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Hemorrhagic transformation in patients with large-artery atherosclerotic stroke is associated with the gut microbiota and lipopolysaccharide
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作者 Qin Huang Minping Wei +3 位作者 Xianjing Feng Yunfang Luo Yunhai Liu Jian Xia 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第7期1532-1540,共9页
Hemorrhagic transformation is a major complication of large-artery atheroscle rotic stroke(a major ischemic stro ke subtype)that wo rsens outcomes and increases mortality.Disruption of the gut microbiota is an importa... Hemorrhagic transformation is a major complication of large-artery atheroscle rotic stroke(a major ischemic stro ke subtype)that wo rsens outcomes and increases mortality.Disruption of the gut microbiota is an important feature of stroke,and some specific bacteria and bacterial metabolites may contribute to hemorrhagic transformation pathogenesis.We aimed to investigate the relationship between the gut microbiota and hemorrhagic transformation in largearte ry atheroscle rotic stro ke.An observational retrospective study was conducted.From May 2020 to September 2021,blood and fecal samples were obtained upon admission from 32 patients with first-ever acute ischemic stroke and not undergoing intravenous thrombolysis or endovascular thrombectomy,as well as 16 healthy controls.Patients with stro ke who developed hemorrhagic transfo rmation(n=15)were compared to those who did not develop hemorrhagic transformation(n=17)and with healthy controls.The gut microbiota was assessed through 16S ribosomal ribonucleic acid sequencing.We also examined key components of the lipopolysaccharide pathway:lipopolysaccharide,lipopolysaccharide-binding protein,and soluble CD14.We observed that bacterial diversity was decreased in both the hemorrhagic transformation and non-hemorrhagic transfo rmation group compared with the healthy controls.The patients with ischemic stro ke who developed hemorrhagic transfo rmation exhibited altered gut micro biota composition,in particular an increase in the relative abundance and dive rsity of members belonging to the Enterobacteriaceae family.Plasma lipopolysaccharide and lipopolysaccharide-binding protein levels were higher in the hemorrhagic transformation group compared with the non-hemorrhagic transfo rmation group.lipopolysaccharide,lipopolysaccharide-binding protein,and soluble CD14 concentrations were associated with increased abundance of Enterobacte riaceae.Next,the role of the gut microbiota in hemorrhagic transformation was evaluated using an experimental stroke rat model.In this model,transplantation of the gut microbiota from hemorrhagic transformation rats into the recipient rats triggered higher plasma levels of lipopolysaccharide,lipopolysaccharide-binding protein,and soluble CD14.Ta ken togethe r,our findings demonstrate a noticeable change in the gut microbiota and lipopolysaccharide-related inflammatory response in stroke patients with hemorrhagic transformation.This suggests that maintaining a balanced gut microbiota may be an important factor in preventing hemorrhagic transfo rmation after stro ke. 展开更多
关键词 gut microbiota hemorrhagic transformation INFLAMMATION LIPOPOLYSACCHARIDE STROKE
