目的:观察探究芪参益气滴丸对2型糖尿病(T2DM)合并急性心肌梗死(AMI)病人经皮冠状动脉介入(PCI)术后心功能的影响。方法:将100例T2DM合并AMI病人随机分为对照组与观察组,各50例,所有病人均接受PCI术,术后对照组给予西医对症治疗,观察组...目的:观察探究芪参益气滴丸对2型糖尿病(T2DM)合并急性心肌梗死(AMI)病人经皮冠状动脉介入(PCI)术后心功能的影响。方法:将100例T2DM合并AMI病人随机分为对照组与观察组,各50例,所有病人均接受PCI术,术后对照组给予西医对症治疗,观察组在对照组基础上加用芪参益气滴丸治疗,疗程3个月。测定围术期血N末端B型脑钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)变化;PCI术后当日及术后3个月测定左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)及二尖瓣舒张早期血流峰值速度/舒张晚期血流峰值速度比值(E/A);评估两组治疗前后主要中医证候积分、空腹血糖(FBG)、糖化血红蛋白(HbA1c)及心功能分级变化,统计治疗不良反应及近期主要不良心血管事件发生率。结果:观察组术后24 h、术后72 h NT-proBNP、CK-MB、cTnI均低于对照组(P<0.05);观察组术后3个月LVEF、E/A高于对照组,LVESD、LVEDD低于对照组。术后3个月,观察组心功能分级优于术后当日(P<0.05);两组术后3个月心功能分级比较差异无统计学意义(P>0.05)。观察组术后3个月胸痛、胸闷、气短、心悸、神疲乏力中医证候积分及HbA1c、FBG均低于对照组(P<0.05);随访3个月,观察组主要不良心血管事件发生率(6.00%)低于对照组(20.00%),差异有统计学意义(P<0.05)。结论:在西医对症治疗基础上联合使用芪参益气滴丸可减轻T2DM合并AMI病人PCI术后心肌损伤,有助于改善心室重构及心功能,减少近期主要不良心血管事件发生。展开更多
In order to study and analyze the stability of engineering rock mass under non-uniform triaxial stress and obtain the evolution mechanism of the whole process of fracture,a series of conventional triaxial compression ...In order to study and analyze the stability of engineering rock mass under non-uniform triaxial stress and obtain the evolution mechanism of the whole process of fracture,a series of conventional triaxial compression tests and three-dimensional numerical simulation tests were carried out on hollow granite specimens with different diameters.The bearing capacity of hollow cylindrical specimen is analyzed based on elasticity.The results show that:1)Under low confining pressure,the tensile strain near the hole of the hollow cylindrical specimen is obvious,and the specimen deformation near the hole is significant.At the initial stage of loading,the compressive stress and compressive strain of the specimen are widely distributed.With the progress of loading,the number of microelements subjected to tensile strain gradually increases,and even spreads throughout the specimen;2)Under conventional triaxial compression,the cracking position of hollow cylinder specimens is concentrated in the upper and lower parts,and the final fracture mode is generally compressive shear failure.The final fracture mode of complete specimen is generally tensile fracture.Under high confining pressure,the tensile cracks of the sample are concentrated in the upper and lower parts and are not connected,while the cracks of the upper and lower parts of the intact sample will expand and connect to form a fracture surface;3)In addition,the tensile crack widths of intact and hollow cylindrical specimens under low confining pressure are larger than those under high confining pressure.展开更多
