Background: A Randomized Controlled Trial (RCT) has been elaborated where goal directed fluid and hemodynamic therapy (GDFHT) will be realized with trans-thoracic echocardiographic aortic blood flow peak velocity vari...Background: A Randomized Controlled Trial (RCT) has been elaborated where goal directed fluid and hemodynamic therapy (GDFHT) will be realized with trans-thoracic echocardiographic aortic blood flow peak velocity variation (ΔVpeak) and distance minute (DM) to guide fluid therapy and hemodynamics in high risk pediatric surgical patients. This RCT will clarify the impact of GDFHT with ΔVpeak and DM on postoperative outcome in terms of morbidity, length of stay in the intensive care unit (LOSICU), length of mechanical ventilation (LMV) and length of hospital stay (LOS) in children. To determine values of ΔVpeak, DM and VTI predictive of these postoperative outcomes, an observational pilot study will be realized. This pilot study is described here. The primary objective of this study is to determine values of ΔVpeak, DM and ITV predictive of postoperative outcome in children in terms of morbidity. The secondary objectives are to determine values of ΔVpeak, DM and ITV predictive of LOSICU, LMV, LOS, intraoperative, postoperative fluid administration and vasoactive-inotropic therapy. Methods: 500 - 1000 children aged less than 18 years will be included prospectively. Statistic analysis will be realized with XLSTAT 2019.4.2 software or plus. Results and Conclusions: This trial protocol will determine values of ΔVpeak, DM and ITV with echocardiography predictive of postoperative outcome in children.展开更多
目的探究超声血流参数[收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)]、D-二聚体手术前后变化及复合模型在创伤骨折患者下肢深静脉血栓形成(DVT)预警中的应用价值。方法选取2021年7月—2023年7月收治的创伤骨折200例,...目的探究超声血流参数[收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)]、D-二聚体手术前后变化及复合模型在创伤骨折患者下肢深静脉血栓形成(DVT)预警中的应用价值。方法选取2021年7月—2023年7月收治的创伤骨折200例,根据术后是否发生下肢DVT分为发生组25例与未发生组175例。收集2组基线资料及手术前后Vs、Vd、RI、D-二聚体数据,根据创伤骨折患者术后下肢DVT发生影响因素构建预测复合模型,评估Vs、Vd、RI、D-二聚体手术前后差值联合及复合模型对创伤骨折患者术后下肢DVT发生的预测价值。绘制决策曲线分析(DCA),分析超声血流参数、D-二聚体与复合模型预测创伤骨折患者术后下肢DVT发生的获益情况。结果发生组手术时间长于未发生组,术中使用止血带比例高于未发生组(P<0.01);发生组术后3 d Vs、Vd低于未发生组,RI、D-二聚体高于未发生组(P<0.01);发生组Vs、Vd、RI及D-二聚体手术前后差值均大于未发生组(P<0.01);多因素Logistic回归分析显示,手术时间、术中使用止血带及Vs、Vd、RI、D-二聚体手术前后差值为创伤骨折患者术后下肢DVT发生的独立危险因素(P<0.01);以Vs、Vd、RI、D-二聚体手术前后差值联合预测下肢DVT的曲线下面积(AUC)为0.882(95%CI:0.829,0.923),敏感度、特异度均为0.88。构建下肢DVT预测模型,其AUC为0.920(95%CI:0.873,0.954);DCA显示,复合模型在阈值概率为0.10~0.90时具有更高的临床价值。结论手术时间、术中使用止血带及Vs、Vd、RI、D-二聚体手术前后差值为创伤骨折患者术后下肢DVT发生的独立危险因素;与Vs、Vd、RI、D-二聚体手术前后差值相比,多指标联合建立的复合模型在创伤骨折术后下肢DVT早期预警中应用价值更高。展开更多
目的分析苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病患者血压变异性(BPV)、血压晨峰(MBPS)现象的影响。方法按照随机数字表法将该院2020年2月至2023年2月收治的84例老年晨峰高血压合并冠心病患者分为对照组和研究...目的分析苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病患者血压变异性(BPV)、血压晨峰(MBPS)现象的影响。方法按照随机数字表法将该院2020年2月至2023年2月收治的84例老年晨峰高血压合并冠心病患者分为对照组和研究组,每组42例。对照组采用苯磺酸氨氯地平片进行治疗,研究组采用苯磺酸氨氯地平片联合酒石酸美托洛尔片进行治疗。比较两组临床疗效、治疗前后收缩压(SBP)、舒张压(DBP)、BPV[包括24 h SBP、24 h DBP、24 h SBP标准差(24 h SSD)、24 h DBP标准差(24 h DSD)]、MBPS、冠状动脉病变程度(以Gensini积分评估)、肾功能相关指标[24 h尿微量清蛋白(24 h MAU)、尿清蛋白与肌酐比值(ACR)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]水平、炎症相关指标[可溶性血管黏附因子-1(sVCAM-1)、金属蛋白酶-9(MMP-9)]水平及外周血单个核细胞核因子-κB(NF-κB)p65阳性率。结果研究组临床总有效率为95.24%,高于对照组的78.57%(P<0.05);治疗后研究组24 h DBP、24 h SBP、24 h DSD、24 h SSD低于对照组(P<0.05);治疗后研究组MBPS、Gensini积分低于对照组(P<0.05);治疗后研究组24 h MAU、HDL-C、TC、TG水平及ACR均低于对照组(P<0.05);治疗后研究组sVCAM-1、MMP-9水平及NF-κBp65阳性率均低于对照组(P<0.05)。结论苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病疗效确切,可有效降低患者BPV、MBPS,减轻血管炎症反应,改善肾功能,促进冠状动脉病变恢复。展开更多
