Core–Shell Microfiber Encapsulation Enables Glycerol‑Free Cryopreservation of RBCs with High Hematocrit

Cryopreservation of red blood cells(RBCs)provides great potential benefits for providing transfusion timely in emergencies.High concentrations of glycerol(20%or 40%)are used for RBC cryopreservation in current clinical practice,which results in cytotoxicity and osmotic injuries that must be carefully controlled.However,existing studies on the low-glycerol cryopreservation of RBCs still suffer from the bottleneck of low hematocrit levels,which require relatively large storage space and an extra concentration process before transfusion,making it inconvenient(time-consuming,and also may cause injury and sample lose)for clinical applications.To this end,we develop a novel method for the glycerol-free cryopreservation of human RBCs with a high final hematocrit by using trehalose as the sole cryoprotectant to dehydrate RBCs and using core–shell alginate hydrogel microfibers to enhance heat transfer during cryopreservation.Different from previous studies,we achieve the cryopreservation of human RBCs at high hematocrit(>40%)with high recovery(up to 95%).Additionally,the washed RBCs post-cryopreserved are proved to maintain their morphology,mechanics,and functional properties.This may provide a nontoxic,high-efficiency,and glycerol-free approach for RBC cryopreservation,along with potential clinical transfusion benefits.

Effect of Point-of-care Hemoglobin/Hematocrit Devices and Autologous Blood Salvage on Reduction of Perioperative Allogeneic Blood Transfusion

Objective To evaluate the effect of point-of-care hemoglobin/hematocrit(POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice. Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference. Results In the hospitals where POC HGB/HCT device was used(n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011(39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased(n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow. Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.

Hematocrit and Slip Velocity Influence on Third Grade Blood Flow and Heat Transfer through a Stenosed Artery

A theoretical investigation concerning hematocrit and slip velocity influence on the flow of blood and heat transfer by taking into account the externally applied magnetic field has been carried out. The mathematical models considered in this work treated blood as a non-Newtonian fluid obeying the third grade fluid model. A suitable geometry of the stenosis is taken into account. Galerkin weighted residual and Newton Raphson methods are used to solve the equations that govern the flow of blood and heat transfer. Analytical expression for the velocity profile, temperature profile, volume flow rate, wall shear stress and resistance to flow were obtained. Graphical representation of results shows that the flow velocity, volumetric flow rate and shear stress increase while resistance to flow and heat transfer rate decrease when the slip velocity increases. Also, flow velocity and volume flow rate decrease while shear stress, heat transfer rate, and resistance to flow increase when the hematocrit parameter increases. Finally, increases in magnetic field parameter lead to decrease in flow velocity, flow rate and shear stress but increase the flow resistance.

Reference value of old people's hematocrit and geographical factors

This paper is written in order to provide a scientific basis for a unified standard of the reference value of Chinese healthy old people's hematocrit. It studies the relationship between the reference values of healthy old people's hematocrit, tested according to the Wintrobe Laws and five geographical factors. It is found that the altitude is the most important factor affecting the reference value of old people's hematocrit. As the altitude gradually increases, the reference value of their hematocrit also increases, the relationship is quite significant. By using the method of stepwise regression analysis, two multivariate regression equations are deduced:1=50.2+0.00248X1-0.0534X3-0.388X4+0.00383X5±2.2, 2=44.5+0.00231X1-0.0600X3-0.260X4+0.00341X5±2.1. If the geographical index values in a particular area in China are known, the reference value of old people's hematocrit in this area can be established by means of the regression equations. Furthermore, according to the dependent relationship of the reference value of old people's hematocrit on geographical factors, China can be divided into six regions: Qinghai-Tibet, Plateau, Southwest, Northwest, Southeast, North and Northeast.