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Advances in the Mechanisms of Hemorrhagic Transformation and Therapeutic Agents after Intravenous Thrombolysis in Ischemic Stroke
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作者 Yue Dai Yongyi Zhan +2 位作者 Mingtian Lu Zehua He Yu Liu 《Yangtze Medicine》 2024年第1期29-40,共12页
Ischemic stroke is an important disease leading to death and disability for all human beings, and the key to its treatment lies in the early opening of obstructed vessels and restoration of perfusion to the local infa... Ischemic stroke is an important disease leading to death and disability for all human beings, and the key to its treatment lies in the early opening of obstructed vessels and restoration of perfusion to the local infarcted area. Intravenous thrombolysis with tissue plasminogen activator (tPA) is one of the effective therapies to achieve revascularization, but it faces strict indications with a narrow therapeutic time window, and significantly increases the incidence of hemorrhagic transformation, HT, after reperfusion of the infarcted foci, which greatly reduces the incidence of patients with ischemic stroke. which significantly increases the incidence of hemorrhagic transformation (HT) after reperfusion of the infarcted focus, greatly reducing patient utilization and clinical benefit. Since the mechanism of HT has not been fully elucidated, and the related molecular mechanisms are complex and interactive, there is no specific and effective therapy to avoid the occurrence of HT. In this article, we focus on the research progress on the mechanism of HT after tPA intravenous thrombolysis in ischemic stroke patients from the aspects of vascular integrity disruption, oxidative stress, and neuroinflammatory response and the corresponding therapeutic strategies, in order to improve the safety and prognosis of tPA intravenous thrombolysis in the clinic. 展开更多
关键词 hemorrhagic transformation Tissue-Type Fibrinogen Activator Acute Ischemic Stroke Blood-Brain Barrier
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Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients 被引量:62
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作者 Gang Lv Guo-Qiang Wang +5 位作者 Zhen-Xi Xia Hai-Xia Wang Nan Liu Wei Wei Yong-Hua Huang Wei-Wei Zhang 《Military Medical Research》 SCIE CAS CSCD 2019年第3期189-200,共12页
Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 ... Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C. 展开更多
关键词 Acute cerebral infarction hemorrhagic transformation Total cholesterol LOW-DENSITY LIPOPROTEIN Intensive LIPID-LOWERING STATINS ANTI-PLATELET Atrial fibrillation modified Rankin scale
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Hemorrhagic transformation of ischemic cerebral proliferative angiopathy: A case report
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作者 Yu Xia Xian-Feng Yu +1 位作者 Zhen-Juan Ma Zhong-Wu Sun 《World Journal of Clinical Cases》 SCIE 2021年第20期5730-5736,共7页
