典型抗精神病药物对心电图影响的临床分析观察

目的 研究典型抗精神病药对心电图影响作用。方法 将使用典型抗精神病药物的患者依照用药情况分为氯丙嗪组、舒必利组、奋乃静、氟哌啶醇组,回顾性分析该药物对心电图的影响作用。结果 心电图异常76例(32.34%)。其中,氯丙嗪组29例(38.67%)、舒必利组21例(36.84%)、氟哌啶醇组9 例(16.98)%、奋乃静组17例(34.00%)。氯丙嗪组与舒必利组心电图发生率明显高于其他两组(P0.05),奋乃静组心电图异常发生率也显著高于氟哌啶醇组(P0.05)。结论 抗精神病药物长期服用对患者心血管系统有较大影响,定期检查心电图有助于了解药物对心血管系统的影响和安全用药。     

三种非经典抗精神病药物对分裂症患者血脂影响

目的:探讨非经典抗精神病药物对分裂症患者血脂的影响。方法:随机收集90例住院分裂症患者,服药三种非经典抗精神病药物(氯氮平、利培酮以及阿立哌唑),治疗前后分别检查胆固醇(TC)、高密度脂蛋白(HDL)、甘油三酯(TG)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)。结果:①治疗后三组血脂的TC、TG、HDL、ApoA项目无统计学差异,而ApoB存在统计学差异(P0.01,)阿立哌唑组氯氮平组利培酮组;②治疗前后血脂各项目配对比较中,TC、HDL、ApoA及ApoB无统计学差异(P0.05),而TG项具有统计学差异(P分别为:0.027,0.000,0.001),治疗后TG升高。结论:氯氮平、利培酮以及阿立哌唑治疗分裂症对载脂蛋白B具有不同程度的影响,三种抗精神病药物治疗中都升高甘油三酯。     

精神病人用药须知

抗精神病药专指一类治疗精神病的药物。根据化学结构分为好几种,常用的有氯丙嗪、氟氮平、奋乃静、舒必利、三氟拉嗪、氟哌啶醇等,由于这类药有时会产生一些副反应,而且药物的选择及剂量的增减都很有讲究,因此都必须在医师     

中毒剂量与常规剂量抗精神病药物对心电图影响的对照分析

对45例中毒量和75例常规量抗精神病药物所致心电图异常改变的特点进行了对照研究，发现中毒量组心电图异常改变率高于常规量组，心电图异常改变的性质也较常规量组严重。另外还提示心电图异常改变率和严重程度与药物中毒量大小和服药自杀至开始抢救的间隔时间长短密切相关。在对奋乃静等5种抗精神病药物心电图异常改变的观察中，提示氟哌啶醇对心脏影响最小，安全度最高；氯氮平对心脏影响最大，安全度最低；奋乃静，氯丙嗪、舒必利介中。     

脑出血急性期血脂代谢异常的临床分析

目的探讨脑出血与血脂之间的关系。方法检验78例经头颅CT证实为脑出血患者的血脂指标,并与作为对照组的70例同期住院非卒中患者的血脂进行比较。结果脑出血组高密度脂蛋白(HDL)、载脂蛋白A1(ApoA1)与对照组比较显著降低,差异有统计学意义(P<0.05)。结论血中HDL、ApoA1降低可能增加脑出血发生的危险性。     

中链脂肪酸对高脂饲料诱导的肥胖大鼠高密度脂蛋白的调节作用

目的观察中链脂肪酸(MCFA)对高脂饲料诱导的肥胖SD大鼠高密度脂蛋白的代谢调节作用,探讨MCFA降低血胆固醇的可能机制。方法高脂饲料诱导SD大鼠肥胖,30只肥胖大鼠按空腹体重随机分为3组,每组10只,分别给予含2%(2 g/100 g)辛酸(C8∶0)、癸酸(C10∶0)和油酸(C18∶1)的高脂饲料喂养8周,于4周和8周时取眼底静脉丛血,测定血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白(HDL)、载脂蛋白A1(ApoA1)、载脂蛋白A2(ApoA2)浓度,于8周时取大鼠肝脏和小肠,ELISA法测定HDL、ApoA1、ApoA2含量,Real-time PCR法测定Apo A1及ApoA2 mRNA表达量。结果中链脂肪酸喂养肥胖大鼠4周时,3组大鼠血清血脂水平无差异,8周时,辛酸组和癸酸组血清TG、TC水平均显著低于4周时(P0.05),且显著低于油酸组(P0.05),HDL水平显著高于油酸组(P0.05)。HDL-c/LDL-c比值以辛酸组最高,且显著高于油酸组(P0.05)。8周时,大鼠小肠中HDL、ApoA1浓度及mRNA表达量也以辛酸组最高,显著高于油酸组(P0.05),但与癸酸组比较差异无统计学意义。大鼠肝脏中各项指标组间差异均无统计学意义。结论中链脂肪酸可能通过增加小肠HDL及ApoA1表达,上调HDL水平及HDL-c/LDL-c比值,降低肥胖大鼠血胆固醇水平。     

