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Objective@#To study the correlation of the degree of sleep apnea with arrhythmia, heart rate variability(HRV)and blood pressure variability(BPV)in elderly patients with obstructive sleep apnea hypopnea syndrome(OSAHS), and to investigate the intervention effects of home-based continuous positive airway pressure(CPAP)treatment.@*Methods@#A total of 122 elderly hypertension patients with OSAHS were recruited in the prospective study.Patients were divided into three groups according to the sleep apnea hypopnea index(apnea hypopnea index, AHI): the mild OSAHS group(5 times/h≤AHI≤15 times/h, n=42), moderate OSAHS group(15 times/h<AHI≤30 times/h, n=40)and severe OSAHS group(AHI>30 times/h, n=40). All patients took ambulatory electrocardiogram and ambulatory blood pressure examinations before and after three months of CPAP treatment.The incidences of arrhythmia, HRV and BPV indexes of each group before and after CPAP treatment were compared between the groups.@*Results@#The incidences of premature atrial contraction, atrial tachycardia and premature ventricular beats were higher in the moderate and severe OSAHS groups than in the mild OSAHS group(P<0.01). Compared with the mild OSAHS group, the RR interval standard deviation(SDNN), root mean square of successive differences(rMSSD), proportion of patients with consecutive RR-interval differences greater than 50 ms(PNN5), standard deviation of the averaged normal RR intervals for all 5 min segments and deceleration capacity of rate increased in the moderate and severe OSAHS groups(P<0.05), and the increases were more obvious in the severe group.Compared with the mild OSAHS group, the standard deviation of 24-h systolic blood pressure, standard deviation of 24-h diastolic blood pressure, standard deviation of daytime systolic blood pressure, standard deviation of nighttime systolic blood pressure and incidence of non-dipper hypertension increased in the moderate and severe OSAHS groups(P<0.05), with the increases were more obvious in the severe group, and the differences was significant between the moderate and severe OSAHS groups(P<0.05). HRV and BPV indicators improved except for high frequency(HF)/low frequency(LF)in all groups(P<0.05)after home treatment of CPAP, and the improvement was more obvious in the severe group.The incidence of non-dipper circadian rhythm of blood pressure improved more significantly in the severe OSAHS group than in the moderate OSAHS group.@*Conclusions@#With aggravated sleep apnea, the incidences of arrhythmias such as premature atrial contraction, atrial tachycardia, and premature ventricular contraction are increased and the HRV and BPV are enlarged in elderly hypertension patients complicated with OSAHS.The home treatment of CPAP can improve the above indicators, and it is an effective way to treat OSAHS complicated by hypertension in elderly patients.
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Objective To study the correlation of the degree of sleep apnea with arrhythmia,heart rate variability(HRV) and blood pressure variability(BPV)in elderly patients with obstructive sleep apnea hypopnea syndrome(OSAHS),and to investigate the intervention effects of home-based continuous positive airway pressure(CPAP)treatment.Methods A total of 122 elderly hypertension patients with OSAHS were recruited in the prospective study.Patients were divided into three groups according to the sleep apnea hypopnea index(apnea hypopnea index,AHI):the mild OSAHS group(5 times/h≤AHI≤15 times/h,n=42),moderate OSAHS group(15 times/h＜ AHI≤30 times/h,n=40) and severe OSAHS group (AHI＞30times/h,n=40).All patients took ambulatory electrocardiogram and ambulatory blood pressure examinations before and after three months of CPAP treatment.The incidences of arrhythmia,HRV and BPV indexes of each group before and after CPAP treatment were compared between the groups.Results The incidences of premature atrial contraction,atrial tachycardia and premature ventricular beats were higher in the moderate and severe OSAHS groups than in the mild OSAHS group(P＜0.01).Compared with the mild OSAHS group,the RR interval standard deviation(SDNN),root mean square of successive differences (rMSSD),proportion of patients with consecutive RR-interval differences greater than 50 ms (PNN5),standard deviation of the averaged normal RR intervals for all 5 min segments and deceleration capacity of rate increased in the moderate and severe OSAHS groups(P＜0.05),and the increases were more obvious in the severe group.Compared with the mild OSAHS group,the standard deviation of 24-h systolic blood pressure,standard deviation of 24-h diastolic blood pressure,standard deviation of daytime systolic blood pressure,standard deviation of nighttime systolic blood pressure and incidence of non-dipper hypertension increased in the moderate and severe OSAHS groups (P ＜ 0.05),with the increases were more obvious in the severe group,and the differences was significant between the moderate and severe OSAHS groups(P ＜0.05).HRV and BPV indicators improved except for high frequency(HF)/low frequency(LF) in all groups (P ＜ 0.05) after home treatment of CPAP,and the improvement was more obvious in the severe group.The incidence of non-dipper circadian rhythm of blood pressure improved more significantly in the severe OSAHS group than in the moderate OSAHS group.Conclusions With aggravated sleep apnea,the incidences of arrhythmias such as premature atrial contraction,atrial tachycardia,and premature ventricular contraction are increased and the HRV and BPV are enlarged in elderly hypertension patients complicated with OSAHS.The home treatment of CPAP can improve the above indicators,and it is an effective way to treat OSAHS complicated by hypertension in elderly patients.