Thermoacoustic assessment of hematocrit changes in human forearms

Abnormal hematocrit(Hct)is associated with an increased risk of pre-hypertension and all-cause death in general population,and people with a high Hct value are susceptible to arterial cardiovascular disease and venous thromboembolism.In this study,we report for the first time on the ability of thermoacoustic imaging(TAI)for in vivo evaluating Hct changes in human forearms.In vitro blood samples with different Hct values from healthy volunteers(n=3)were prepared after centrifugation.TAI was performed using these samples in comparison with the direct measurements of conductivity.In vivo TAI was conducted in the forearm of healthy volunteers(n=7)where Hct changes were produced through a vascular occlusion stimulation over a period of time.The results of in vitro blood samples obtained from the 3 healthy subjects show that the thermoacoustic(TA)signals changes due to the variation of blood conductivity are closely related to the changes in Hct.In addition,the in vivo TA signals obtained from the 7 healthy subjects consistently increase in the artery/muscle and decrease in the vein during venous or arterial occlusion because of the changed Hct value in their forearms.These findings suggest that TAI has the potential to become a new tool for monitoring Hct changes for a variety of pre-clinical and clinical applications.

Hematocrit level correlates with lungs resistivity in elderly patients with cardiogenic pulmonary edema

Regular monitoring of pulmonary congestion in car-diogenic pulmonary edema (CPE) patients is neces-sary for its adequate management via pharmaceuti-cal treatment. It is well known that the development of CPE is accompanied with an increase in hema-tocrit, plasma protein concentration and colloid os-motic pressure due to the decrease in the plasma volume. In the present study the mean left and right lung resistivity values taken pre- and post treatment with diuretics using a hybrid bio-impedance electri-cal impedance tomography system were correlate to the measured changes in hematocrit level. A marginal significant correlation was found between the abso-lute mean lung resistivity and hematocrit levels (Pearson’s correlation coefficient of R = 0.4, p-value = 0.057). When the change in the mean lung resistivity of a patient was plotted vs. the change in hematocrit readout, a significant linear correlation was found (R = 0.7, p-value = 0.02). These results support the validity of the resistivity measurements using bio-impedance system in monitoring changes of pulmonary edema in CPE patients.

Change and Relationship of Hematocrit and Electrocardiogram of the Crew in High Altitude Span Transportation

Objective: To investigate the effect of high altitude span transportation on the change of hematocrit and electrocardiogram of the crew in the plateau construction, and discuss their relationship. Method: By SPSS 11.0 statistical software, to treat hematocrit and electrocardiogram in the examination data of the the crew, who took part in the construction of Qinghai-Tibetan railway in 2003, before, during and after the construction. Then, we compared the data among the constructors in the fixed altitude during the same period. Result: The hematocrit of the crew slowly and continually rose to the maximum(p<0.01) after the construction in the high altitude span during one construction year, and the abnormal rate of electrocardiogram obviously decreased(p<0.05). The abnormal rate of electrocardiogram apparently improved when hematocrit reached 52% among the range from 45.12% to 52.24%, and the correlation analysis showed that the electrocardiographic change was closely and negatively correlated with the hematocrit among the range of hematocrit(p<0.05). Conclusion: Although the higher-level stress state of the crew made the hematocrit in the blood continually increase in the long-term high altitude span construction, the hematocrit reached the more reasonable hematocrit compensation and made it the optimum state of Hct in the end. As a result, the perfusion of tissues and organs was improved. The abnormal rate of electrocardiogram apparently improved because the oxygen delivery of the myocardium reached the optimum compensation.

紫绀型和非紫绀型先天性心脏病患儿的凝血参数特点

目的 凝血异常是未矫正先天性心脏病患儿的严重并发症和死亡原因,本研究旨在筛查先天性心脏病患儿凝血异常的患病率和相关因素,并比较紫绀型和非紫绀型患儿的凝血异常情况。方法 纳入年龄在0~3岁于2016年1月至2019年12月在中国医学科学院阜外医院就医的未矫正先天性心脏病患儿650例,包括245例紫绀型先天性心脏病和405例非紫绀型先天性心脏病。统计紫绀型与非紫绀型先天性心脏病患儿全血细胞计数和凝血常规检测结果,使用血小板计数、凝血酶原时间、活化部分凝血活酶时间、D-二聚体、纤维蛋白原和纤维蛋白降解产物测定值判断是否发生凝血异常。结果 紫绀型和非紫绀型先天性心脏病患儿凝血异常发生率分别是60.4%和44.7%。红细胞数、血红蛋白浓度、红细胞比容、红细胞体积分布宽度与血小板计数、凝血酶原时间、活化部分凝血酶原时间相关性具有统计学意义(P<0.05)。结论 未经矫正的先心病患儿凝血异常是常见的,相较于非紫绀型先天性心脏病患儿,紫绀型先天性心脏病患儿凝血异常更易发生。