BACKGROUND Cerebral proliferative angiopathy(CPA)is a rare vascular disease characterized by the presence of diffuse vascular proliferation,progressive vascular hyperflow and vasodilation of multiple vessels in the no... BACKGROUND Cerebral proliferative angiopathy(CPA)is a rare vascular disease characterized by the presence of diffuse vascular proliferation,progressive vascular hyperflow and vasodilation of multiple vessels in the normal brain parenchyma.Unlike cerebral arteriovenous malformations,CPA has a mixed appearance between that of lesions with cell proliferation and endothelial proliferation.To date,the pathogenesis of CPA is unclear,in which changes induced by cortical ischemia in the elastic layer of the blood supply artery and smooth muscle cells may be involved.CASE SUMMARY In this article,we retrospectively analyzed a case of hemorrhagic transformation of ischemic CPA diagnosed by digital subtraction angiography and reviewed the related literature for further exploration of its pathogenesis,diagnosis and treatment.CONCLUSION The information in the present case report may facilitate further clinical research on this cerebrovascular disease. 展开更多
关键词 hemorrhagic transformation Cerebral proliferative angiopathy PATHOGENESIS Diagnosis Treatment Case report
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Hemorrhagic transformation after acute ischemic stroke caused by polycythemia vera:Report of two case
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作者 Ya-Yun Cao Jie Cao +2 位作者 Zhua-Jin Bi Sha-Bei Xu Chen-Chen Liu 《World Journal of Clinical Cases》 SCIE 2021年第25期7551-7557,共7页
BACKGROUNDPolycythemia vera (PV) is a chronic myeloproliferative disorder characterized byan increase in red blood cells in the peripheral blood. Previous work has reportedthe occurrence of thrombosis or hemorrhage ar... BACKGROUNDPolycythemia vera (PV) is a chronic myeloproliferative disorder characterized byan increase in red blood cells in the peripheral blood. Previous work has reportedthe occurrence of thrombosis or hemorrhage arising in the cerebral vasculaturesecondary to PV. However, hemorrhagic transformation after PV-associated acuteischemic stroke has not been previously described.CASE SUMMARYWe herein present two cases of PV where hemorrhagic transformation occurredafter an acute ischemic stroke. Case 1 was a 57-year-old woman with a history ofhypertension who was admitted for left-sided weakness. Case 2 was a 68-year-oldman who was admitted for a 10-d sudden left arm weakness. Imaging examinationsfor the two patients revealed hemorrhagic transformation after acuteischemic stroke. Both patients had JAK-2-V617F mutation and receivedantiplatelet therapy. Both of them had a good prognosis during the follow-up.CONCLUSIONThis report suggested that hemorrhagic transformation may occur in acuteischemic stroke caused by PV. Antiplatelet drugs do not seem to influence thelong-term outcomes in such patients. Future research should focus on establishinga standard antiplatelet treatment strategy for this condition. 展开更多
关键词 Polycythemia vera Acute ischemic stroke hemorrhagic transformation Antiplatelet treatment THROMBOSIS Case report
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Study on risk factors of hemorrhagic transformation in patients with acute cerebral infarction after non thrombolysis
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作者 Li-Na Ma Xing Li +2 位作者 Dan Yu Guo-Shuai Yang Zhi-Ping Zhou 《Journal of Hainan Medical University》 2018年第6期21-24,共4页
