ABSTRACT
Objective:To investigate the immediate and lasting effects of enhanced external counterpulsation(EECP)on blood pressure in elderly patients with hypertension.Methods:In this real-world prospective non-randomized controlled study, the elderly hypertensive patients who were newly diagnosed as hypertension or had poor blood pressure control in the Geriatrics Department of Shandong University Qilu Hospital from May 2019 to December 2019, were enrolled as EECP group, and those with systolic blood pressure(SBP)≥180mmHg(1mmHg=0.133 kPa)or had contraindications for EECP treatment were excluded from EECP group(28 cases). Based on the 1∶1 ratio being consistent with the tendency score-matching method, patients' blood pressure was matched at 3 d before the start of the EECP treatment course, with other matched data of baseline data, coexisting disease, cardiovascular medication were choosed as control group(n=28). The EECP group received an additional 36 hours of EECP treatment(6 times/week, 1 hour/time)including lifestyle improvement and anti-hypertensive drugs.The patient's supine blood pressure was collected 3 minutes before each EECP treatment(baseline), 30 minutes during treatment, and 3 minutes after treatment.In the EECP group, family self-measured blood pressure was collected 3 days before the start of the 6-week treatment course(0w), the 6th week(6w)of the treatment course, and the 2nd week(+ 2w), 4th week(+ 4w)and 12th week(+ 12w)after the end of the treatment course, respectively.And the data of control group were collected at the same time point mentioned above.Results:Compared with baseline, the average immediate SBP of elderly hypertensive patients at the 30th minute of EECP treatment was decreased by(5.5±13.6)mmHg( P<0.001), and the average immediate diabolic blood pressure(DBP)was decreased by(1.1±7.5)mmHg( P<0.001). When the baseline SBP was between 160 and 169 mmHg, the probability of a further increase in SBP during treatment was 2.2%(2/89 cases), and when the baseline SBP was between 170 and 179 mmHg, the probability of a further increase in SBP during treatment was 0%(0/57). At 6 weeks, the decrease in SBP was significantly greater in the EECP group than in the control group[(-17.0±8.7)mmHg vs.(-10.5±7.3)mmHg, P<0.01], and the difference continued to + 2w[(-15.5±6.6)mmHg vs.(-10.6±2.5)mmHg, P<0.01]and + 4w[(-13.3±5.4)mmHg vs.(-10.7±2.1)mmHg, P<0.05]. At + 12w, the blood pressure drop was still greater in EECP group than in the control group, but it did not achieve statistically significant differences.Smoking history, history of diabetes, family history of hypertension, and improvement of comorbidities were the key factors that affect the continuous anti-hypertensive effect of EECP. Conclusions:EECP treatment has an immediate effect on lowering blood pressure in elderly hypertensive patients.A 6-week course of EECP treatment has a sustained effect on lowering blood pressure, and the effect can last from 4 to 12 weeks after the end of the course of treatment.
ABSTRACT
Objective To investigate the effect of vitamin D combined with iron succinate on children with premature anemia .Methods 66 patients with premature anemia from November 2013 to June 2015 in our hospital were selected and randomly divided into the control group and the experiment group, with 33 cases in each group.The patients in the both groups were give regular treatment, the experimental group was given the protein succinate oral solution (phenipril) 1.5 mL/kg on the basis of conventional treatment, Vitamin D drops ,one times a day.Two groups were treated continuously for 60 days.The hemoglobin, serum iron, ferritin, liver and kidney function and adverse reactions were compared before and after treatment.Results The hemoglobin, serum iron and ferritin levels in two groups were higher after treatment(P<0.05),compared with the control group,the hemoglobin, serum iron and ferritin levels in the experimental group were higher(P<0.05).Compared with before treatment ,the levels of serum ALT, AST, Cr and BUN in the two groups were not statistically significant.There was no significant difference in adverse reactions between two groups.Conclusion Vitamin D and iron proteinsuccinylate combined treatment of anemia in premature infants clinical curative effect, improve the body hemoglobin, serum iron and ferritin levels, without causing damage to liver and kidney function, drug safety.