通心络治疗伴有高脂血症的脑梗死患者的疗效观察

目的探讨通心络胶囊对伴有高脂血症的脑梗死患者的疗效观察。方法随机选择42例伴有高脂血症的脑梗死患者,服用通心络胶囊8周,4粒／次,3次／d。治疗前后分别测定胆固醇（CHO）、甘油三酯（TG）、高密度脂蛋白（HDL—C）、低密度脂蛋白（LDL—C）、载脂蛋白AⅠ（ApoA1）、载脂蛋白B（ApoB）及ApoA1／ApoB比值．并进行组间对比研究。结果治疗后血清CHO、TG、LDL—C、ApoB水平低于治疗前,HDL-C、ApoA1、ApoA1／ApoB比值较前升高,差异均有统计学意义（P〈0．05）。结论通心络可降低血脂,是预防脑梗死的有效药物。     

抗精神病药的锥体外系反应

抗精神病药，顾名思义就是治疗各种精神疾病的药物。抗精神药物的种类很多，目前百姓较容易接受的药物分为两大类：传统抗精神病药和新型抗精神病药。前者数十年来在临床上一直广泛应用，价格低廉，但是副反应较大，患者耐受性差，例如氯丙嗪、奋乃静、氟哌啶醇、舒必利等；后者是近年来研制的新药，价格较贵，但副反应较轻，患者耐受性较好，例如利培酮、奎硫平、奥氮平、阿立哌唑等。从疗效上看，两类药物都差不多。     

妊娠期高血压疾病孕妇血脂水平的临床分析

目的:探讨妊娠期高血压疾病患者血脂变化的特点。方法:选择正常未孕妇女68例,正常孕妇120例,妊娠期高血压疾病孕妇208例,分别测定其血脂水平。结果:妊娠期高血压疾病组除高密度脂蛋白(HDL)外,其余各项指标均比对照组高,差异有显著性(P<0.05);各组间HDL比较无统计学差异;与正常妊娠组比较,妊高征组血清脂蛋白(a)〔LP(a)〕水平明显增高,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、载脂蛋白B(ApoB)水平亦增高(P<0.05),HDL水平无明显变化,载脂蛋白A1(ApoA1)水平降低;随着病情加重,LP(a)、TC、TG、LDL、ApoB明显增加。结论:妊娠期高血压疾病患者存在血脂代谢异常,孕期应严密监测,积极防治妊高病,以保证良好的妊娠结局。     

盐酸氟奋乃静引起精神障碍2例报告

抗精神病新药——盐酸氟奋乃静(盐酸氟啡那嗪),是目前国内外最常用的三种吩噻嗪类药物(氯丙嗪、甲硫达嗪、氟奋乃静)之一,具有强大的抗精神病作用与轻微的镇静作用,镇吐作用为氯丙嗪的200倍,催眠作用很弱。适用于急性、慢性精神分裂症及具有妄想、幻觉、情感、意向障碍的各型精神病。治疗时必须从小剂量开始,根据病情、身体及药物反应的情况,逐渐增加药量。     

The interaction of alcohol consumption and oral contraceptive use on lipids and lipoproteins