急性缺血性脑卒中患者静脉溶栓后血小板参数对不良预后的预测价值

目的探讨急性缺血性脑卒中患者静脉溶栓后血小板参数水平对不良预后的预测价值。方法纳入保定市第一中心医院110例急性缺血性脑卒中患者进行研究,所有患者行静脉溶栓治疗,均在溶栓治疗后测定血小板参数,治疗后随访3个月,根据改良Rankin量表(mRS)评估患者预后,将mRS≥3分者纳入预后不良组(n=32),mRS<3分者纳入预后良好组(n=78),比较2组一般资料、血小板参数、分析影响急性缺血性脑卒中静脉溶栓治疗患者不良预后的危险因素及血小板参数对不良预后的预测价值。结果预后不良组年龄、入院NIHSS评分、血清TG、LDL-C、PT、Fib水平显著高于预后良好组(P<0.05),2组性别、BMI、吸烟史、饮酒史、并发症、TOAST分型、梗死部位、血清TC、HDL-C、TT、APTT、Scr水平无统计学差异(P>0.05);预后不良组PLT、PDW、MPV水平显著高于预后良好组(P<0.05);入院NIHSS评分、PT、PLT、PDW、MPV是影响急性缺血性脑卒中患者静脉溶栓治疗预后的危险因素(P<0.05);PLT、PDW、MPV单独及联合预测急性缺血性脑卒中患者静脉溶栓治疗不良预后的敏感度为81.25%、84.38%、81.25%、93.75%,特异度为61.54%、70.51%、65.38%、61.54%,AUC为0.749、0.816、0.745、0.921。结论急性缺血性脑卒中患者静脉溶栓后血小板参数PLT、PDW、MPV与患者预后呈显著相关性,可用于预测患者预后。

BISAP评分、NIR、HCT及钙离子评估急性胰腺炎严重程度及预后的临床价值

目的:探讨急性胰腺严重床旁指数(BISAP)评分、中性粒细胞和淋巴细胞比(NLR)、红细胞比容(HCT)、血清钙离子(Ca^(2+))与急性胰腺炎(AP)严重程度和预后的关系。方法:选取371例AP患者为研究对象,根据病情分为轻症AP组(MAP组,n=220)、中度重症AP组(MSAP组,n=111)及重症AP组(SAP组,n=40);根据患者预后分为死亡组(n=15)和生存组(n=356)。比较不同病情患者临床资料(性别、年龄、住院时间、住院费用)及不同病情和预后患者实验室检查指标[中性粒细胞与淋巴细胞比值(NLR)、红细胞比容(HCT)、Ca^(2+)、AP严重程度床旁指数(BISAP)评分],分析实验室检查指标与AP严重程度和预后的关系。结果:不同病情患者NLR、HCT、Ca^(2+)、BISAP评分均有统计学差异(P<0.05),且随病情加重,NLR、HCT、BISAP评分均增加(P<0.05),Ca^(2+)水平均降低(P<0.05)。生存组患者NLR、HCT水平及BISAP评分均低于死亡组(P<0.05),Ca^(2+)水平高于死亡组(P<0.05)。ROC曲线分析显示,NLR、HCT、Ca^(2+)水平与BISAP评分预测AP患者预后死亡的曲线下面积(AUC)分别为0.857(95%CI:0.817~0.891)、0.842(95%CI:0.801~0.878)、0.806(95%CI:0.762~0.845)、0.870(95%CI:0.831~0.902);灵敏度分别为80.00%、66.67%、73.33%、93.33%,特异度分别为92.70%、93.26%、80.06%、76.40%,均对AP患者预后死亡有较好的预测价值(P<0.05)。结论:NLR、HCT及血清钙离子水平及BISAP评分指标均可辅助评估AP病情严重程度,并对患者预后有一定的预测价值。