Objective: To investigate if an exaggerated peak exercise systolic blood pressure (peak ESBP) is associated with alteration of cardiometabolic risk factors and predict future resting hypertension in middle aged women....Objective: To investigate if an exaggerated peak exercise systolic blood pressure (peak ESBP) is associated with alteration of cardiometabolic risk factors and predict future resting hypertension in middle aged women. Methods: Data analysis was performed in 95 healthy normotensive premeno-pausal women at baseline and 84 after 5-year follow-up (age, 49.9 ± 1.9 years;BMI, 23.3 ± 2.2 kg/m2;resting BP, 117/73 ± 11.8/7.6 mmHg). Blood pressure was measured at rest and during a progressive exercise test on treadmill. Women were divided into two groups according to their peak ESBP <190 mmHg vs. ≥190 mmHg. Other outcome measures were: cardiorespiratory fitness (VO2 peak), body composition, body fat distribution and fasting plasma lipids, glucose and insulin levels. Results: 15% and 27% of women presented an exaggerated peak ESBP response (≥190 mmHg) at baseline and year 5 respectively. Linear mixed model repeated measures analysis revealed higher values of fasting glucose, resting systolic and diastolic BP in women with an exaggerated peak ESBP (≥190 mmHg) compared to women with a peak ESBP (<190 mmHg). No significant difference was observed between the two groups for VO2 peak, body composition and body fat distribution indices and other cardiometabolic risk factors. Finally, baseline peak ESBP was not a significant risk factor for future resting hypertension (OR: 2.96, 95%CI [0.48 - 18.12];P = 0.24). Conclusion: Our results, despite being non significant, are of great interest because in healthy and active premenopausal women, exaggerated peak ESBP is not predictive of future hypertension after 5-year follow-up throughout menopause transition.展开更多
Background: Rare are the studies which treated the effect of training and successive fights of karate on haemodynamic and blood lactate concentrations responses. Objectives: To evaluate and analyze the aerobic capacit...Background: Rare are the studies which treated the effect of training and successive fights of karate on haemodynamic and blood lactate concentrations responses. Objectives: To evaluate and analyze the aerobic capacity of elite Congolese karate athletes, as well as their haemodynamic and blood lactate concentrations responses changes during Ruffier test and stimulated competition. Methods: Twelve karate athletes (6 seniors and 6 juniors) took part in the study. These karate athletes were selected within the national karate teams (senior and junior) of Congo-Brazzaville. Anthropometric, bioenergetic and haemodynamic (HR, SBP, DBP) parameters and blood lactate [La] concentrations were measured at rest, immediately after the end of Ruffier test and each fight (n = 3). Results: Peak aerobic power (PAP) and maximum oxygen uptake (VO2 max) values averaged 437 ± 23 watts and 57.61 ± 2.2 ml/kg/mn, values varying as function