ABSTRACT
Objective To investigate the corrections of critical closing pressure (CrCP) with cerebral vasospasm (CVS),delayed cerebral ischemia (DCI) and outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods Patients with aSAH were retrospectively enrolled.CrCP was calculated on the basis of recorded arterial pressure and blood flow velocities at the proximal middle cerebral artery detected by transcranial Doppler.Univariate analysis and multivariable logistic regression analysis were used to identify the factors influencing CVS,DCI and poor outcome (Glasgow Outcome Scale scores 1-3).The correlations between CrCP and CVS,DCI and poor outcome was analyzed.Results A total of 104 patients with aSAH were included in the study,including 56 (53.8％) with CVS,and 36 (34.6％) with DCI.100 patients were included in the analysis of the outcome,including 47 cases of poor outcome.There were significant differences in CrCP values before and after CVS (40.2 ± 11.5 mmHg vs 33.8 ± 10.4 mmHg,1 mmHg =0.133 kPa;t =3.089,P=0.001).Multivariable logistic regression analysis showed that CrCP is the independent risk factor of CVS (odds ratio [OR] 1.149,95％ confidence interval[CI] 1.112-1.352;P =0.019),DCI (OR 13.413,95％ CI 3.458-51.710;P =0.005) and poor outcome (OR 1.832,95％ CI 1.088-3.357;P =0.042) in patients with aSAH.Conclusion Increased CrCP was independently associated with CVS,DCI,and poor outcome in patients with aSAH.
ABSTRACT
Objective To investigate the effect of telmisartan on serum adiponectin, endothelial cell differentiation and carotid atherosclerosis in patients with essential hypertension.Methods A total of 126 patients with essential hypertension enrolled in our hospital from April 2012 to September 2016 were randomly divided into the conventional group (n=61) and telmisartan group (n=65), telmisartan group was given compound telmisartan ; Conventional group was treated with compound losartan.After treatment, blood pressure, adiponectin, nitric oxide, endothelin and carotid intima-media thickness were measured. Results The systolic blood pressure and diastolic blood pressure of telmisartan group were slightly higher than those in the conventional group;The levels of ADPN and NO in the telmisartan group were higher than those in the conventional group, while the EL and IMT were lower than those in the conventional group(P<0.05). The effective rate of telmisartan group was higher than that of the conventional group (P<0.05).Conclusion Telmisartan can effectively control and reduce the blood pressure in patients with essential hypertension, repair vascular endothelial differentiation and inhibit the progression of atherosclerosis.