白细胞与红细胞比容比值对急性ST段抬高型心肌梗死再灌注治疗后院内主要不良心血管事件的预测价值

目的探讨白细胞与红细胞比容比值(WBCHR)对急性ST段抬高型心肌梗死(STEMI)患者再灌注治疗后发生院内主要不良心血管事件(MACE)的预测价值。方法采用病例-对照研究方法,回顾性选取首次确诊STEMI并接受经皮冠状动脉介入治疗(PCI)的319例患者作为研究对象,按照住院期间是否发生MACE分为MACE组69例和非MACE组250例。比较2组患者的临床资料,包括一般资料、实验室检验指标、超声心动图和冠状动脉造影结果。采用单因素与多因素Logistic回归分析探讨STEMI患者再灌注治疗后发生院内MACE的危险因素,绘制受试者工作特征(ROC)曲线分析WBCHR对STEMI患者再灌注治疗后发生院内MACE的预测价值。结果MACE组空腹血糖、尿酸、肌酐、白细胞计数、中性粒细胞计数、超敏C反应蛋白(hs-CRP)、D-二聚体、WBCHR水平均高于非MACE组,红细胞计数、血红蛋白、红细胞比容、左室射血分数均低于非MACE组,差异有统计学意义(P<0.05);2组患者年龄、性别、吸烟史、高血压史、糖尿病史、入院首次接触导丝至通过病变血管(D2W)时间、总胆固醇、甘油三酯和病变血管数目比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,尿酸水平升高(OR=1.005,95%CI:1.002~1.009,P=0.004)、血红蛋白浓度降低(OR=0.964,95%CI:0.941~0.988,P=0.003),hs-CRP水平升高(OR=1.032,95%CI:1.009~1.056,P=0.007)、WBCHR水平升高(OR=1.455,95%CI:1.295~1.635,P<0.001)均为STEMI患者再灌注治疗后发生院内MACE的独立危险因素。ROC曲线分析结果显示,WBCHR预测STEMI患者再灌注治疗后发生院内MACE的曲线下面积为0.855(95%CI:0.796~0.914,P<0.001),灵敏度为63.8%,特异度为99.6%。结论WBCHR是STEMI患者再灌注治疗后发生院内MACE的独立影响因素,对STEMI患者再灌注治疗后发生院内MACE具有较高的预测价值。

RDW、HCT、NLR水平与急性心力衰竭患者病情严重程度的相关性

目的:分析红细胞体积分布宽度(RDW)、血细胞比容(HCT)、中性粒细胞/淋巴细胞比值(NLR)水平与急性心力衰竭患者病情严重程度的相关性。方法:选取2021年8月至2023年3月该院收治的128例急性心力衰竭患者为研究组,另选取同期本院128名健康体检者为对照组。比较两组、不同美国纽约心脏病协会心功能分级患者RDW、HCT、NLR水平,采用Spearman相关性分析RDW、HCT、NLR水平与急性心力衰竭患者病情严重程度的相关性。结果:研究组RDW、NLR水平均高于对照组,HCT水平低于对照组,差异有统计学意义(P<0.05);心功能分级Ⅳ级患者RDW、NLR水平均高于Ⅲ级、Ⅱ级患者,且Ⅲ级患者高于Ⅱ级患者,心功能分级Ⅳ级患者HCT水平均低于Ⅲ级、Ⅱ级患者,且Ⅲ级患者低于Ⅱ级患者,差异有统计学意义(P<0.05);Spearman相关性分析结果显示,RDW、NLR水平与急性心力衰竭患者病情严重程度均呈正相关(r>0,P<0.05),HCT水平与急性心力衰竭患者病情严重程度呈负相关(r<0,P<0.05)。结论:RDW、NLR水平与急性心力衰竭患者病情严重程度均呈正相关,HCT水平与急性心力衰竭患者病情严重程度呈负相关。