Objective:To study the risk factors of hemorrhagic transformation in patients with acute cerebral infarction and to analyze the risk factors.Methods: A total of 96 patients with acute cerebral infarction after the thr... Objective:To study the risk factors of hemorrhagic transformation in patients with acute cerebral infarction and to analyze the risk factors.Methods: A total of 96 patients with acute cerebral infarction after the thrombolysis in our hospital from June 2016 to December 2017 were selected as the research object. And they were divided into bleeding group 48 cases and hemorrhage transformation group 48 cases according to whether with hemorrhage occurs transformation. Then the lipid metabolism, atrial fibrillation, history of smoking and drinking, history of hypertension and diabetes, blood pressure, treatment time after onset and infarction area of two groups were compared, and the relationship between those factors and the disease were analyzed by the multi-factor Logistic regression analysis.Results: The atrial fibrillation, history of smoking and drinking of two groups had significant differences;The hospital fasting plasma glucose and LDL-C level of two groups had significant differences;the treatment time after onset and infarction area of two groups had significant differences;The multi-factor Logistic regression analysis showed that atrial fibrillation, blood glucose on admission, LDL-C and large area of infarction are the factors affecting the risk of bleeding in patients with acute cerebral infarction transformation.Conclusion:Atrial fibrillation, blood glucose on admission, LDL-C, treatment time after onset and large area of infarction belongs to the patients with acute cerebral infarction after the thrombolysis transformation of bleeding risk factors. 展开更多
关键词 Acute CEREBRAL INFARCTION hemorrhagE transformation Influencing factors LOGISTIC regression analysis
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血清ESM-1、E-cad对ACI-LAA溶栓后HT的预测价值
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作者 茹姗 邹婷 +2 位作者 杜磊 韩登峰 马建华 《脑与神经疾病杂志》 CAS 2024年第2期96-99,共4页
目的 探讨血清内皮细胞特异性分子-1 (ESM-1)、E-钙黏连蛋白(E-cad)对大动脉粥样硬化型脑梗死(ACI-LAA)溶栓后出血转化(HT)的预测价值。方法 选取2020年1月至2022年12月新疆医科大学第一附属医院收治的110例ACI-LAA患者,根据是否发生HT... 目的 探讨血清内皮细胞特异性分子-1 (ESM-1)、E-钙黏连蛋白(E-cad)对大动脉粥样硬化型脑梗死(ACI-LAA)溶栓后出血转化(HT)的预测价值。方法 选取2020年1月至2022年12月新疆医科大学第一附属医院收治的110例ACI-LAA患者,根据是否发生HT分为HT组和non-HT组。对比两组基础资料及血清ESM-1、E-cad水平。采用ROC曲线分析ESM-1、E-cad预测ACI-LAA患者发生HT的价值。结果 HT组患者NIHSS评分高于non-HT组,梗死面积大于non-HT组(P <0.05),HT组患者血清ESM-1、E-cad水平也高于non-HT组(P<0.05)。Logistic回归分析显示,梗死面积大、NIHSS评分高、血清ESM-1和E-cad水平升高是ACI-LAA患者发生HT的危险因素(P<0.05)。ESM-1联合E-cad预测ACI-LAA患者发生HT的曲线下面积为0.859,预测灵敏度为84.6%,特异度为72.6%。结论 血清ESM-1和E-cad水平与ACI-LAA患者HT密切相关,可作为早期预测发生HT的参考指标。 展开更多
关键词 动脉粥样硬化 脑梗死 出血转化 内皮细胞特异性分子-1 E-钙黏连蛋白
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基于CEEMDAN-HT的永磁同步电机匝间短路振动信号故障特征提取研究
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作者 夏焰坤 李欣洋 +1 位作者 任俊杰 寇坚强 《振动与冲击》 EI CSCD 北大核心 2024年第5期72-81,共10页
