背景日常活动量减少和运动功能受限是心力衰竭患者的特征性表现之一,体位/体动信息与心衰患者疾病严重程度和预后密切相关。通过可穿戴生理监测系统量化体位/体动信息或可作为一种潜在的心衰病情严重程度定量评价手段,其与纽约心脏病协...背景日常活动量减少和运动功能受限是心力衰竭患者的特征性表现之一,体位/体动信息与心衰患者疾病严重程度和预后密切相关。通过可穿戴生理监测系统量化体位/体动信息或可作为一种潜在的心衰病情严重程度定量评价手段,其与纽约心脏病协会(New York Heart Association,NYHA)心功能分级的关系需进一步研究。目的探讨心衰患者体位/体动信息定量分析结果与NYHA分级的相关性。方法纳入2021年5月—2022年11月在四川大学华西医院心内科住院的心衰患者,通过可穿戴生理监测系统采集患者入院当天和出院前1 d各24 h的连续生理监测数据,同步收集临床数据。通过对可穿戴生理监测系统内的三轴加速传感器信息进行处理分析,计算卧床时间、活动时间、步数、睡眠翻身次数4个体位/体动指标。基于患者入院时NYHA分级、入院和出院情况、出院时NYHA分级改善与否进行分组,分析体位/体动指标与NYHA分级的关联性。结果纳入心衰患者69例,平均年龄(60.90±14.24)岁,其中男性40例,NYHAⅡ、Ⅲ、Ⅳ级的患者分别有9例、24例、36例。随着NYHA分级的升高,心衰患者全天的卧床时间占比逐渐增多,而全天的活动时间占比、平均每小时步数逐渐降低,以上3个指标在NYHAⅡ、Ⅲ、Ⅳ级间均有统计学差异(P均<0.05);其中卧床时间占比(r_(s)=0.319,P=0.008)与NYHA分级呈正相关,活动时间占比(r_(s)=-0.312,P=0.009)、平均每小时步数(r_(s)=-0.309,P=0.010)与NYHA分级存在负相关。出院时的卧床时间占比显著低于入院时(96.25%vs 97.63%,P=0.026);出院时的活动时间占比显著高于入院时(3.32%vs 1.78%,P<0.001);出院时的平均每小时步数显著高于入院时(97.17步/h vs 35.58步/h,P<0.001);其中出院时NYHA改善组患者的体位/体动指标变化趋势同上,未改善组仅出院时的平均每小时步数显著高于入院时,NYHA改善组的出入院平均每小时步数变化值显著高于未改善组(71.21步/h vs 21.31步/h,P=0.003)。结论可穿戴生理监测系统能够对心衰患者的体位/体动信息进行客观长程的监测,心衰患者的卧床时间与NYHA分级呈正相关关系;活动时间、步数与NYHA分级呈负相关关系,这些体位/体动指标或可作为心衰患者疾病严重程度分级和状态监测评估的有用指标,未来可进一步延伸到对患者的居家和长程监测。展开更多
Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years fema...Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.展开更多
文摘背景日常活动量减少和运动功能受限是心力衰竭患者的特征性表现之一,体位/体动信息与心衰患者疾病严重程度和预后密切相关。通过可穿戴生理监测系统量化体位/体动信息或可作为一种潜在的心衰病情严重程度定量评价手段,其与纽约心脏病协会(New York Heart Association,NYHA)心功能分级的关系需进一步研究。目的探讨心衰患者体位/体动信息定量分析结果与NYHA分级的相关性。方法纳入2021年5月—2022年11月在四川大学华西医院心内科住院的心衰患者,通过可穿戴生理监测系统采集患者入院当天和出院前1 d各24 h的连续生理监测数据,同步收集临床数据。通过对可穿戴生理监测系统内的三轴加速传感器信息进行处理分析,计算卧床时间、活动时间、步数、睡眠翻身次数4个体位/体动指标。基于患者入院时NYHA分级、入院和出院情况、出院时NYHA分级改善与否进行分组,分析体位/体动指标与NYHA分级的关联性。结果纳入心衰患者69例,平均年龄(60.90±14.24)岁,其中男性40例,NYHAⅡ、Ⅲ、Ⅳ级的患者分别有9例、24例、36例。随着NYHA分级的升高,心衰患者全天的卧床时间占比逐渐增多,而全天的活动时间占比、平均每小时步数逐渐降低,以上3个指标在NYHAⅡ、Ⅲ、Ⅳ级间均有统计学差异(P均<0.05);其中卧床时间占比(r_(s)=0.319,P=0.008)与NYHA分级呈正相关,活动时间占比(r_(s)=-0.312,P=0.009)、平均每小时步数(r_(s)=-0.309,P=0.010)与NYHA分级存在负相关。出院时的卧床时间占比显著低于入院时(96.25%vs 97.63%,P=0.026);出院时的活动时间占比显著高于入院时(3.32%vs 1.78%,P<0.001);出院时的平均每小时步数显著高于入院时(97.17步/h vs 35.58步/h,P<0.001);其中出院时NYHA改善组患者的体位/体动指标变化趋势同上,未改善组仅出院时的平均每小时步数显著高于入院时,NYHA改善组的出入院平均每小时步数变化值显著高于未改善组(71.21步/h vs 21.31步/h,P=0.003)。结论可穿戴生理监测系统能够对心衰患者的体位/体动信息进行客观长程的监测,心衰患者的卧床时间与NYHA分级呈正相关关系;活动时间、步数与NYHA分级呈负相关关系,这些体位/体动指标或可作为心衰患者疾病严重程度分级和状态监测评估的有用指标,未来可进一步延伸到对患者的居家和长程监测。
文摘Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.
