代谢综合征致病的诊疗思考

如果将心血管疾病喻为冰山一角,潜在水中的冰山是危险因素的话,那么代谢综合征(MetS)就是深藏于水中冰山的最底层,这一形象的比喻是人类长期与疾病作斗争中运用科学思维的总结.目前,MetS已被公认是心血管疾病的危险因素,是与糖尿病和心血管疾病密切相关的一种疾病,其发病率居心血管疾病危险因素之首.     

浅谈心血管疾病预防的重要性和可操作性

心血管疾病是人类死亡的主要病因,其危险因素包括吸烟、血脂异常、糖尿病、高血压、肥胖等。目前我国医务工作者限于治疗疾病,忽视疾病预防,这种模式过于被动,需要高昂的医疗支出。如果不做好心血管疾病的预防工作,将会极大影响国民经济增长。因此改善生活方式、预防心血管疾病发生,形成疾病预防模式就显得尤为重要,并具有可操作性。     

浅谈心血管疾病预防的重要性和可操作性

心血管疾病是人类死亡的主要病因,其危险因素包括吸烟、血脂异常、糖尿病、高血压、肥胖等.目前我国医务工作者限于治疗疾病,忽视疾病预防,这种模式过于被动,需要高昂的医疗支出.如果不做好心血管疾病的预防工作,将会极大影响国民经济增长.因此改善生活方式、预防心血管疾病发生,形成疾病预防模式就显得尤为重要,并具有可操作性.     

人际敏感:从社会认知到心理危险因素

作为一种社会认知能力,人际敏感受到了研究者的广泛关注。近年来,研究者将这种以不断担心负面的社会评价为特征,对他人评价保持警觉与敏感,并采取防御性行为(如服从或抑制行为)以避免负面社会评价的倾向作为个体一种整合的人格特征。研究发现人际敏感是传染性疾病的心理危险因素,并可能会增加心血管疾病的风险。未来研究应发展信效度良好的测量工具,进一步地整合相关模型,明确人际敏感影响健康的内部机制,为疾病的预防与心理干预提供指导。     

ICU患者低钙血症发生率调查与危险因素分析

筛查大连地区ICU患者早期低钙血症发生率,并分析其危险因素.选择自2010年9月14日至2010年9月30日新入大连市8家三级医院ICU的患者.入选44例患者中低钙血症患者20例,低钙血症发生率为45.4％.入选患者中全身性感染低钙血症发生率最高为61.1％,随后依次为其他疾病、心血管疾病、创伤和神经系统疾病.低钙血症的危险因素为蛋白水平、血磷水平、乳酸水平以及日照时间长短.     

落实科学发展观,领跑健康中国,开创心血管疾病防控新局面

心血管疾病已成为影响国民健康的最大杀手,但半个世纪累积的大量流行病学数据与临床试验证据,与发达国家已有的的心血管疾病防控经验,证实心血管疾病可防可控.心血管疾病的预防需要整合平台,多学科参与,综合控制多种危险因素才能实现事半功倍的效果.广大临床医生应积极参与"健康中国2020"战略,领跑健康中国,为提前实现心血管疾病死亡率下降拐点的目标,开创我国心血管疾病防控新局面而奋斗.     

过敏性哮喘合并鼻炎患者危险因素的Logistic回归分析

探讨过敏性哮喘合并鼻炎(CAARS)患者的危险因素,为临床防治CAARS疾病提供依据。选择确诊为CAARS的患者998例作为观察对象,调查记录CAARS患者和健康者的年龄、性别、职业接触粉尘、家族过敏史、文化程度、上班/上学交通工具、饮食习惯、居住/工作环境等信息。结果证实:文化程度高中、初中者患CAARS疾病的危险分别是本科或研究生的2.822倍和10.146倍,父亲存在过敏性疾病史者患CAARS疾病的危险是父亲无过敏史的11.385倍,母亲存在过敏性疾病史者患CAARS疾病的危险是母亲无过敏史的9.694倍,室内环境不常清洗者患CAARS疾病的危险是常清洗者的3.015倍,花粉过敏者患CAARS疾病的危险是花粉不过敏者的11.220倍。文化程度低、年龄高、父母具有过敏史及环境不经常清洁等为CAARS疾病的危险因素。开窗通风与适宜运动为CAARS疾病的保护性因素。危险因素分析对于CAARS疾病的临床管理和防治具有十分重要的指导意义。     

