Early cardiopulmonary resuscitation on serum levels of myeloperoxidase,soluble ST2,and hypersensitive C-reactive protein in acute myocardial infarction patients

BACKGROUND Prompt and effective cardiopulmonary resuscitation(CPR)can promote the recovery of spontaneous circulation to some extent and can save patients’lives.The minimum target of cardiac resuscitation is the restoration of spontaneous circulation(ROSC).However,owing to prolonged sudden cardiac arrest,there is relatively high mortality within 24 h after cardiac resuscitation.Moreover,severe cerebral anoxia can deteriorate the prognosis of patients.Therefore,it is important to adopt an effective clinical evaluation of acute myocardial infarct(AMI)patients’prognosis after cardiac resuscitation for the purpose of prevention and management.AIM To investigate early CPR effects on human myeloperoxidase(MPO),soluble ST2(sST2),and hypersensitive C-reactive protein(hs-CRP)levels in AMI patients.METHODS In total,54 patients with cardiac arrest caused by AMI in our hospital were selected as the observation group,and 50 other patients with AMI were selected as the control group.The differences in serum levels of MPO,sST2,and hs-CRP between the observation group and the control group were tested,and the differences in the serum levels of MPO,sST2,and hs-CRP in ROSC and non-ROSC patients,and in patients who died and in those who survived,were analyzed.RESULTS Serum levels of MPO,sST2,hs-CRP,lactic acid,creatine kinase isoenzyme(CKMB),and cardiac troponin I(cTnI)were significantly higher in the observation group than in the control group(P<0.05).Serum levels of MPO,sST2,hs-CRP,lactic acid,CK-MB,and cTnI in the observation group were lower after CPR than before CPR(P<0.05).In the observation group,MPO,sST2,hs-CRP,lactic acid,CK-MB,and cTnI serum levels were lower in ROSC patients than in non-ROSC patients(P<0.05).MPO,sST2,hs-CRP,and lactic acid serum levels of patients who died in the observation group were higher than those of patients who survived(P<0.05).The areas under receiver operating characteristic curve predicted by MPO,sST2,hs-CRP,lactic acid,CK-MB,and cTnI were 0.616,0.681,0.705,0.704,0.702,and 0.656,respectively(P<0.05).The areas under receiver operating characteristic curve for MPO,SST2,hs-CRP,and lactic acid to predict death were 0.724,0.800,0.689,and 0.691,respectively(P<0.05).Logistic regression analysis showed that MPO,sST2,and hs-CRP were the influencing factors of ROSC[odds ratios=1.667,1.589,and 1.409,P<0.05],while MPO,sST2,hs-CRP,and lactic acid were the influencing factors of death(odds ratios=1.624,1.525,1.451,and 1.365,P<0.05).CONCLUSION Serum levels of MPO,sST2,hs-CRP,and lactic acid have a certain value in predicting recovery and prognosis of patients with ROSC.

Prognostic value of C-reactive protein levels within 6 hours after the onset of acute anterior myocardial infarction with primary PCI

Background Increased levels of inflammatory markers have been documented in various settings of coronary artery disease. The vulnerability of coronary lesions in acute myocardial infarction(AMI) at the time of onset may be related to serum levels of C reactive protein(CRP) on admission, before CRP levels are affected by myocardial damage.Objective This study assessed the predictive value of CRP levels within six hours after the onset of acute anterior myocardial infarction with primary percutaneous coronary intervention(PCI).Methods The plasma CRP of 76 patients with first acute anterior myocardial infarction was measured within 6 hours after onset. They were divided into 2 groups: group 1( n =20) with elevated CRP( ≥0.3mg/dl ) on admission within 6 hours after onset and group 2( n =56) with normal CRP( <0.3mg/dl ) within 6 hours after onset. All patients were treated by primary PCI. The primary combined end points, including death due to cardiac causes, re MI related to the infarction artery(RIA) and repeat intervention of the RIA, and the restenosis rate were assessed in relation to CRP levels within 6 hours after onset. Left ventricular end diastolic volume index(EDVI),end systolic volume index(ESVI),and ejection fraction(EF) on admission and 6 month after the onset were assessed by left ventriculography. Changes in EDVI(ΔEDVI),ESVI(ΔESVI), and EF(ΔEF) were obtained by subtracting respective on admission values from corresponding 6 month follow up values. Results There were no significant differences in baseline characteristics between the two groups. The primary combined end points were significantly more frequent in group 1(20%) than those in group 2( 1.79% , P <0.01 ).In addition, restenosis rates were significantly higher in group 1 than in group 2(41.18% vs 16.07%, P<0.05). Group 1 showed greater increases in left ventricular volume and less improvement in EF compared with group 2(ΔEDVI 6.31 ±2.17 vs 3.29 ±9.46ml/m 2 , ΔESVI 5.92 ±2.31 vs 3.86 ±1.08ml/m 2 , ΔEF 1.92 ±0.47 vs 4.79 ±1.73% , P <0.05 , respectively).Conclusions CRP levels within 6 hours after the onset of AMI might predict adverse outcome after primary PCI and progressive ventricular remodeling within 6 month of AMI.