as age division (senior vs junior). The recovery index was 5.4 ± 3.4 for juniors and 6.8 ± 3.2 for seniors. SBP, HR and [La] concentrations increased significantly during fights, compared to the resting values. HRmax was 182.3 ± 1.6 bpm (89% theoretical HRmax) for seniors and 182.0 ± 13.5 bpm (86% theoretical HRmax) for juniors. Peak [La] concentrations were 10.3 ± 1.5 mmol/l for seniors and 10.8 ± 1.2 mmol/l for juniors. Conclusion: Congolese karate athletes call upon high levels of the anaerobic and aerobic capacities. The karate training program in Congo should emphasize more gold improvising lower body anaerobic power and endurance.展开更多
目的 观察原发性高血压患者室性心律失常易感性状况,并分析动态心电图P波离散度、T波峰-末(Tp-e)间期联合血压变异性对其预测效能。方法 纳入2020年6月至2022年6月医院126例原发性高血压患者为研究对象。入院时所有患者均接受动态心电...目的 观察原发性高血压患者室性心律失常易感性状况,并分析动态心电图P波离散度、T波峰-末(Tp-e)间期联合血压变异性对其预测效能。方法 纳入2020年6月至2022年6月医院126例原发性高血压患者为研究对象。入院时所有患者均接受动态心电图检查与血压变异性检查,记录P波离散度、Tp-e间期值,观察患者室性心律失常发生状况,并将其分为室性心律失常组与非室性心律失常组,分析动态心电图P波离散度、Tp-e间期联合血压变异性对原发性高血压患者室性心律失常易感性的预测效能。结果 126例原发性高血压患者中发生室性心律失常39例,占30.95%;室性心律失常组右心房横径(RAD)[(47.39±6.25)mm]长于非室性心律失常组[(40.37±6.74)mm],P波离散度[(42.82±8.14)ms]、Tp-e间期[(112.96±11.34)ms]、24 h舒张压标准差(24 h diastolic blood pressure standard deviation,24 h DPB-SD)[(13.79±5.22)mmHg]、24 h收缩压标准差(24 h systolic blood pressure standard deviation,24 h SBP-SD)值[(18.75±5.76)ms]高于非室性心律失常组[(36.16±7.28)ms、(99.23±12.61)ms、(9.78±4.36)mmHg、(14.03±5.17)mmHg](P<0.05);经点二列相关性分析显示,动态心电图P波离散度、Tp-e间期、血压变异性(24 h DPB-SD、24 h SBP-SD)值与原发性高血压患者发生室性心律失常呈正相关(r=0.276、0.463、0.207、0.293,P均<0.05);经logistic回归分析,结果显示,高P波离散度、高Tp-e间期、高24 h DPB-SD、高24 h SBP-SD是原发性高血压患者发生室性心律失常的危险因素(OR=1.112、1.095、1.199、1.177,P<0.05);ROC曲线结果显示,P波离散度、Tp-e间期、24 h DPB-SD、24 h SBP-SD预测原发性高血压患者发生室性心律失常的AUC分别为0.733(95%CI 0.635~0.830)、0.800(95%CI 0.723~0.877)、0.719(95%CI 0.621~0.817)、0.712(95%CI 0.614~0.810)、0.912(95%CI 0.863~0.961)。结论 动态心电图P波离散度、Tp-e间期联合血压变异性对原发性高血压患者室性心律失常易感性具有较高预测价值。展开更多
文摘Background: A Randomized Controlled Trial (RCT) has been elaborated where goal directed fluid and hemodynamic therapy (GDFHT) will be realized with trans-thoracic echocardiographic aortic blood flow peak velocity variation (ΔVpeak) and distance minute (DM) to guide fluid therapy and hemodynamics in high risk pediatric surgical patients. This RCT will clarify the impact of GDFHT with ΔVpeak and DM on postoperative outcome in terms of morbidity, length of stay in the intensive care unit (LOSICU), length of mechanical ventilation (LMV) and length of hospital stay (LOS) in children. To determine values of ΔVpeak, DM and VTI predictive of these postoperative outcomes, an observational pilot study will be realized. This pilot study is described here. The primary objective of this study is to determine values of ΔVpeak, DM and ITV predictive of postoperative outcome in children in terms of morbidity. The secondary objectives are to determine values of ΔVpeak, DM and ITV predictive of LOSICU, LMV, LOS, intraoperative, postoperative fluid administration and vasoactive-inotropic therapy. Methods: 500 - 1000 children aged less than 18 years will be included prospectively. Statistic analysis will be realized with XLSTAT 2019.4.2 software or plus. Results and Conclusions: This trial protocol will determine values of ΔVpeak, DM and ITV with echocardiography predictive of postoperative outcome in children.
