药物，这种情形并非罕见，”参与研究的简林克(David M. Juurlink)医生说，并解释说，红霉素和克拉霉素的问题是他们会在血液里保持一种酶，这种酶对于钙通道阻滞药的代谢非常重要。结果就是血液中钙通道阻滞药的水平急剧上升，并有可能导致严重的血压降低。而阿奇霉素则不会产生这样的问题。相关论文发表于《加拿大医学会杂志》（Canadian Medical Association Journal）。