Relationship among soluble CD105, hypersensitive C-reactive protein and coronary plaque morphology： an intravascular ultrasound study

Background Rupture of unstable plaque with subsequent thrombus formation is the common pathophysiological substrate of acute coronary syndrome （ACS）. It is of potential significance to explore the blood indexes predicting plaque characteristics. We investigated the relationship among soluble CD105, hypersensitive C-reactive protein （hs-CRP）, and coronary plaque morphology.Methods A clinical study from April 2004 to December 2006 was conducted in 130 patients who were divided into 3 groups： 56 patients （43.1%） in stable angina （SA） group, 52 patients （40.0%） in unstable angina （UA） group and 22 patients （16.9%） in acute myocardial infarction group. The concentrations of soluble CD105 and hs-CRP were measured in all of the patients by cardioangiography （CAG）. Plasma samples of arterial blood were collected prior to the procedure. The levels of soluble CD105 and hs-CRP were measured by enzyme-linked immunosorbent assay （ELISA）.Results Unstable and ruptured plaque was found more frequently in patients with acute myocardial infarction and UA. External elastic membrane cross-sectional area （EEM CSA）, plaque area, lipid pool area and plaque burden were significantly larger in the ruptured and unstable plaque group. Positive remodeling, thinner fabric-cap, smaller minimal lumen cross-sectional area （MLA）, dissection and thrombus were significantly more frequent in the ruptured and unstable plaque group. Remodeling index （RI） was positively correlated with the levels of soluble CD105 in the UA group （r=0.628, P〈0.01） and the acute myocardial infarction group （r=0.639, P〈0.01）. The levels of soluble CD105 and hs-CRP were higher in the ruptured plaque group. Soluble CD105 〉4.3 ng/ml was used to predict ruptured plaque with a receiver operating characteristic （ROC） curve area of 0.77 （95% confidence interval （CI）, 66.8%-87.2%）, a sensitivity of 72.8%, a specificity of 78.0% and an accuracy of 70.2% （P〈0.01）, similarly for hs-CRP 〉 5.0 mg/ml with a ROC curve area of 0.70 （95% CI, 59.2%-80.2%）, a sensitivity of 70.2%, a specificity of 76.2% and an accuracy of 67.2% （P〈0.01）.Conclusions The plaque characteristics correlate with the clinical presentation. The elevation of soluble CD105 and hs-CRP is related to the plaque instability and rupture.

Infliximab trough level combined with inflammatory biomarkers predict long-term endoscopic outcomes in Crohn’s disease under infliximab therapy