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Objective To evaluate the effect of tirofiban injection in coronary artery occlusion by suction catheter on the opening time of the coronary artery occlusion , the improvement of the blood flow and the incidence of adverse events in 30 days. Methods A total of 97 patients with acute myocardial infarction in recent 4 years were included , whose culprit vessels were subtotal occlusion or total occlusion by angiography and were randomly divided into thrombus aspiration group (group A) and tirofiban injection in occlusion and thrombus aspiration group (group B). The opening time of the coronary artery, the improvement of the blood flow and the incidence of adverse events in 30 days were compared between two groups. Results The opening time of the coronary artery occlusion in group A was shortened when compared with group B but the blood flow arriving TIMI III grade in group B was shorter (P 0.05). Conclusion Direct tirofiban injection in coronary artery occlusion could effectively shorten the opening time of the coronary artery occlusion reduce no-reflow incidence , and improve coronary perfusion but could not decrease the incidence of adverse cardiovascular events in 30 days.
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Objective:To explore the relationship between thyroid function and cardiovascular diseases .Methods:A total of 980 patients undergoing thyroid function examination during hospitalization were selected . According to their thyroid function ,they were divided into normal thyroid function group (normal group ,n= 930) , hyperthy-roidism group (n=18) ,and hypothyroidism group (n=32) .Clinical data were analyzed ,blood lipids and coagula-tion function indexes were examined and compared among three groups . Results:Compared with normal group ,the incidence rate of atrial fibrillation significantly rose ,incidence rate of hypertension ,cardiac insufficiency signifi-cantly reduced;levels of TC、TG、 LDL-C、 HDL-C significantly reduced ,activated partial thromboplastin time significantly extended in hyperthyroidism group , P<0.01 all;incidence rate of coronary heart disease significantly rose ,levels of TG、HDL-C significantly rose ,levels of TC 、LDL-C significantly reduced in hypothyroidism group , P<0.01 all;Compared with hyperthyroidism group ,the incidence rate of hypertension ,coronary heart disease sig-nificantly rose ,atrial fibrillation significantly reduced ,P<0.05 or <0.01 ;levels of TG、LDL-C、HDL-C signifi-cantly rose ,TC level significantly reduced in hypothyroidism group , P<0. 01 all .Conclusion:Thyroid function is closely related to cardiovascular diseases .so it′s suggested that thyroid function detection should be regarded as a routine examination in patients with cardiovascular diseases and a follow-up index for those with thyroid dysfunc-tion .
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<p><b>OBJECTIVE</b>Bloom's syndrome is an autosomal recessive disorder characterized by genomic instability and a predisposition to many cancers. Mutations of the BLM gene (encoding a BLM helicase) may form a structure of the etiology of this disease. As a global pollutant, mercury poses a major threat to human health. The current study was conducted to elucidate the effects of Hg(2+) on the structure and activity of BLM642-1290 recombinant helicase, and to further explore the molecular mechanisms of mercury toxicity to the DNA helicase.</p><p><b>METHODS</b>The effects of Hg(2+) on biological activity and structure of BLM642-1290 recombinant helicase were determined by fluorescence polarized, ultraviolet spectroscopic, and free-phosphorus assay technologies, respectively.</p><p><b>RESULTS</b>The helicase activity, the DNA-binding activity, and the ATPase activity of BLM642-1290 recombinant helicase were inhibited by Hg(2+) treatment. The LMCT (ligand-to-metal charge transition) peaks of the helicase were enhanced with the increase of the Hg(2+) level. The LMCT peaks of the same concentration of helicase gradually increased over time.</p><p><b>CONCLUSION</b>The biological activity of BLM642-1290 recombinant helicase is inhibited by Hg(2+) treatment. The conformation of the helicase is significantly altered by Hg(2+). There exist two binding sites between Hg(2+) and the helicase, which are located in the amino acid residues 1063-1066 and 940-944 of the helicase, respectively.</p>