红细胞压积、血红蛋白与老年心力衰竭患者心脏结构的关系

目的分析红细胞压积、血红蛋白与老年心力衰竭患者心脏结构的关系。方法选择2020年2月至2023年3月于泰州市第四人民医院收治的97例老年心力衰竭患者作为研究对象,入院前测定红细胞压积与血红蛋白,根据患者是否发生心脏结构改变分为发生组(n=45)与非发生组(n=52)。比较两组患者的红细胞压积、血红蛋白及临床资料,多因素Logistic回归分析老年心力衰竭患者发生心脏结构改变的影响因素。结果发生组红细胞压积、血红蛋白均低于未发生组(P<0.05)。发生组N末端脑钠肽前体(NT-proBNP)水平高于未发生组(P<0.05),两组年龄、性别、吸烟史、饮酒史、家族遗传病、糖尿病、收缩压(SBP)、舒张压(DBP)、心功能分级、体质指数(BMI)、血清白蛋白(ALB)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、合并基础疾病[高血压、冠状动脉粥样硬化性心脏病(冠心病)、心房颤动、慢性阻塞性肺疾病]、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,NT-proBNP、红细胞压积、血红蛋白为老年心力衰竭患者发生心脏结构改变的影响因素(P<0.05)。结论红细胞压积、血红蛋白与老年心力衰竭患者心脏功能改变密切相关。

PLT和HCT对腹腔镜胆囊切除术患者术后并肺部感染的预测价值

目的分析血小板计数(PLT)及红细胞比容(HCT)在预测腹腔镜胆囊切除术(LC)患者术后并肺部感染中的临床应用价值。方法收集2022年1月~2023年1月医院收治的182例行LC患者,根据术后是否发生肺部感染分为无肺部感染组及合并感染组。检测两组患者PLT、HCT水平。收集患者相关临床资料,并利用Logistic回归因素分析LC患者术后肺部感染的相关因素,并应用受试者工作特征曲线(ROC)分析PLT、HCT对于LC患者术后肺部感染的预测价值。结果182例患者中共发生肺部感染患者38例。合并肺部感染组患者HCT水平明显高于无肺部感染组(P<0.05),PLT水平明显低于无肺部感染组(P<0.05)。合并肺部感染组患者年龄、既往肺部疾病病史、手术时间、术中出血量、WBC、Neu、CRP水平均高于无肺部感染组(P<0.05)。Logistic多因素回归分析显示,年龄、PLT、HCT均为影响LC患者术后肺部感染的相关因素(P<0.05)。ROC曲线分析显示,PLT联合HCT预测LC患者术后并发肺部感染的灵敏度、准确度及AUC分别为87.67%、82.89%、0.817,均高于血清PLT、HC单独预测,而特异度为62.08%低于PLT、HCT单独预测。结论PLT在LC术后合并肺部感染患者体内呈现低表达,HCT高表达,且是影响LC患者术后肺部感染的危险因素,可用于临床中预测LC患者术后肺部感染.

Postoperative Changes in Hemoglobin and Hematocrit in Patients Undergoing Primary Total Hip and Knee Arthroplasty

INTRODUCTION Total hip arthroplasty （THA） and total knee arthroplasty （TKA） are currently two effective treatments for many diseases of the hip and knee. Despite the ability to minimize intraoperative blood loss, postoperative hemoglobin （Hgb） loss is expected, and a number of studies have reported on hidden blood loss after THA and TKA.