BACKGROUND Infliximab trough level(ITL)severely affects therapeutic outcomes of Crohn’s disease(CD)patients under infliximab(IFX).Recently,frontier research has focused on identifying ITL based on different therapeutic targets.Although previous studies have elaborated clinical value of ITL monitoring on short-term outcomes in CD patients during therapy,studies contraposing the predictive value of ITL on long-term endoscopic outcomes in CD patients are still scarce domestically and overseas.AIM To explore the predictive value of ITL in combination with inflammatory biomarkers on long-term endoscopic outcomes in CD with clinical remission during IFX maintenance therapy.METHODS CD patients with endoscopic remission under long-term IFX maintenance therapy in the First Affiliated Hospital of Zhejiang Chinese Medicine University from January 2012 to December 2020 were collected.ITL and inflammatory biomarkers were continuously monitored during the therapy.The Step I study was conducted from weeks 14 to 54 of IFX treatment.The Step II study was conducted from weeks 54 to 108 of IFX treatment.Endoscopic outcomes were defined as endoscopic activity(Crohn’s disease endoscopic index of severity score>2 points or Rutgeerts score>i1)and endoscopic remission(Crohn’s disease endoscopic index of severity score≤2 points or Rutgeerts≤i1).Endoscopic relapse free survival was defined as endoscopic remission at the beginning of the study stage and maintaining endoscopic remission during the study stage.RESULTS At week 14,low ITL[odds ratio(OR)=0.666,95%confidence interval(CI):0.514-0.862,P<0.01]and high fecal calprotectin(FCP)level(OR=1.002,95%CI:1.001-1.004,P<0.01)increased the risk of endoscopic activity at week 54.At week 54,low ITL(OR=0.466,95%CI:0.247-0.877,P<0.01)and high C-reactive protein(CRP)level(OR=1.590,95%CI:1.007-2.510,P<0.01)increased the risk of endoscopic activity at week 108.At week 14,ITL≤5.60μg/mL[area under the curve(AUC)=0.83,95%CI:0.73-0.90,P<0.001]and FCP>238μg/g(AUC=0.82,95%CI:0.72-0.89,P<0.001)moderately predicted endoscopic activity at week 54.ITL≤5.60μg/mL in combination with FCP>238μg/g indicated 82.0%possibility of endoscopic activity.At week 54,ITL≤2.10μg/mL(AUC=0.85,95%CI:0.72-0.93,P<0.001)and CRP>3.00 mg/L(AUC=0.73,95%CI:0.60-0.84,P=0.012)moderately predicted moderate endoscopic activity at week 108.ITL≤2.10μg/mL in combination with CRP>3.00 mg/L indicated 100.0%possibility of endoscopic activity.From weeks 14 to 54 of IFX treatment,patients with ITL>5.60μg/mL had higher rate of endoscopic relapse free survival than those with ITL≤5.60μg/mL(95.83%vs 46.67%).From weeks 54 to 108 of IFX treatment,patients with ITL>2.10μg/mL had higher rate of endoscopic survival free relapsed rate than those with ITL≤2.10μg/mL(92.68%vs 30.77%).CONCLUSION Combination of ITL,CRP,and FCP contribute to long-term endoscopic prognosis monitoring.During IFX maintenance treatment,low ITL,high CRP level,and high FCP level were independent risk factors of CD patients with clinical remission in adverse endoscopy outcomes within 1-year follow-up.

Analysis of correlation between carotid atherosclerotic plaques and serum hs-CRP, Apo-B, ox-LDL and MMP-9 levels in patients with atherosclerotic cerebral infarction

ObjectiveTo analyze the correlation between the levels of serum hypersensitive c-reactive protein(hs-CRP),apolipoprotein-B(Apo-B),oxidized low-density lipoprotein(ox-LDL)and matrix metalloproteinase-9(MMP-9)and carotid arteryplaque(CAP)in patients with atherosclerotic cerebral infarction(ASCI).Methods 125 patients with ASCI diagnosed in the Department of Neurology of Panzhihua Central Hospital from January 2018 to December 2018 were selected as the case group,and 125 healthy volunteers in the same period were selected as the control group.Serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 were compared between the two groups.Carotid ultrasound was performed in patients with ASCI.The correlation between serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 and the formation of CAP in patients with ASCI was analyzed by SPSS 23.0 statistics.Results Compared with the control group,the levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 increased significantly in the case group(P<0.01).The serum levels of hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with CAP were significantly higher than those without CAP in the case group(P<0.01).Multivariate logistic regression analysis showed that serum levels of hs-CRP(OR=4.76,95%CI:2.35-9.18),Apo-B(OR=3.16,95%CI:1.59-7.32),ox-LDL(OR=1.48,95%CI:1.15-2.01)and MMP-9(OR=3.86,95%CI:1.63-9.14)were independent risk factors for CAP formation in patients with ASCI(P<0.05).ConclusionsThe contents of serumhs-CRP,Apo-B,ox-LDL and MMP-9 may reflect the serverity of inflammation and instability of carotid atherosclerotic plaque in ASCI patient.The levels of serum hs-CRP,Apo-B,ox-LDL and MMP-9 in patients with ASCI are significantly increased,which are closely related to the formation of CAP in patients with ASCI,so it can be used as important serum biomarkers for clinical diagnosis of ASCI and CAP formation.