由于长时间处于高负荷运行状态,永磁同步电机(permanent magnet synchronous motor, PMSM)定子绕组线圈匝与匝之间的绝缘性能容易降低,导致出现匝间短路,此时电机的振动强度会发生改变。针对此现象,提出将自适应噪声完备经验模态分解(co... 由于长时间处于高负荷运行状态,永磁同步电机(permanent magnet synchronous motor, PMSM)定子绕组线圈匝与匝之间的绝缘性能容易降低,导致出现匝间短路,此时电机的振动强度会发生改变。针对此现象,提出将自适应噪声完备经验模态分解(complete ensemble empirical mode decomposition with adaptive noise, CEEMDAN)与希尔伯特变换(Hilbert transform, HT)结合,构成一种CEEMDAN-HT非线性信号分析方法,并将其应用于提取振动信号故障特征。首先,利用CEEMDAN算法分解振动信号,得到一系列本征模态函数(intrinsic mode function, IMF),并将主元分析中的方差贡献率用于识别包含故障特征信息的IMF。其次,使用HT对方差贡献率较高的IMF进行分析,并以三维联合时频图呈现时间、瞬时频率与幅值,得到了主要故障特征。最后,使用ANSYS有限元软件建立了电机短路故障模型,并搭建了短路故障试验平台,通过对比有限元仿真结果与试验结果,对提出的方法进行了有效性和准确性验证。 展开更多
关键词 永磁同步电机(permanent magnet synchronous motor PMSM) 振动信号 自适应噪声完备经验模态分解(complete ensemble empirical mode decomposition with adaptive noise CEEMDAN) 特征提取 希尔伯特变换(Hilbert transform ht)
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基于MEEMD与HT的谐波检测方法 被引量:3
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作者 周军 李永祥 任佳鹏 《电力系统及其自动化学报》 CSCD 北大核心 2023年第6期73-82,共10页
为解决采用希尔伯特-黄变换进行谐波分析对信号进行分解时出现的模态混叠、端点效应、抗噪能力弱及虚假分量等问题,提出一种基于改进型总体平均经验模态分解和改进的自适应波形匹配延拓结合希尔伯特变换的谐波检测新方法。首先,采用改... 为解决采用希尔伯特-黄变换进行谐波分析对信号进行分解时出现的模态混叠、端点效应、抗噪能力弱及虚假分量等问题,提出一种基于改进型总体平均经验模态分解和改进的自适应波形匹配延拓结合希尔伯特变换的谐波检测新方法。首先,采用改进型总体平均经验模态分解算法和改进的自适应波形匹配延拓方法对谐波信号进行分解,获得一系列固有模态函数,再对各个固有模态函数进行希尔伯特变换,从而得到各次谐波的瞬时幅值和瞬时频率。采用经验模态分解、总体平均经验模态分解、完全经验模态分解算法和文中所提方法分别与希尔伯特变换结合进行谐波分析,仿真结果表明,所提方法能有效抑制模态混叠和端点效应,其受参数影响较小,自适应性较强,产生较少的虚假分量,且在强噪声下仍然具有很高的谐波检测精度。 展开更多
关键词 谐波检测 模态混叠 端点效应 去噪 希尔伯特变换
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Effect of Hypertonic Versus Isotonic Saline Resuscitation on Heme Oxygenase-1 Expression in Visceral Organs Following Hemorrhagic Shock in Rats 被引量:4
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作者 LU Yuan Qiang GU Lin Hui +1 位作者 JIANG Jiu Kun MOU Han Zhou 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2013年第8期684-688,共5页
To compare the early effects of hypertonic and isotonic saline resuscitation on heme oxygenase-1 (HO-1) expression in organs of rats with hemorrhagic shock. Rats were randomly divided into hypertonic saline resuscit... To compare the early effects of hypertonic and isotonic saline resuscitation on heme oxygenase-1 (HO-1) expression in organs of rats with hemorrhagic shock. Rats were randomly divided into hypertonic saline resuscitation (HTS), normal saline resuscitation (NS) and sham groups. HO-1 mRNA, protein expression and apoptosis were evaluated in organs. In the HTS group, significant difference was noted in HO-1 protein in small intestinal mucosa and liver compared with the NS and sham groups, and in HO-1 mRNA in liver and kidney compared with the sham group. The apoptosis of small intestinal mucosa, liver, heart, and lung was significantly lower in the HTS group than that in the NS group. In this study, small volume resuscitation with HTS can efficiently up-regulate the expression level of HO-1 in small intestinal mucosa and liver, which may be one of the mechanisms alleviating organ damage. 展开更多
关键词 htS Effect of Hypertonic Versus Isotonic Saline Resuscitation on Heme Oxygenase-1 Expression in Visceral Organs Following hemorrhagic Shock in Rats HO
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Determination of Instantaneous Frequencies of Low Plasma Waves in the Magnetosheath Using Empirical Mode Decomposition (EMD) and Hilbert Transform (HT)