文摘目的探究超声血流参数[收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)]、D-二聚体手术前后变化及复合模型在创伤骨折患者下肢深静脉血栓形成(DVT)预警中的应用价值。方法选取2021年7月—2023年7月收治的创伤骨折200例,根据术后是否发生下肢DVT分为发生组25例与未发生组175例。收集2组基线资料及手术前后Vs、Vd、RI、D-二聚体数据,根据创伤骨折患者术后下肢DVT发生影响因素构建预测复合模型,评估Vs、Vd、RI、D-二聚体手术前后差值联合及复合模型对创伤骨折患者术后下肢DVT发生的预测价值。绘制决策曲线分析(DCA),分析超声血流参数、D-二聚体与复合模型预测创伤骨折患者术后下肢DVT发生的获益情况。结果发生组手术时间长于未发生组,术中使用止血带比例高于未发生组(P<0.01);发生组术后3 d Vs、Vd低于未发生组,RI、D-二聚体高于未发生组(P<0.01);发生组Vs、Vd、RI及D-二聚体手术前后差值均大于未发生组(P<0.01);多因素Logistic回归分析显示,手术时间、术中使用止血带及Vs、Vd、RI、D-二聚体手术前后差值为创伤骨折患者术后下肢DVT发生的独立危险因素(P<0.01);以Vs、Vd、RI、D-二聚体手术前后差值联合预测下肢DVT的曲线下面积(AUC)为0.882(95%CI:0.829,0.923),敏感度、特异度均为0.88。构建下肢DVT预测模型,其AUC为0.920(95%CI:0.873,0.954);DCA显示,复合模型在阈值概率为0.10~0.90时具有更高的临床价值。结论手术时间、术中使用止血带及Vs、Vd、RI、D-二聚体手术前后差值为创伤骨折患者术后下肢DVT发生的独立危险因素;与Vs、Vd、RI、D-二聚体手术前后差值相比,多指标联合建立的复合模型在创伤骨折术后下肢DVT早期预警中应用价值更高。
文摘目的分析苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病患者血压变异性(BPV)、血压晨峰(MBPS)现象的影响。方法按照随机数字表法将该院2020年2月至2023年2月收治的84例老年晨峰高血压合并冠心病患者分为对照组和研究组,每组42例。对照组采用苯磺酸氨氯地平片进行治疗,研究组采用苯磺酸氨氯地平片联合酒石酸美托洛尔片进行治疗。比较两组临床疗效、治疗前后收缩压(SBP)、舒张压(DBP)、BPV[包括24 h SBP、24 h DBP、24 h SBP标准差(24 h SSD)、24 h DBP标准差(24 h DSD)]、MBPS、冠状动脉病变程度(以Gensini积分评估)、肾功能相关指标[24 h尿微量清蛋白(24 h MAU)、尿清蛋白与肌酐比值(ACR)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]水平、炎症相关指标[可溶性血管黏附因子-1(sVCAM-1)、金属蛋白酶-9(MMP-9)]水平及外周血单个核细胞核因子-κB(NF-κB)p65阳性率。结果研究组临床总有效率为95.24%,高于对照组的78.57%(P<0.05);治疗后研究组24 h DBP、24 h SBP、24 h DSD、24 h SSD低于对照组(P<0.05);治疗后研究组MBPS、Gensini积分低于对照组(P<0.05);治疗后研究组24 h MAU、HDL-C、TC、TG水平及ACR均低于对照组(P<0.05);治疗后研究组sVCAM-1、MMP-9水平及NF-κBp65阳性率均低于对照组(P<0.05)。结论苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病疗效确切,可有效降低患者BPV、MBPS,减轻血管炎症反应,改善肾功能,促进冠状动脉病变恢复。
文摘Objective: To investigate if an exaggerated peak exercise systolic blood pressure (peak ESBP) is associated with alteration of cardiometabolic risk factors and predict future resting hypertension in middle aged women. Methods: Data analysis was performed in 95 healthy normotensive premeno-pausal women at baseline and 84 after 5-year follow-up (age, 49.9 ± 1.9 years;BMI, 23.3 ± 2.2 kg/m2;resting BP, 117/73 ± 11.8/7.6 mmHg). Blood pressure was measured at rest and during a progressive exercise test on treadmill. Women were divided into two groups according to their peak ESBP <190 mmHg vs. ≥190 mmHg. Other outcome measures were: cardiorespiratory fitness (VO2 peak), body composition, body fat distribution and fasting plasma lipids, glucose and insulin levels. Results: 15% and 27% of women presented an exaggerated peak ESBP response (≥190 mmHg) at baseline and year 5 respectively. Linear mixed model repeated measures analysis revealed higher values of fasting glucose, resting systolic and diastolic BP in women with an exaggerated peak ESBP (≥190 mmHg) compared to women with a peak ESBP (<190 mmHg). No significant difference was observed between the two groups for VO2 peak, body composition and body fat distribution indices and other cardiometabolic risk factors. Finally, baseline peak ESBP was not a significant risk factor for future resting hypertension (OR: 2.96, 95%CI [0.48 - 18.12];P = 0.24). Conclusion: Our results, despite being non significant, are of great interest because in healthy and active premenopausal women, exaggerated peak ESBP is not predictive of future hypertension after 5-year follow-up throughout menopause transition.
