ABSTRACT
Objective:To investigate the effect of metoprolol tartrate combined with atorvastatin calcium on lipid metabolism, vascular endothelial function and inflammatory factors in patients with essential hypertension.Methods:From January 2015 to December 2018, 80 patients with essential hypertension admitted to the People's Hospital of Dongyang were divided into observation group (40 cases) and control group (40 cases) according to the random digital table method.On the basis of routine treatment, the control group was treated with atorvastatin calcium, while the observation group was treated with atorvastatin calcium and metoprolol.The course of treatment in both two groups was 6 months.The changes of systolic and diastolic blood pressure, lipid metabolism, endothelial function and inflammatory factors were compared before and after treatment.Results:The total effective rate of the observation group (92.50%, 37/40) was higher than that of the control group (70.00%, 28/40) (χ 2=6.646, P<0.05). The systolic blood pressure [(123.15±7.89) mmHg] and diastolic blood pressure [(75.52±3.89)mmHg] in the observation group were lower than those in the control group [(134.29±10.31)mmHg and (82.31±4.04)mmHg] ( t=5.427, 7.657, all P<0.05). The level of serum NO [(69.74±5.46)nmol/L] in the observation group was higher than that in the control group [(57.87±3.67)nmol/L], while ET-1 [(56.48±5.49)mg/L] in the observation group was lower than that in the control group [(73.24±7.18)mg/L], the differences were statistically significant( t=11.411, 11.728, all P<0.05). The serum levels of CRP [(1.18±0.23)mg/L], TNF-α [(0.63±0.18)μg/L] and IL-6 [(84.35±17.28)ng/L] in the observation group were lower than those in the control group [(1.64±0.45)mg/L, (1.23±0.26)μg/L and (128.43±19.86)ng/L] ( t=5.757, 12.000, 10.590, all P<0.05). Conclusion:Metoprolol tartrate combined with atorvastatin calcium is effective in the treatment of essential hypertension, and can improve lipid metabolism, vascular endothelial function, and reduce inflammation.
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Objective: To investigate the diagnostic value of combined examination of copeptin and high sensitivity cardiac troponin T (hs-cTnT) in patients at the early stage of acute myocardial infarction (AMI) . Methods: A total of 272 patients were enrolled in this study, all of them suffered from chest pain and admitted within 4 hours. The patients were divided into 4 groups according to coronary artery angiography (CAG) results. Control group, the patients with normal CAG,n=64, UAP group (unstable angina pectoris),n=50, STEMI group,n=82, NSTEMI group,n=76. All patients received in-hospital observation, plasma levels of copeptin and hs-cTnT were examined at admission and at 6 hours after the chest pain respectively. Results: Within 4 hours of chest pain, combined examination of copeptin and hs-cTnT had the higher sensitivity for diagnosing AMI than a single detection of hs-cTnT with the cut-off point of hs-cTnT ≤ 14ng/L and Copeptin < 14pmol/L. In NSTEMI group, the AUC (area under curve) for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.75 (95% CI 0.62-0.87),P<0.05. In STEMI group, the AUC for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.74 (95% CI 0.60-0.88),P< 0.05. The AUC for combined examination of copeptin and hs-cTnT in diagnosing early AMI was 0.912 (95% CI 0.812-0.961) which was higher than single detection of hs-cTnT, AUC 0.851 (95% CI 0.713-0.936), Z=2.553,P<0.05. Conclusion: Combined examination of copeptin and hs-cTnT had the higher sensitivity and accuracy for diagnosing the patients at the early stage of AMI, it may help the risk stratiifcation of chest pain which is valuable in clinical practice.
ABSTRACT
Objective To know the medication compliance in elderly patients with hypertension,to analyze the influence factors of medication compliance,and to propose forward intervention countermeasures.Methods The treatment of hypertension in elderly patients was investigated by questionnaire survey.Medication compliance and influence factors were analyzed.Results 166 cases with poor medication compliance,and the rate was 45.0％; 203 cases with good medication compliance,and the rate was 55.0％.It's showed significantly difference on degree of education between the observation group and control group (x2 =12.071,P=0.002).The proportion of peasant and worker was higher in the observation group than control group (78.9％ vs.62.1％,x2 =12.817,P=0.002).The smoker (48.8％) and drinker (59.0％) in observation group more than smoker (27.1％) and drinker (31.0％) in control group(x2=18.481,P＜0.001; x2=29.115,P＜ 0.001).The ratio of payout of-pocket for healthcare was higher in the observation group (21.1％) than control group (9.9％) (x2=9.084,P=0.003).The duration of hypertension was longer in the observation group (8.8±4.6) than control group (6.0±4.1) (t=1.806,P=0.036).The income per month was less in the observation group (1850±150) than control group (2150±200) (t=5.799,P＜ 0.001).There were regression relationship between medication compliance and degree of education,medical security and duration of hypertension.Conclusions According to the influence factors of medication compliance in elderly hypertensive patients,it's useful to improve medication compliance by enhancing health education and designing a personal treatment.