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作者 Ekong Ufot Nathaniel Nyakno Jimmy George Sunday Edet Etuk 《Atmospheric and Climate Sciences》 2013年第4期576-580,共5页
The observations of in-situ spacecraft mission in the magnetosheath and a region of thermalized subsonic plasma behind the bow shock reveal a non-linear behaviour of plasma waves. The study of waves and optics in Phys... The observations of in-situ spacecraft mission in the magnetosheath and a region of thermalized subsonic plasma behind the bow shock reveal a non-linear behaviour of plasma waves. The study of waves and optics in Physics has given the understanding of the effect of many waves coming together to form a wave field or wave packet. The common aspect of such study shows that two or more waves can superimpose constructively or destructively. The sudden high magnetic field data in the magnetosheath displays such possibility of superposition of waves. In this paper, we use the empirical mode decomposition (EMD) and Hilbert transform (HT) techniques to determine the instantaneous frequencies of low frequency plasma waves in the magnetosheath. Our analysis has shown that the turbulent behavior of magnetic field in the magnetosheath within the selected period is due to superposition of waves. 展开更多
关键词 Plasma WAVES Instantaneous Frequency Empirical Mode Decomposition (EMD) HILBERT transform (ht)
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Development of HTS Transformers and a 10 kVA HTS Transformer Prototype Design
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作者 Xiao-Yuan Chen Jian-Xun Jin 《Journal of Electronic Science and Technology of China》 2008年第2期130-136,共7页
With the improvement of high temperature superconductor (HTS) practical performance, research and development concerning the applications of HTS transformers have been progressed actively worldwide. This paper provi... With the improvement of high temperature superconductor (HTS) practical performance, research and development concerning the applications of HTS transformers have been progressed actively worldwide. This paper provides a comprehensive summary on various HTS transformers, and studies the design of a single-phase 10 kVA (220V/24V) HTS transformer prototype to verify HTS for practical transformer applications. 展开更多
关键词 htS htS power transformer htS traction transformer htS windings.
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应激性血糖升高比值联合糖化血红蛋白水平对老年急性缺血性脑卒中病人静脉溶栓后出血转化的预测价值 被引量:1
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作者 吴旭明 柯先金 +1 位作者 孙波 孙振杰 《实用老年医学》 CAS 2024年第1期54-58,共5页
目的 探讨应激性血糖升高比值(SHR)联合HbA1c对老年急性缺血性脑卒中(AIS)病人静脉溶栓后出血转化(HT)的预测价值。方法 纳入2018年6月至2020年12月连云港市第一人民医院和江苏大学附属医院接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓... 目的 探讨应激性血糖升高比值(SHR)联合HbA1c对老年急性缺血性脑卒中(AIS)病人静脉溶栓后出血转化(HT)的预测价值。方法 纳入2018年6月至2020年12月连云港市第一人民医院和江苏大学附属医院接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓AIS老年住院病人共234例,依据急性期内复查CT或MRI结果,将病人分为HT组(n=50)和非HT组(n=184)。收集并比较2组病人临床基线资料。采用多因素Logistic回归分析老年AIS病人rt-PA静脉溶栓后HT的危险因素,应用ROC曲线分析SHR、HbA1c及二者联合预测老年AIS病人rt-PA后HT的价值。结果 2组年龄、溶栓前NIHSS评分、FPG、HbA1c水平,房颤、TOAST分型和梗死大面积比例差异均有统计学意义(P<0.05或P<0.01)。多因素Logistic回归分析结果表明:高水平SHR(OR=39.443,95%CI:1.847~842.343)、HbA1c(OR=1.777,95%CI:1.091~2.859)以及大面积梗死(OR=3.093,95%CI:1.359~7.036)是老年AIS病人rt-PA静脉溶栓后HT的独立危险因素。HbA1c、SHR及二者联合预测老年AIS病人rt-PA静脉溶栓后HT风险的AUC分别为:0.631(95%CI:0.541~0.721)、0.656(95%CI:0.654~0.748)、0.741(95%CI:0.665~0.816)。HbA1c联合SHR预测的AUC显著大于两指标单独预测,差异有统计学意义(P均<0.05)。结论 高水平SHR和HbA1c是老年AIS病人rt-PA静脉溶栓后HT的独立危险因素,两者联合可更好地预测老年AIS病人rt-PA静脉溶栓后HT风险。 展开更多