个体化给药辅助决策系统JPKD对肾移植受者他克莫司血药浓度预测能力评估

目的分析个体化给药辅助决策系统Java PK®for Desktop(JPKD)对肾移植受者他克莫司血药浓度的预测能力及影响因素。方法收集149例肾移植术后早期受者他克莫司血药浓度监测数据,使用JPKD预测他克莫司剂量调整后的血药谷浓度,计算实测浓度与预测浓度之间的绝对值权重偏差和相对预测误差。使用单因素和多因素logistic回归分析影响绝对权重偏差的相关因素,并绘制受试者工作特征(ROC)曲线评价影响因素对软件预测准确性的判断价值。结果收集149例患者266例次血药浓度数据,他克莫司血药浓度实测值为(6.5±3.0)ng/mL(1.1~16.6 ng/mL),JPKD进行计算的预测值为(5.6±2.5)ng/mL(1.4~14.4 ng/mL),计算结果的绝对权重偏差为28.38%,相对预测误差为−13.55%。单因素分析显示性别、白蛋白、红细胞比容变化、细胞色素P450(CYP)3A5*3基因型、C3435T基因型与预测结果不准确有关。多因素logistic回归分析显示CYP3A5*3基因型为AA、红细胞比容变化是影响JPKD预测他克莫司血药浓度准确性的独立危险因素。ROC曲线分析显示,红细胞比容变化>2.25%时,软件预测不准确的风险增加。结论JPKD用于预测肾移植受者他克莫司血药浓度具有一定的准确性,可以提高血药浓度的达标率,但CYP3A5*3基因型、红细胞比容变化会影响预测的准确性。

静脉-动脉体外膜肺氧合启动后即刻血液稀释对心脏疾病患者器官功能和治疗策略的影响

目的 探讨心脏疾病患者在静脉-动脉体外膜肺氧合(VA-ECMO)辅助启动后血液快速稀释对器官功能改变及临床治疗策略选择的影响。方法 回顾性分析2019年1月至2023年1月于中国人民解放军总医院第一医学中心心血管内科重症监护室接受VA-ECMO辅助的50例患者的临床资料。根据VA-ECMO启动后红细胞压积(Hct)下降的程度,将患者分为Hct下降≥30%组(Hct^(Δ30%+)组,n=17)和Hct下降<30%组(Hct^(Δ30%-)组,n=33)。比较两组患者器官功能相关生物标志物、接受输血、主动脉内球囊反搏(IABP)及持续肾替代治疗(CRRT)情况。采用SPSS 25.0统计软件进行数据分析。根据数据类型,分别采用t检验、Mann-Whitney U检验、χ^(2)检验或Fisher精确检验进行组间比较。结果 Hct^(Δ30%+)组65岁及以上患者占比52.9%(9/17),Hct^(Δ30%-)组65岁及以上患者占比36.4%(12/33)。Hct^(Δ30%+)组与Hct^(Δ30%-)组患者一般临床特征及VA-ECMO辅助前临床指标比较,差异均无统计学意义(P>0.05)。在VA-ECMO启动后,肌酸激酶同工酶、天冬氨酸氨基转移酶及丙氨酸氨基转移酶的峰值在Hct^(Δ30%+)组中更高,差异均有统计学意义(P<0.05)。Hct^(Δ30%+)组与Hct^(Δ30%-)组相比,接受IABP(70.6%和36.4%)和CRRT(64.7%和18.2%)治疗的患者比例更高;Hct^(Δ30%+)组患者输注悬浮红细胞和血浆的单位数更多,差异均有统计学意义(P<0.05)。结论 VA-ECMO启动后Hct降低≥30%的患者输血量更大、器官损伤更重,采用IABP或CRRT联合辅助比例更高。VA-ECMO启动后Hct降低≥30%作为一个新的临床指标,为治疗策略的选择及改善预后提供重要参考依据。