Oral contraceptive (OC) use and alcohol consumption have been shown to alter the levels of lipids and lipoproteins in the blood. The effect of alcohol consumption on levels of total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, LDL-B, Apo-A1, the ratio of HDL cholesterol/total cholesterol, HDL cholesterol/LDL cholesterol, and the ratio of LDL cholesterol/LDL-B among normal healthy young women before initiation of oral contraceptives and after six months of oral contraceptive use are both described. Of primary interest is the mediating effect of alcohol consumption on the association between steroid usage and blood lipid values. At baseline, ethanol consumption was found to be positively associated with triglycerides, HDL-C, and Apo-A1 and negatively associated with LDL-C/LDL-B. After adjustment for several covariables, alcohol consumption was found to be positively associated with the increases in triglycerides and in Apo-A1 observed at 3 and 6 months after initiation of OCs. Since these two parameters are believed to have opposite relationships to cardiovascular disease, the effect of alcohol consumption remains uncertain.     

Cardiac rehabilitation outcomes in a conventional versus telemedicine-based programme

We studied patients who were eligible for phase II cardiac rehabilitation. Rehabilitation was delivered either conventionally or by telemedicine using videoconferencing. There were 226 participants: 173 at the conventional site and 53 at the telemedicine site. At baseline, blood pressure, anthropometric measurements, lipid profiles, activity levels, dietary intake and behaviours were assessed. Assessments at baseline were repeated after 12 weeks, at the end of the rehabilitation programme. There were no significant differences (P > 0.05) in the change from baseline to post-programme values between the conventional and the telemedicine groups. The results show the suitability of telemedicine for delivering cardiac rehabilitation for risk factor modification and exercise monitoring to patients who otherwise would not have access to it.     

Effect of Sesamin Supplementation on Cardiovascular Risk Factors in Women with Rheumatoid Arthritis

Objective: Rheumatoid arthritis (RA) is an inflammatory disease with increased mortality from cardiovascular disease (CVD). Oxidative stress has a critical role in the pathogenesis of RA and CVD. Sesamin, the main lignin constituent of sesame, has several antioxidant and anti-inflammatory effects. This study aimed to investigate the effects of sesamin supplementation on anthropometric indices, lipid profile, blood pressure, and oxidative stress markers in women with RA.

Methods: In this randomized, double-blind, placebo-controlled clinical trial, 44 patients with RA were randomly divided into 2 groups (intervention and control). Patients consumed 200 mg/day sesamin supplement and placebo in the intervention and control groups, respectively, for 6 weeks (spring 2014). At baseline and at the end of the study, anthropometric indices and blood pressure were assessed. Serum concentrations of lipid profile, malondialdehyde (MDA), and total antioxidant capacity (TAC) were also determined.

Results: At the end of study, sesamin supplementation significantly decreased serum levels of MDA (p = 0.018) and increased TAC and high-density lipoprotein cholesterol (HDL-C) levels in patients with RA (p = 0.020 and p = 0.007, respectively). In the sesamin group, the mean of weight, body mass index, waist-to-hip ratio, body fat, systolic blood pressure, and the concentration of other lipid profiles (triglycerides, total cholesterol, and low-density lipoprotein cholesterol [LDL-C]) were also significantly decreased at the end of study compared to baseline values (p < 0.05). However, the difference between the 2 groups was not statistically significant in this regard (p > 0.05).

Conclusion: Sesamin exhibited a protective effect on cardiovascular risk factors in patients with RA. However, further investigation is suggested.     

HDCP患者心肌酶谱与血脂指标的关联性研究

目的 探讨妊娠期高血压疾病(HDCP)患者心肌酶谱与血脂指标的关联性.方法 收集2014年1月1日至6月30日在深圳沙井医院就诊的91例HDCP患者,其中妊娠期高血压20例、轻度子痫前期45例、重度子痫前期26例,选择50例同期在医院正常分娩产妇作为对照组,测量各组血脂指标及心肌酶谱,对两种指标的相关性进行评估.结果 妊娠期高血压组、轻度子痫前期组、重度子痫前期组的体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)及肌酸激酶(CK)与对照组比较差异均有统计学意义(t=1.845~13.482,均P<0.05);轻、重度子痫前期组的BMI、LDL-C、TC、TG、HDL-C、Apo-A、Apo-B、LDH、AST及CK与妊娠期高血压组比较差异均有统计学意义(t=1.663~14.258,均P<0.05);重度子痫前期组的BMI、LDL-C、TC、TG、HDL-C、Apo-A、Apo-B、LDH、AST及CK与轻度子痫前期组比较差异均有统计学意义(t=1.488~16.225,均P<0.05);对照组与各HDCP组脂蛋白a(Lpa)及肌酸激酶同工酶(CK-MB)组间比较差异均无统计学意义(均P>0.05).多因素相关分析表明,LDL-C、Apo-B均为AST和CK的独立相关因素(r2分别为0.513、0.497和0.391、0.445,均P<0.05).结论 HDCP患者血清中LDL-C、TC、TG、Apo-B、AST、LDH及CK均有所升高,HDL-C和Apo-A则明显下降,而且随着病情的加重变化更为明显,心肌酶谱指标AST和CK与LDL-C、Apo-B具有一定的相关性.     