关键词 急性缺血性脑卒中 出血转化 应激性血糖升高比值 糖化血红蛋白 危险因素
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CT及MRI预测急性缺血性脑梗死出血性转化的价值研究进展
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作者 李明 陈克敏 +1 位作者 潘自来 罗禹 《诊断学理论与实践》 2024年第1期83-89,共7页
脑梗死是全球排名第二大致死原因,在中国已成为第一大致残及死亡原因。急性缺血性脑梗死(acute ischemic stroke,AIS)则是最常见的脑梗死类型,约占全部脑梗死的80%。出血性转化(hemorrhagic transformation,HT)是AIS患者的自然转归过程... 脑梗死是全球排名第二大致死原因,在中国已成为第一大致残及死亡原因。急性缺血性脑梗死(acute ischemic stroke,AIS)则是最常见的脑梗死类型,约占全部脑梗死的80%。出血性转化(hemorrhagic transformation,HT)是AIS患者的自然转归过程之一,也是静脉溶栓治疗(intravenous thrombolysis,IVT)或血管内取栓治疗等治疗后最严重的并发症,给患者及其家庭和社会都带来沉重的负担。精准预测、评估AIS的HT具有重要临床意义。近年影像学研究集中于CT和MRI评估HT的价值。CT平扫诊断HT价值有限,AIS治疗前,阿尔伯塔脑梗死计划早期诊断评分≤7分与HT发生相关(P=0.033),高密度大脑中动脉征是发生HT的独立危险因素(OR=10.334);AIS取栓治疗后24 h复查双能CT,预测2~7 d内发生HT风险的效能较高(灵敏度82.5%、特异度100%)。CT血管造影中,血栓负荷高的患者HT发生概率上升(OR=1.28);侧支循环良好的AIS患者HT发生率低。CT灌注成像参数包括表面渗透性、脑血容量、Tmax等,均有较好的HT预测价值。MRI平扫中,FLAIR上高信号可预测HT的发生;MRI弥散加权成像,高信号区域体积可预测HT(ROC曲线下面积0.78);MRI磁敏感率加权成像,刷状征、微出血灶提示HT的发生;MRI增强T1加权成像,脑实质强化与HT发生显著相关(P<0.05);MRI灌注加权成像中,梗死区脑血容量降低可预测HT。此外,CT及MRI图像后处理系统RAPID提升了评估HT的效能。建议根据各急救中心的硬件及当地医疗情况,设置个性化的影像学检测方式及流程,预测及管理HT。 展开更多
关键词 计算机断层摄影 核磁共振成像 脑梗死 出血性转化
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基于VMD的广义三次互相关管道泄漏定位检测
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作者 王冬梅 童影力 +1 位作者 何壮 路敬祎 《压力容器》 北大核心 2024年第2期72-80,共9页
针对天然气管道泄漏检测声波定位技术中,二次互相关时延估计算法存在较大误差的问题,提出了一种基于变分模态分解(VMD)结合广义三次互相关的时延估计算法。该方法首先利用VMD算法对两路信号进行分解并重构信号;其次,在二次互相关的基础... 针对天然气管道泄漏检测声波定位技术中,二次互相关时延估计算法存在较大误差的问题,提出了一种基于变分模态分解(VMD)结合广义三次互相关的时延估计算法。该方法首先利用VMD算法对两路信号进行分解并重构信号;其次,在二次互相关的基础上再进行一次相关,并在互相关算法的峰值检测阶段引入希尔伯特变换(HT),对峰值进行尖锐化处理,成为一种新型的广义三次互相关时延估计算法。通过对平台搭建的油气管道泄漏检测系统采集数据进行模拟试验,分析了各算法的精度。试验表明,相较于二次互相关,改进广义三次互相关时延估计算法定位平均精度有明显的提升,有着更高的精度和更好的抗噪性能,在天然气管道泄漏定位方面有着更广泛的应用前景。 展开更多
关键词 管道泄漏检测 变分模态分解 广义三次互相关 希尔伯特变换(ht)
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MTHFR基因多态性对脑梗死患者阿替普酶静脉溶栓后出血性转化的影响
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作者 陆景红 王训 《中国现代医学杂志》 CAS 2024年第4期66-71,共6页
目的分析亚甲基四氢叶酸还原酶(MTHFR)基因多态性对脑梗死患者阿替普酶静脉溶栓后出血性转化(HT)的影响。方法回顾性分析2020年7月—2023年7月在安徽医科大学附属阜阳人民医院接受治疗的120例脑梗死患者的临床资料。依据治疗后24~72 h H... 目的分析亚甲基四氢叶酸还原酶(MTHFR)基因多态性对脑梗死患者阿替普酶静脉溶栓后出血性转化(HT)的影响。方法回顾性分析2020年7月—2023年7月在安徽医科大学附属阜阳人民医院接受治疗的120例脑梗死患者的临床资料。依据治疗后24~72 h HT发生情况分为HT组(15例)、无HT组(105例)。比较两组基线资料、MTHFR基因多态性、纤维蛋白原(Fib)、同型半胱氨酸(Hcy)。采用多因素一般Logistic回归模型分析脑梗死患者阿替普酶静脉溶栓后HT发生的危险因素。绘制受试者工作特征(ROC)曲线,分析入院时美国国立卫生院卒中量表(NIHSS)评分、Hcy预测脑梗死患者阿替普酶静脉溶栓后HT发生的价值。结果HT组心房颤动发生率、MTHFR基因型677CT占比、入院时NIHSS评分、Hcy水平均高于无HT组(P<0.05)。多因素一般Logistic回归分析结果显示:心房颤动史[OR=1.478(95%CI:1.126,1.940)]、入院时NIHSS评分升高[OR=1.656(95%CI:1.125,2.438)]、MTHFR基因型为677CT[OR=1.871/2.362(95%CI:1.052,3.328/1.081,4.652)]、Hcy水平升高[OR=2.149(95%CI:1.108,4.168)]均为脑梗死患者阿替普酶静脉溶栓后HT发生的危险因素(P<0.05)。ROC曲线分析结果显示,入院时NIHSS评分、Hcy均可预测脑梗死患者阿替普酶静脉溶栓后HT发生,其敏感性分别为80.0%(95%CI:0.765,0.883)、73.3%(95%CI:0.717,0.834),特异性分别为74.3%(95%CI:0.659,0.817)、74.3%(95%CI:0.824,0.931)。677CT型患者Hcy水平高于677CC、677TT型患者(P<0.05)。结论心房颤动、MTHFR基因型、入院时NIHSS评分、Hcy均为影响脑梗死患者阿替普酶静脉溶栓后HT发生的重要因素,临床应结合以上指标对高危患者进行重点筛查,尽早采取干预措施。 展开更多
关键词 脑梗死 基因多态性 亚甲基四氢叶酸还原酶 阿替普酶 出血性转化