The effects of enhanced external counterpulsation on the serum level of C-reactive protein and endothelin-1 in patients with ischemic stroke

Objective To explore the effects of enhanced external counterpulsation(EECP)on the serum level of C-reactive protein and endothelin-1 in patients with cerebral ischemic stroke,to provide clinical evidence for the treatment and secondary prevention of patients with serebral ischemic stroke.Methods Total 187 patients with ischemic stroke and enrolled measure the serum level

不同剂量阿托伐他汀对急性心肌梗死患者冠状动脉介入治疗后早期血脂及近期心血管事件影响的临床研究

目的 探讨不同剂量阿托伐他汀对急性心肌梗死患者冠状动脉介入治疗后早期血清高敏C反应蛋白（hs-CRP）、血脂水平及近期心血管事件的影响.方法 选取2014年1-9月新疆维吾尔自治区人民医院收治的急性心肌梗死患者120例,所有患者均行急诊冠状动脉介入治疗,完全随机分为A组和B组,每组各60例.A组入院后在常规治疗的基础上给予阿托伐他汀20 mg/d,B组在常规治疗的基础上给予阿托伐他汀40 mg/d,持续治疗1个月;比较不同剂量阿托伐他汀对术后早期（1周内）hs-CRP、血脂水平的影响,同时记录患者近期（1个月内）心血管不良事件（心绞痛发生次数）.结果 治疗1周后,2组血清hs-CRP、高密度脂蛋白胆固醇（HDL-C）、总胆固醇、低密度脂蛋白胆固醇（LDL-C）水平较治疗前均明显下降,差异均有统计学意义[A组：（6.1±1.6）mg/L比（15.6±3.6）mg/L、（0.86±0.20） mmol/L比（1.00±0.24） mnmol/L、（3.7±0.6） mmol/L比（4.5±1.0）mmol/L、（2.3±0.6） mmol/L比（3.0±0.9） mmol/L;B组：（6.0±1.8） mg/L比（15.6±5.3）mg/L、（0.81±0.15） mmol/L比（0.97±0.25） mmol/L、（2.9 ±0.5） mmol/L比（4.1±0.9）mmol/L、（1.7±0.4）mmol/L比（2.7±0.8）mmol/L,均P＜0.05];B组在治疗后LDL-C下降大于A组（P＜0.01）.2组均未出现心源性死亡,A组心绞痛发生率明显高于B组,差异有统计学意义[43.3％ （26/60）比16.7％（10/60）,x2 =5.079,P＜0.05）.结论 急性心肌梗死介入术后患者应用阿托伐他汀治疗对降低hs-CRP、血脂水平有效,并且40mg较20mg阿托伐他汀早期降脂及减少近期心绞痛事件作用更佳.

小儿上呼吸道感染高敏C反应蛋白表达水平的研究

目的探讨上呼吸道感染患儿高敏C反应蛋白(hs-CRP)表达水平的临床价值。方法选取2014年4月至2015年7月本院收治的90例上呼吸道感染患儿为研究对象,根据细菌和血清学检测结果分为支原体感染组(39例)和细菌感染组(51例)。观察并比较两组患儿白细胞计数和hs-CRP水平变化情况。结果细菌感染组患儿白细胞计数、血清hs-CRP水平及其异常率明显高于支原体感染组(P<0.05)。细菌感染组患儿治疗后白细胞计数、血清hs-CRP水平及其异常率明显低于治疗前(P<0.05)。结论 hs-CRP水平动态检测可用于评估不同病原菌引起的小儿上呼吸道感染的治疗效果,为小儿上呼吸道感染的早期诊断与治疗提供重要的参考依据。