文摘目的基于心脏影像学特点和血清标志物分析持续性心房颤动(atrial fibrillation,AF)患者环肺静脉隔离+顶部线+后壁线的射频消融术后复发的危险因素,并建立列线图模型。方法选取2022年6月至2023年9月阜阳市第二人民医院收治的持续性AF患者172例,根据术后6个月是否复发分为复发组51例和未复发组121例。于术前常规予以心电图、经胸和食管心动图检查,同时检测血常规和相关生化指标,均行环肺静脉隔离+顶部线+后壁线的射频消融术治疗,术后随访6个月。用二元logistic分析患者术后复发的独立危险因素,建立并评估列线图模型的诊断效能。结果复发组左心房直径、左心房容积指数、中性粒细胞、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、B型钠尿肽、C反应蛋白高于未复发组,左心耳峰值填充流速、左心耳峰值排空流速、左心耳射血分数低于未复发组(P<0.01)。二元logistic回归分析显示,持续性AF患者左心房容积指数升高(OR=1.160,95%CI:1.006~1.337)、左心耳峰值排空流速降低(OR=0.740,95%CI:0.583~0.940)、左心耳射血分数降低(OR=0.608,95%CI:0.422~0.877)、B型钠尿肽升高(OR=1.017,95%CI:1.004~1.030)和NLR升高(OR=10.116,95%CI:1.316~77.755)是环肺静脉隔离+顶部线+后壁线的射频消融术后复发的独立危险因素(P<0.05,P<0.01)。以左心房容积指数、左心耳峰值排空流速、左心耳射血分数、B型钠尿肽、NLR构建的列线图模型预测持续性AF患者术后复发的曲线下面积为0.889(95%CI:0.833~0.932)。结论持续性AF患者心脏影像学参数左心房容积指数、左心耳峰值排空流速、左心耳射血分数及血清标志物B型钠尿肽、NLR与环肺静脉隔离+顶部线+后壁线的射频消融术后复发密切相关,且相关列线图模型对术后复发的诊断价值较佳。
文摘目的:观察探究芪参益气滴丸对2型糖尿病(T2DM)合并急性心肌梗死(AMI)病人经皮冠状动脉介入(PCI)术后心功能的影响。方法:将100例T2DM合并AMI病人随机分为对照组与观察组,各50例,所有病人均接受PCI术,术后对照组给予西医对症治疗,观察组在对照组基础上加用芪参益气滴丸治疗,疗程3个月。测定围术期血N末端B型脑钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)变化;PCI术后当日及术后3个月测定左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)及二尖瓣舒张早期血流峰值速度/舒张晚期血流峰值速度比值(E/A);评估两组治疗前后主要中医证候积分、空腹血糖(FBG)、糖化血红蛋白(HbA1c)及心功能分级变化,统计治疗不良反应及近期主要不良心血管事件发生率。结果:观察组术后24 h、术后72 h NT-proBNP、CK-MB、cTnI均低于对照组(P<0.05);观察组术后3个月LVEF、E/A高于对照组,LVESD、LVEDD低于对照组。术后3个月,观察组心功能分级优于术后当日(P<0.05);两组术后3个月心功能分级比较差异无统计学意义(P>0.05)。观察组术后3个月胸痛、胸闷、气短、心悸、神疲乏力中医证候积分及HbA1c、FBG均低于对照组(P<0.05);随访3个月,观察组主要不良心血管事件发生率(6.00%)低于对照组(20.00%),差异有统计学意义(P<0.05)。结论:在西医对症治疗基础上联合使用芪参益气滴丸可减轻T2DM合并AMI病人PCI术后心肌损伤,有助于改善心室重构及心功能,减少近期主要不良心血管事件发生。
基金Projects(52074116,51804113)supported by the National Natural Science Foundation of China。
文摘In order to study and analyze the stability of engineering rock mass under non-uniform triaxial stress and obtain the evolution mechanism of the whole process of fracture,a series of conventional triaxial compression tests and three-dimensional numerical simulation tests were carried out on hollow granite specimens with different diameters.The bearing capacity of hollow cylindrical specimen is analyzed based on elasticity.The results show that:1)Under low confining pressure,the tensile strain near the hole of the hollow cylindrical specimen is obvious,and the specimen deformation near the hole is significant.At the initial stage of loading,the compressive stress and compressive strain of the specimen are widely distributed.With the progress of loading,the number of microelements subjected to tensile strain gradually increases,and even spreads throughout the specimen;2)Under conventional triaxial compression,the cracking position of hollow cylinder specimens is concentrated in the upper and lower parts,and the final fracture mode is generally compressive shear failure.The final fracture mode of complete specimen is generally tensile fracture.Under high confining pressure,the tensile cracks of the sample are concentrated in the upper and lower parts and are not connected,while the cracks of the upper and lower parts of the intact sample will expand and connect to form a fracture surface;3)In addition,the tensile crack widths of intact and hollow cylindrical specimens under low confining pressure are larger than those under high confining pressure.