糖化血红蛋白联合血细胞比容、甲状腺功能指标对妊娠期糖尿病的诊断价值研究

目的探讨糖化血红蛋白(HbA1c)联合血细胞比容(HCT)、甲状腺功能指标[血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]对妊娠期糖尿病(GDM)的诊断价值。方法回顾性分析200例进行早期GDM筛查的孕妇临床资料,所有孕妇均进行孕12~16周HbA1c、HCT、甲状腺功能指标检查及孕中期口服葡萄糖耐量实验(OGTT)检查。比较不同检查方法的检查结果,比较孕中期OGTT正常与异常孕妇的HbA1c、HCT、甲状腺功能指标,分析孕12~16周HbA1c、HCT、甲状腺功能指标检查对GDM的诊断敏感性及特异性。结果200例孕妇进行孕12~16周HbA1c、HCT、甲状腺功能指标检查,192例正常、正常率为96.0%,8例异常、异常率为4.0%;经孕中期OGTT检查,正常183例、正常率为91.5%,17例异常、异常率为8.5%;孕12~16周HbA1c、HCT、甲状腺功能指标检查的异常率与孕中期OGTT检查比较差异无统计学意义(P>0.05)。孕中期OGTT异常者的HbA1c(9.07±0.61)%、HCT(40.41±3.23)%、TSH(4.01±0.85)mlU/L均明显高于正常者的(4.69±0.35)%、(37.72±2.98)%、(1.95±0.78)mlU/L,FT_(3)(3.68±0.54)pmol/L、FT_(4)(10.22±1.59)pmol/L均明显低于正常者的(4.52±0.73)、(14.01±1.76)pmol/L,差异具有统计学意义(P<0.05)。以孕中期OGTT检查结果为金标准,孕12~16周HbA1c、HCT、甲状腺功能指标检查对GDM的诊断敏感性及特异性分别为41.2%和99.5%。结论HbA1c联合HCT、甲状腺功能指标对GDM的早期诊断具有较高的特异性,可作为GDM患者的诊断指标。

象皮粉联合氢溴酸山莨菪碱治疗缺血性糖尿病足的效果观察

目的分析象皮粉与氢溴酸山莨菪碱联合治疗缺血性糖尿病足(IDF)的效果。方法选取2020年8月至2021年10月收治的93例IDF,按照治疗方式不同均分为3组,观察组给予象皮粉外敷联合氢溴酸山莨菪碱治疗,对照1组给予象皮粉外敷治疗,对照2组给予氢溴酸山莨菪碱治疗,均治疗1个月后比较3组临床疗效,治疗前后血流变学指标、炎性因子、生活质量评分和治疗期间不良反应。结果治疗后观察组临床总有效率为96.77%(30/31)高于对照1组和对照2组[74.19%(23/31)、77.42%(24/31)](P<0.05)。治疗后,3组纤维蛋白原、红细胞压积、血浆黏度、白细胞介素-6、血管细胞黏附因子-1、内皮素-1均降低,且观察组低于对照1组和对照2组(P<0.05)。治疗后,3组健康状况调查简表各维度评分均升高,且观察组高于对照1组和对照2组(P<0.05)。观察组治疗期间不良反应发生率低于对照1组和对照2组(P<0.05)。结论IDF患者给予象皮粉与氢溴酸山莨菪碱联合治疗效果明显,可以让创面尽快愈合,控制不良反应发生,调节血流变学指标及炎症反应,从而有效提高生活质量。

不同输血方式治疗消化道出血的疗效及对疾病转归的影响

目的:探讨不同输血方式治疗消化道出血的疗效及对疾病转归的影响。方法:选取2020年1月~2023年12月厦门医学院附属第二医院收治的118例消化道出血患者,采用随机数字表法分为常规组、观察组,各59例,常规组采用积极输血治疗,观察组采用限制性输血治疗。比较两组治疗前后凝血功能指标凝血酶原时间(PT)、红细胞比积(HCT)及血液流变学全血黏度、血浆黏度(PV)的变化,统计两组疗效及再出血、头晕等并发症发生情况。结果:治疗前两组PT、HCT差异无统计学意义(P>0.05);与治疗前比,治疗后两组PT、HCT水平均降低,差异有统计学意义(P<0.05);治疗后观察组PT、HCT均低于常规组,差异有统计学意义(P<0.05)。治疗前两组全血黏度、PV对比差异均无统计学意义(P>0.05);与治疗前比,治疗后两组全血黏度、PV均提高,差异有统计学意义(P<0.05);且观察组上述指标均高于常规组,差异有统计学意义(P<0.05)。观察组总有效率高于常规组,差异有统计学意义(P<0.05)。与常规组相比,观察组并发症发生率较低,差异无统计学意义(P>0.05)。结论:限制性输血治疗消化道出血患者,有利于提高治疗效果,促进凝血功能、血液流变学的恢复,可降低并发症发生率。