急性心肌梗死患者早期不同剂量阿托伐他汀对hs-CRP、血脂水平的影响

目的：探讨不同剂量阿托伐他汀治疗对急性心肌梗死（AMI）患者早期超敏C反应蛋白（hs-CRP）、血脂水平的影响。方法：选取2014年1月～5月入院确诊的AMI患者60例，随机分为20mg组和40mg组，每组30例，所有患者入院后均在常规治疗的基础上加用阿托伐他汀，分别给予20mg和40mg。比较两组患者入院时和治疗1周后不同剂量对血清hs-CRP、血脂水平的影响。结果：两组治疗前后1周血清hs—CRP、总胆固醇、低密度脂蛋白胆固醇（LDL．C）及高密度脂蛋白胆固醇水平均较入院时显著下降，且40mg组较20mg组治疗后LDL-C水平显著下降，两组间差异有统计学意义（P〈0．05）。结论：AMI患者早期（1周内）阿托伐他汀治疗对降低hs—CRP、血脂水平有效，并且40mg组在LDL-C降低幅度上优于20mg组。

疗养期间心理干预对冠心病患者症状和超敏C反应蛋白水平的影响

目的探讨心理干预对冠心病患者症状和超敏C反应蛋白(hs-CRP)水平的影响。方法选择冠心病患者184例,分别进行焦虑自评量表(SAS)及抑郁自评量表(SDS)调查,并运用西雅图心绞痛量表(SAQ)评测患者的心绞痛症状,同时检测hs-CRP水平,随机分为心理干预组96例和常规治疗组88例。两组患者均进行常规冠心病治疗,同时对心理干预组额外进行心理干预。1个月后重新对以上个体进行SAS、SDS、SAQ评分及hs-CRP水平检测。结果与治疗前比较,两组SAS、SDS评分明显降低,SAQ评分明显增高,hs-CRP水平明显下降(P<0.01),且心理干预组较常规治疗组变化更明显(P<0.01)。结论心理危机干预可以减轻冠心病患者的焦虑、抑郁,改善心绞痛症状,降低炎性因子水平。

D-二聚体、hs-CRP及MMP-9水平联合监控在急性缺血性脑梗死患者中的临床意义

目的探讨D-二聚体水平、hs-CRP及MMP-9联合监控在急性缺血性脑梗死患者中的临床意义。方法选取2014年3月至2016年3月收治的急性缺血性脑梗死患者80例,同期选取健康体检者80例,分别测定2组D-二聚体、hs-CRP及MMP-9水平,及不同程度(轻度、中度、重度)急性缺血性脑梗死患者的D-二聚体、hs-CRP及MMP-9的水平,并分析D-二聚体、hs-CRP及MMP-9在急性缺血性脑梗死患者的相关性。结果急性脑缺血性脑梗死组D-二聚体、hs-CRP及MMP-9水平[(1.49±0.12)mg/L、(11.38±2.12)mg/L、(332.27±54.62)μg/L]高于健康组[(0.25±0.04)mg/L、(2.14±0.51)mg/L、(124.68±27.59)μg/L],差异有统计学意义(P<0.05);轻度急性脑缺血性脑梗死组D-二聚体、hs-CRP及MMP-9水平[(0.68±0.14)mg/L、(3.16±0.87)mg/L、(227.48±43.26)μg/L]低于中度组[(1.13±0.25)mg/L、(7.54±1.3)mg/L、(325.69±62.74)μg/L]、且低于重度组[(1.54±0.37)mg/L、(13.49±1.50)mg/L、(497.23±74.35)μg/L],差异有统计学意义(P<0.05);急性脑缺血性脑梗死患者D-二聚体、hs-CRP及MMP-9水平均呈正相关(P<0.05)。结论联合监控D-二聚体、hs-CRP、MMP-9水平能够辅助急性脑缺血性脑梗死患者的诊断,并可评估疾病的进展,指导临床治疗。