局部振动作业工人对血脂和血黏度的影响

目的探讨局部振动对血脂、血黏度等指标的影响.方法检测暴露组和对照组工人的血胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血黏度、载脂蛋白(Apo)、红细胞(RBC)、血小板(PLT)、平均红细胞容量(MCV)、餐后血糖(PBS)、血清蛋白.比较两组间均值与异常率的差异.结果暴露组TG[(1.01±0.85)mmol/L]、TC[(3.25±0.61)mmol/L]、HDL[(1.14±0.20)mmol/L]比对照组[分别为(1.89±1.47)、(3.87±0.82)、(1.22±0.26)mmol/L]明显减低,差异有显著性(P＜0.01、P＜0.05);Apo-A亦明显减低[分别为(1.13±0.29)、(1.23±0.16)g/L],差异有显著性(P＜0.01);血黏度明显增高[分别为(2.76±0.42)、(2.54±0.33)mpa@s],差异有显著性(P＜0.01).暴露组与对照组Apo-A异常率分别是23.30%、4.50%,差异有显著性(P＜0.01).结论局部振动可使作业工人血脂降低、血黏度增加并引起其他血液指标变化.     

新疆哈萨克族居民高尿酸血症与脂代谢关系

目的了解新疆哈萨克族高尿酸血症患者的血脂水平,分析哈萨克族高尿酸血症与脂代谢之间的关系。方法在新疆伊犁哈萨克族居民集中的地区随机抽取256例作为研究对象,其中高尿酸血组128例,对照组128人,分别检测血尿酸(SUA)及血脂相关生化指标。结果生化指标中除总胆固醇TC、载脂蛋白-A1(Apo-A1)外,高尿酸组血尿酸SUA(469.31±87.38)μmol/L、尿素氮BUN(6.10±2.45)mmol/L、肌酐SCr(88.34±20.39)μmol/L、甘油三酯TG(1.66±1.24)mmol/L、低密度脂蛋白胆固醇LDL-C(2.72±1.13)mmol/L、载脂蛋-B(Apo-B)为(0.91±0.27)g/L、空腹血糖GLU(6.12±2.52)mmol/L,均高于对照组(P<0.05);高密度脂蛋白胆固醇HDL-C(1.49±0.82)mmol/L、Apo-A1/Apo-B(1.36±0.42)低于对照组(P<0.01).高尿酸组SUA男性(509.21±91.73)μmol/L,女性(424.09±54.46)μmol/L;对照组SUA男性(248.89±75.37)μmol/L,女性(199.49±54.30)μmol/L,差异均有统计学意义(P<0.01);各年龄段均存在不同程度的脂代谢紊乱(除了≤30岁年龄段),以31～40岁年龄段脂代谢紊乱最为明显;相关性分析中血尿酸与年龄、TC、TG、BUN、SCr、LDL-C、Apo-B呈正相关,与HDL-C、Apo-A1/Apo-B呈负相关;多元回归分析结果表明,性别、HDL-C、BUN、TC、Apo-A1、Apo-A1/Apo-B是影响血尿酸的独立危险因素。结论哈萨克族高尿酸血症患者的血脂水平均高于非高尿酸血症者;其尿酸水平的升高与脂代谢紊乱的发生密切相关;建议预防和治疗哈萨克族高尿酸血症时,应注意控制血脂水平的变化,降低血脂有助于治疗高尿酸血症。     

Effect of soy protein containing isoflavones on blood lipids in moderately hypercholesterolemic adults: a randomized controlled trial