高尿酸血症与冠心病之间的关系

高尿酸血症是一种嘌呤代谢障碍性疾病,早期人们主要关注高尿酸血症对关节及肾脏的影响,但随着尿酸水平的升高,患心血管疾病的风险也相应的增加,近年来越来越多的研究用于证明高尿酸血症与心血管疾病之间的相互作用,人们才逐渐关注高尿酸血症对心血管疾病的影响,并且一直是学者关注的焦点之一,高尿酸血症是否为冠心病的独立危险因素？高尿酸血症是否直接和冠心痛的预后相关？两者之间的关系一直存在争议,本文就高尿酸血症与冠心病关系、高尿酸血症对冠心痛影响的可能机制作一综述.     

对心血管病临床强化治疗的质疑

强化治疗是最近几年反复提到的话题。很多临床试验研究各种强化治疗对心血管疾病预后的影响,但结果显示强化治疗并未能带来更多的益处,甚至有害。因此我们必须理性地看待这些所谓的强化治疗。更应该倾向于个体化治疗、综合治疗,包括控制各种危险因素,改善生活的方式。把治疗的眼光放到疾病发生的早期,早治疗,以求更多获益。     

对心血管病临床强化治疗的质疑

强化治疗是最近几年反复提到的话题.很多临床试验研究各种强化治疗对心血管疾病预后的影响,但结果显示强化治疗并未能带来更多的益处,甚至有害.因此我们必须理性地看待这些所谓的强化治疗.更应该倾向于个体化治疗、综合治疗,包括控制各种危险因素,改善生活的方式.把治疗的眼光放到疾病发生的早期,早治疗,以求更多获益.     

Metabolic syndrome and Alzheimer's disease: a link to a vascular hypothesis?

Current evidence from epidemiological, neuroimaging, pathological, pharmacotherapeutic, and clinical studies indicate an association of Alzheimer's disease with risk factors of vascular atherosclerotic disease either in isolation or in aggregate. "Metabolic syndrome" (MetS) is the name for a clustering of risk factors for cardiovascular disease and type 2 diabetes that are of metabolic origin. These include central obesity, elevated plasma glucose, high blood pressure, atherogenic dyslipidemia, a prothrombotic state, and a proinflammatory state. In this article, we provide an overview of the relevant literature with regard to the relationship of Alzheimer's disease with MetS. Accumulating evidence suggests a "vascular hypothesis" to be related to the pathology of Alzheimer's disease. In the light of this evidence, clinician may consider lifestyle interventions toward an early and effective cardiovascular risk-factor management to reduce the cardiometabolic and the cognitive decline risk, while further research of other preventive strategies may be warranted.     

Psychological risk factors in cardiovascular diseases

Recent research has shown that psychological risk factors play an important role in the pathogenesis of cardiovascular diseases. The so-called ‘coronary prone behaviour pattern’ predominates, an important part of which is the ‘Type A behaviour pattern’. This is characterized by a marked ambition, a constant feeling of being under pressure, due to latent aggression and to a striving to dominate. For cerebrovascular diseases the so-called ‘pressured pattern’ as a risk factor has been found to be typical which is comparable to the Type A behaviour. Psychological risk factors and their components are not equally important for different vascular diseases. Besides the explanation of the question as to how far psychological processes really are involved in the development of vascular diseases, the research on psychological risk factors serves as a foundation for psychosomatic theories.     