杏贝止咳颗粒联合沙美特罗替卡松吸入治疗对慢性阻塞性肺疾病稳定期患者血清乙酰胆碱酯酶及炎症指标水平变化的影响

目的 杏贝止咳颗粒联合沙美特罗替卡松吸入治疗对慢性阻塞性肺疾病(COPD)稳定期患者血清乙酰胆碱酯酶(AchE)及炎症指标水平变化的影响。方法 采用回顾性分析,选择2020年1月至2021年12月于中国人民解放军陆军第七十一集团军医院确诊的80例COPD稳定期患者,按照治疗方式不同分为COPD组(常规沙美特罗替卡松粉吸入剂治疗,n=40)和杏贝止咳颗粒组(在COPD组基础上实施杏贝止咳颗粒治疗,n=40)。对比分析两组患者肺功能指标[1秒用力呼气量(FEV1)、FEV1占预计值百分比(FEV1%)、FEV1/用力肺活量(FVC)]、血清AchE、炎症因子[超敏C反应蛋白水平(hs-CRP)、白细胞(WBC)数量、肿瘤坏死因子α(TNF-α)和白细胞介素-6(IL-6)]水平以及不良反应情况。结果 治疗前,两组肺功能指标比较,差异均无统计学意义(P> 0.05);与治疗前相比,治疗后,两组肺功能指标FEV1、FEV1%和FEV1/FVC均显著增加,差异均有统计学意义(P <0.05);治疗后,杏贝止咳颗粒组FEV1、FEV1/预计值和FEV1/FVC为(1.88±0.30) L、(69.33±3.97)%、(67.90±5.33)%,均显著高于COPD组[(1.53±0.21)L、(60.96±4.50)%、(62.47±4.65)%],差异均有统计学意义(P <0.05)。治疗后,杏贝止咳颗粒组血清hs-CRP、WBC、TNF-α和IL-6水平为(3.78±0.12)μg/mL、(10.62±1.24)×10~9/L、(178.69±44.23) ng/L、(433.09±59.19)ng/L,均显著低于COPD组[(10.33±1.53)μg/mL、(15.31±2.09)×10~9/L、(253.09±34.29) ng/L、(545.43±48.90)ng/L],差异均有统计学意义(P <0.05)。治疗后,杏贝止咳颗粒组AchE水平为(5.70±0.32) U/L,显著高于COPD组[(2.12±0.43) U/L],差异有统计学意义(P <0.05)。两组不良反应发生情况比较,差异无统计学意义(P> 0.05)。结论 在常规治疗基础上结合杏贝止咳颗粒治疗,可对慢性阻塞性肺疾病稳定期患者发挥显著治疗效果,具体体现在可显著改善患者肺功能,并进一步调控血清AchE以及炎症反应水平,且临床安全性较好。

短期胰岛素泵治疗对新诊断2型糖尿病患者血糖波动及超敏C-反应蛋白水平的影响

目的探讨短期胰岛素泵治疗对新诊断2型糖尿病患者血糖波动及超敏C-反应蛋白水平的影响。方法选取2018年4月至2019年4月我院内分泌科收治的新诊断2型糖尿病患者86例为研究对象,随机将其等分为观察组和对照组。对照组采用常规多次皮下注射胰岛素治疗,观察组采用短期胰岛素泵治疗,比较两组患者干预前后血糖波动、超敏C-反应蛋白水平以及胰岛β细胞功能。结果两组血糖波动呈较稳定状态,观察组血糖波动幅度低于对照组(P<0.05);观察组患者的超敏C-反应蛋白水平明显低于对照组(P<0.05);观察组患者的胰岛β细胞功能均高于对照组(P<0.05)。结论短期胰岛素泵治疗可明显控制新诊断2型糖尿病患者的血糖波动幅度,有效地降低患者的超敏C-反应蛋白水平,改善并增强胰岛β细胞功能,减轻胰岛素抵抗并加快胰岛素分泌,值得临床推广和应用。

胸腔镜肺叶切除术治疗非小细胞肺癌的效果及对炎症因子、应激水平的影响

目的探讨胸腔镜肺叶切除术(PLT)治疗非小细胞肺癌(NSCLC)的效果及对白介素-6(IL-6)、白介素-10(IL-10)、超敏C反应蛋白(hs-CRP)及应激水平的影响。方法选取2020年2月至11月朝阳市中心医院接受手术治疗的NSCLC患者138例作为研究对象,按照随机数字表法分为观察组与对照组,每组各69例。观察组采用PLT术式治疗,对照组采用传统的开胸术式治疗。比较两组的治疗效果,术前及术后5 d的IL-6、IL-10、hs-CRP及应激水平。结果观察组的手术时间和住院时间均短于对照组,术中出血量和引流量均少于对照组,差异有统计学意义(P<0.05)。术后5 d两组的IL-6、IL-10及hs-CRP均高于治疗前,但观察组的IL-6、IL-10及hs-CRP低于对照组,差异有统计学意义(P<0.05)。术后5 d两组的P物质、生长激素、皮质醇水平均高于治疗前,但观察组的P物质、生长激素、皮质醇水平低于对照组,差异有统计学意义(P<0.05)。结论应用PLT术式治疗NSCLC患者的效果较好,还可改善其术后机体的炎症反应及应激状态,值得推广。