BACKGROUND: Dietary intake of soy protein with isoflavones may be associated with reductions in serum cholesterol. OBJECTIVES: To compare the effects of a water-washed soy protein concentrate with a milk-protein based control on blood lipid levels in hyperlipidemic men and women. METHODS: A randomized, double-blind, controlled clinical trial including 159 subjects. After a 3-week run-in period during which all subjects consumed a milk protein-based supplement, participants were randomized into one of two groups: a control group (continued milk protein) and an intervention group (soy protein) for a five-week period. Fasting venous blood draws for lipid measurement were obtained at baseline, towards the end of the run-in period and at the end of the intervention. Blood isoflavone concentrations were measured at the end of the study. RESULTS: Blood lipid levels were not significantly different between groups at any point in time; and there were no significant associations between blood isoflavones and lipid levels. Significant decreases in total cholesterol (19 mg/dL), and LDL-cholesterol (11 mg/dL), were observed during the run-in period, with no further decreases in lipids during the intervention period in either group. CONCLUSIONS: These results do not support the hypothesis that water-washed soy protein has an effect on blood lipids. Several hypotheses are discussed, highlighting the selective nature of the effect of soy consumption in the population. The cholesterol-lowering effect during the run-in period may be explained by the "regression to the mean effect" and by other factors related to study participation, mainly nutrient displacement induced by the protein supplement.     

血糖、血脂对脑出血、脑梗死的影响

目的探讨脑出血、脑梗死的发病与血糖、血脂的关系,并比较各种危险因素在脑出血与脑梗死患者中的差异。方法经CT或磁共振成像（MRI）确诊的脑梗死组42例、脑出血组40例,对照组38例健康受试者。测定三组患者的血糖、血脂含量,并对结果进行比较分析。结果与对照组相比,脑梗死组血糖和LDL-C显著升高（P〈0.05）,脑出血组血糖和TG显著升高（P〈0.05）,其它指标差异无统计学意义（P〉0.05）。脑出血组与脑梗死组比较,血糖、HDL-C显著增高,差异有统计学意义（P〈0.05）,Apo-B显著降低,差异有统计学意义（P〈0.05）,而TC、TG、LDL-C、Apo-A差异无统计学意义（P〉0.05）。结论血糖、部分血脂成份共为脑出血、脑梗死的危险因素,对脑出血和脑梗死的预防应重视对高血脂、高血糖的积极防治,采取综合措施。     

血脂与高血压关系的前瞻性研究

目的 探讨基线血压正常者在随访期间发展为高血压的危险与基线时不同血脂变量水平的关系.方法 2000年4月建立年龄为34～74岁共8685人的研究队列,取得基线数据.2006年6月开始对其中基线调查满5年的对象进行随访;对进入随访、符合纳入标准且资料完整的2603名基线血压正常者在中位数随访6.38年期间发展为高血压的危险与基线不同血脂变量水平的关系进行分析.结果 基线血脂水平与随访期间高血压发生率之间有一定的联系,调整性别、年龄模型中,各血脂指标变量均与高血压有联系(趋势检验P<0.01);多变量调整模型中,HDL-C[αRR=0.71(95%CI:0.61～0.99)]、非HDL-C[αRR=1.28(95%CI:1.14～1.83)]、TC/HDL-C的比值[αRR=1.41(95%CI:1.25～2.03)]和TG[αRR=1.49(95%CI:1.30～2.13)]仍与高血压有联系(趋势检验P<0.05);进一步调整BMI后,减弱了各血脂指标变量与高血压联系的aRR,但aRR仍有统计学意义;用Cox模型调整基线SBP、DBP后各血脂指标变量与高血压关系的αRR有所降低,但HDL-C、TC/HDL-C比值、TG与高血压发病率仍有显著的联系.当剔除肥胖患者(BMl≥28)和已经诊断为糖尿病的这2个与高血压明显相关的危险因子后HDL-C(趋势检验P=0.01)、TG(趋势检验P<0.05)、非HDL-C(趋势检验P<0.05)和TC/HDL-C的比值(趋势检验P<0.05)仍然与高血压有联系.结论 血脂异常可能发生在高血压之前,即使排除了肥胖和糖尿病患者,或者调整了吸烟、饮酒甚至是基线SBP、DBP水平后,HDL-C、TC/HDL-C和TG仍与高血压有联系.