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探讨NLR、PLR、hs-CRP、Hb、D-D与ACI非溶栓治疗后出血性转化的相关性分析
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作者 张玫娜 郭志鹏 曹扬 《脑与神经疾病杂志》 2024年第1期26-30,共5页
目的 探讨急性脑梗死患者(ACI)非溶栓治疗前血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、D-二聚体(D-D)与治疗后出血性转化(HT)的相关性,以期为临床预防ACI非溶栓治疗后发生... 目的 探讨急性脑梗死患者(ACI)非溶栓治疗前血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、D-二聚体(D-D)与治疗后出血性转化(HT)的相关性,以期为临床预防ACI非溶栓治疗后发生提供指导依据。方法 本研究病历组(设为转化组)共纳入80例样本,选取自2015年1月至2019年12月在吉林大学第一医院检验科接受非溶栓治疗后并出现HT的ACI患者,根据HT严重程度等级化分1级、2级、3级、4级,各严重程度患者分别为27例、22例、18例、13例。选取50例在接受非溶栓治疗后未出现HT的ACI患者作为对照(非转化组)。比较各组的血清NLR、PLR、hs-CRP、Hb、D-D表达水平差异,并通过Spearman秩相关检验分析NLR、PLR、hs-CRP、Hb、D-D与HT严重程度的相关性。并采用ROC曲线分析NLR、PLR、hsCRP、Hb、D-D对ACI患者HT的预测作用。结果 转化组的血清NLR、PLR、hs-CRP、D-D表达水平均高于非转化组,Hb的表达水平低于非转化组(均P<0.05)。1级、2级、3级、4级患者的血清NLR、PLR、hs-CRP、D-D表达水平依次上升,Hb表达水平依次降低,差异有统计学意义(P<0.05),且组间两两比较,差异有统计学意义(P<0.05)。ACI非溶栓治疗后HT严重程度与血清NLR、PLR、hs-CRP、D-D均呈正相关(r值分别为:0.729、0.692、0.601、0.578,均P<0.05),与Hb呈负相关(r值为:-0.678,P<0.05)。ROC曲线分析显示,NLR的AUC值为0.896[95%CI(0.737~0.962)]、PLR的AUC值为0.775 [95%CI(0.626~0.917)]、hs-CRP的AUC值为0.840 [95%CI(0.712~0.948)]、Hb的AUC值为0.782 [95%CI(0.493~0.914)]、D-D的AUC值为0.725 [95%CI(0.403~0.852)]。结论 ACI患者的NLR值、PLR值、hs-CRP、Hb、D-D表达水平与其在非溶栓治疗后发生HT存在相关性,临床上可将这些指标作为预测HT风险。 展开更多
关键词 NLR PLR HS-CRP HB D-D 急性脑梗死 出血性转化
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1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理
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作者 龚艳艳 吴桃红 曹敏芝 《全科护理》 2024年第4期786-790,共5页
总结1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理经验。护理要点:无创呼吸机辅助通气治疗的护理、液体及营养支持管理、静脉血栓的预防及处理、预防和控制感染、联合康复科制订渐进式康复方案、出院指导与随... 总结1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理经验。护理要点:无创呼吸机辅助通气治疗的护理、液体及营养支持管理、静脉血栓的预防及处理、预防和控制感染、联合康复科制订渐进式康复方案、出院指导与随访。经过21 d的精心治疗和护理,病人病情稳定,顺利转回当地医院继续康复治疗。 展开更多
关键词 急性脑梗死 出血转化 心肾综合征 无创机械辅助通气 护理
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基于EMD和HT的旋转机械振动信号时频分析 被引量:48
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作者 胡劲松 杨世锡 +1 位作者 吴昭同 严拱标 《振动.测试与诊断》 EI CSCD 2004年第2期106-110,共5页
把一列时间序列数据通过经验模态分解 (Em pirical Mode Decomposition,简称 EMD)成本征模函数组(Intrinsic Mode Function,简称 IMF) ,然后经希尔伯特变换 (Hilbert Transform ation,简称 HT)获得频谱的信号时频分析新方法引入到旋转... 把一列时间序列数据通过经验模态分解 (Em pirical Mode Decomposition,简称 EMD)成本征模函数组(Intrinsic Mode Function,简称 IMF) ,然后经希尔伯特变换 (Hilbert Transform ation,简称 HT)获得频谱的信号时频分析新方法引入到旋转机械振动信号处理领域。介绍了该方法的理论和算法。首先 ,采用调频调幅仿真信号对该方法进行仿真验证 ;其次 ,把一实测的旋转机械油膜涡动故障振动信号进行了基于 EMD和 HT的时频分析。仿真和实测信号的分析结果说明 ,用基于 EMD和 展开更多
关键词 旋转机械 振动信号 经验模态分解 希尔伯特变换 时频分析
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旋转机械振动信号基于EMD的HT和STFT时频分析比较 被引量:9
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作者 胡劲松 杨世锡 +1 位作者 吴昭同 严拱标 《汽轮机技术》 北大核心 2002年第6期336-338,共3页
基于经验模态分解(EmpiricalModeDecomposition,EMD)的希尔伯特变换(HilbertTransformation,HT),是先把一列时间序列数据通过经验模态分解,然后经过希尔伯特变换获得频谱的信号处理新方法。介绍了该方法的理论和算法。对仿真和旋转机械... 基于经验模态分解(EmpiricalModeDecomposition,EMD)的希尔伯特变换(HilbertTransformation,HT),是先把一列时间序列数据通过经验模态分解,然后经过希尔伯特变换获得频谱的信号处理新方法。介绍了该方法的理论和算法。对仿真和旋转机械油膜涡动故障振动信号分别用基于EMD的HT和基于STFT(Short-TimeFourierTransforma tion,STFT)的时频分析进行了比较研究,研究结果说明,用基于EMD的HT方法对旋转机械的振动信号进行时频分析比STFT有效。 展开更多
关键词 旋转机械 振动信号 EMD ht STFT 时频 希尔伯特变换 经验模态分解 短时傅立叶变换
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