文摘Background: Rare are the studies which treated the effect of training and successive fights of karate on haemodynamic and blood lactate concentrations responses. Objectives: To evaluate and analyze the aerobic capacity of elite Congolese karate athletes, as well as their haemodynamic and blood lactate concentrations responses changes during Ruffier test and stimulated competition. Methods: Twelve karate athletes (6 seniors and 6 juniors) took part in the study. These karate athletes were selected within the national karate teams (senior and junior) of Congo-Brazzaville. Anthropometric, bioenergetic and haemodynamic (HR, SBP, DBP) parameters and blood lactate [La] concentrations were measured at rest, immediately after the end of Ruffier test and each fight (n = 3). Results: Peak aerobic power (PAP) and maximum oxygen uptake (VO2 max) values averaged 437 ± 23 watts and 57.61 ± 2.2 ml/kg/mn, values varying as function as age division (senior vs junior). The recovery index was 5.4 ± 3.4 for juniors and 6.8 ± 3.2 for seniors. SBP, HR and [La] concentrations increased significantly during fights, compared to the resting values. HRmax was 182.3 ± 1.6 bpm (89% theoretical HRmax) for seniors and 182.0 ± 13.5 bpm (86% theoretical HRmax) for juniors. Peak [La] concentrations were 10.3 ± 1.5 mmol/l for seniors and 10.8 ± 1.2 mmol/l for juniors. Conclusion: Congolese karate athletes call upon high levels of the anaerobic and aerobic capacities. The karate training program in Congo should emphasize more gold improvising lower body anaerobic power and endurance.
文摘目的 观察原发性高血压患者室性心律失常易感性状况,并分析动态心电图P波离散度、T波峰-末(Tp-e)间期联合血压变异性对其预测效能。方法 纳入2020年6月至2022年6月医院126例原发性高血压患者为研究对象。入院时所有患者均接受动态心电图检查与血压变异性检查,记录P波离散度、Tp-e间期值,观察患者室性心律失常发生状况,并将其分为室性心律失常组与非室性心律失常组,分析动态心电图P波离散度、Tp-e间期联合血压变异性对原发性高血压患者室性心律失常易感性的预测效能。结果 126例原发性高血压患者中发生室性心律失常39例,占30.95%;室性心律失常组右心房横径(RAD)[(47.39±6.25)mm]长于非室性心律失常组[(40.37±6.74)mm],P波离散度[(42.82±8.14)ms]、Tp-e间期[(112.96±11.34)ms]、24 h舒张压标准差(24 h diastolic blood pressure standard deviation,24 h DPB-SD)[(13.79±5.22)mmHg]、24 h收缩压标准差(24 h systolic blood pressure standard deviation,24 h SBP-SD)值[(18.75±5.76)ms]高于非室性心律失常组[(36.16±7.28)ms、(99.23±12.61)ms、(9.78±4.36)mmHg、(14.03±5.17)mmHg](P<0.05);经点二列相关性分析显示,动态心电图P波离散度、Tp-e间期、血压变异性(24 h DPB-SD、24 h SBP-SD)值与原发性高血压患者发生室性心律失常呈正相关(r=0.276、0.463、0.207、0.293,P均<0.05);经logistic回归分析,结果显示,高P波离散度、高Tp-e间期、高24 h DPB-SD、高24 h SBP-SD是原发性高血压患者发生室性心律失常的危险因素(OR=1.112、1.095、1.199、1.177,P<0.05);ROC曲线结果显示,P波离散度、Tp-e间期、24 h DPB-SD、24 h SBP-SD预测原发性高血压患者发生室性心律失常的AUC分别为0.733(95%CI 0.635~0.830)、0.800(95%CI 0.723~0.877)、0.719(95%CI 0.621~0.817)、0.712(95%CI 0.614~0.810)、0.912(95%CI 0.863~0.961)。结论 动态心电图P波离散度、Tp-e间期联合血压变异性对原发性高血压患者室性心律失常易感性具有较高预测价值。