Anger and cardiovascular risk in adolescents

The present investigation examined the relationship between anger and elevations in cardiovascular risk among adolescents (n = 213). The adolescents were assessed on an anger index and also on certain physical (e.g., blood pressure, cholesterol) and psychological (e.g., anxiety, life dissatisfaction) variables associated with increased risk of cardiovascular diseases. The anger index, a composite of items from various sources, was factor analyzed, producing a terminal solution of two factors: frequent anger directed outward (FAO) and anger-producing situations (AS). Two factor scores were then computed for each subject. Regression analyses, controlling for age and sex, showed that the factor scores were predictive of the physical and psychological measures of cardiovascular risk, and that the factor scores were differentially related to these indices. These preliminary findings are supportive of systematic study both of the multidimensional nature of anger and of the associations of the dimensions of anger with indices of cardiovascular risk.     

回避与趋近性负性人格特质对应激心血管反应模式的不同影响

本研究考察了回避与趋近性负性特质对不同强度心理社会应激刺激重复暴露的心血管反应、应激后心血管反应恢复、重复应激心血管反应的影响,并探讨了应激认知评价在其中的作用。167名大学生被试被随机分配到中/高强度应激条件中,连续采集其在基线期、首次应激期、恢复期、重复应激期四个阶段的心血管反应数据。结果发现:(1)无论应激强度如何,回避性负性特质预测首次和重复应激中较低(钝化)的心血管反应和应激后较差的恢复,而趋近性负性特质预测较大的心血管反应和应激后较差的恢复。(2)重复应激个人资源感知在回避性负性特质与重复应激心率反应之间起中介作用。因此,回避性负性特质与持续较低(钝化)的应激心血管反应和应激后较差的恢复相联系,而趋近性负性特质与较大的应激心血管反应和应激后较差的恢复相联系,即两类负性特质均表现出不适应的固化的应激心血管反应模式,这可能构成了两类不同负性特质增加罹患心血管疾病风险的生理机制。     

OSAHS在2型糖尿病发病中的作用与对策

阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）是一种常见的睡眠呼吸紊乱性疾病,以睡眠时反复发作的上气道部分或完全阻塞为特征。近年发现OSAHS与2型糖尿病之间有着明显的相关性,二者均为心血管疾病的高危因素,合并存在能够严重影响生命质量与预期寿命...     

The Contributing Role of Negative Affectivity and Experiential Avoidance to Increased Cardiovascular Risk

Depression and anxiety are independent risk factors for the onset of cardiovascular disease, independent of classical risk factors, such as smoking, obesity, or hypertension. The present paper argues that the tendency to avoid difficult thoughts and feelings helps explain this relationship. There is a strong positive relationship between experiential avoidance and negative affectivity. Experiential avoidance is also related to several health behaviors recognized for increasing cardiovascular risk and may help functionally explain why individuals engage in problematic behaviors, such as smoking, drinking, and binge eating. Treatments that undermine experiential avoidance could be useful psychosocial approaches to cardiovascular risk reduction.     

高血压联合用药与靶器官保护

高血压是造成心血管疾病最重要的可逆性危险因素之一,但大多数患者仍未采取合适治疗,或未达到合适的血压控制目标。循证医学证实,联合使用降压药物不仅是控制血压达标的主要手段,而且是保护靶器官的重要措施,可明显减少心、脑、肾等重要靶器官损害,降低心血管疾病的发病率、病死率和致残率。高血压的联合用药应得到高度重视。     

Cardiovascular Disease in Elders: Is It Inevitable?

Cardiovascular disease is the major cause of death and disability in America. The burden of cardiovascular disease is higher in elders than in younger populations, presumably because of life-long exposure to risk factors such as hypertension, smoking, abnormal blood lipids, lack of exercise, and/or obesity. Many assume that it is too late to attempt to modify risk factors in elders because behavior is so difficult to change. The purpose of this article is to argue that cardiovascular risk factor modification is effective in elders and should be vigorously pursued for the good of individuals, families, communities, and societies.