血脂水平联合hs-CRP和Hcy检测在结缔组织病相关动脉粥样硬化性心血管疾病中的价值

目的探讨血脂水平、超敏C反应蛋白(hs-CRP)和同型半胱氨酸(Hcy)在结缔组织病(CTD)相关动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)中的临床价值。方法选取2016年1月至2019年11月于本院风湿免疫科就诊的32例结缔组织病合并动脉粥样硬化性心血管疾病患者(实验组)及同期结缔组织病患者26例(对照组)。所有研究对象均检测血脂水平、hs-CRP和Hcy水平,分析其在预测ASCVD的中的临床价值。结果实验组血清TG、TC、LDL-C、hs-CRP和Hcy水平高于对照组,而HDL低于对照组,组间比较差异具有统计学意义(P<0.05);联合检测时准确率最高,明显高于各指标单独检测,差异具有统计学意义(P<0.05)。结论血清脂质水平、hs-CRP和Hcy是结缔组织病相关动脉粥样硬化性心血管疾病有效的预测指标,定期检测,可降低心血管事件的危险性,具有重要的临床价值。

针刺联合康复训练治疗脑血管意外后遗症临床研究

目的:观察针刺联合康复训练治疗脑血管意外后遗症的临床疗效及其对患者神经功能、中医证候、免疫力的影响。方法:将92例脑血管意外后遗症患者按随机数字表法分为对照组和观察组各46例,对照组给予常规疗法,观察组在对照组的基础上给予针刺联合康复训练治疗。比较两组治疗后的临床疗效、美国国立卫生院卒中量表(NIHSS)评分、中医证候评分及血清超敏C反应蛋白(hs-CRP)水平。结果:(1)观察组治疗后的临床总有效率明显高于对照组,差异有统计学意义(P<0.05)。(2)两组治疗后的NIHSS和中医证候评分较治疗前均降低,差异有统计学意义(P<0.05);观察组治疗后的NIHSS和中医证候评分均低于对照组,差异有统计学意义(P<0.05)。(3)治疗后两组患者血清hs-CRP水平较治疗前均降低,差异有统计学意义(P<0.05);治疗后观察组患者血清hs-CRP水平低于对照组,差异有统计学意义(P<0.05)。结论:在常规治疗的基础上进行针刺联合康复训练能提高脑血管意外后遗症患者的临床疗效,改善其神经功能和中医证候,提高免疫力。

超敏C反应蛋白检测在流感早期诊断中的应用

目的探究超敏C反应蛋白检测在流感早期诊断的应用。方法随机选取2016年10月至2017年10月本院收治的80例呼吸道感染患者,包括细菌感染40例、流感40例,同期时段在本院进行健康体检的40例健康者。将细菌感染患者作为观察组1,流感患者作为观察组2,健康者作为对照组,所有研究对象均实施超敏C反应蛋白检测与白细胞水平检测。结果超敏C反应蛋白指标观察组1高于对照组(P<0.05);但观察组2与对照组比较差异无统计学意义(P>0.05);白细胞水平比较观察组1高于对照组,且观察组2低于对照组(P<0.05)。上呼吸道感染的检出率97.5%(78/80),敏感度98.7%(78/79)。结论在流感早期诊断中应用超敏C反应蛋白检测,具有较高的临床诊断价值,可为临床诊治提供有效的参考依据。

低能量激光对重度牙周炎治疗效果的临床研究

目的评估牙周基础治疗联合低能量激光照射对需要拔除患牙的重度牙周炎患者的治疗效果。方法选取2018年6月至2019年5月于天津市第一中心医院口腔科就诊的重度牙周炎患者18例(共43颗患牙,每例均有2颗及以上牙周炎患牙需要拔除),按随机数字表法分为对照组和试验组,其中对照组9例(20颗患牙),试验组9例(23颗患牙)。对照组和试验组均进行牙周基础治疗,试验组在牙周基础治疗后的第1、2、7天进行低能量激光照射治疗(808 nm Ga·Al·As半导体连续激光,输出功率80 mW,能量密度4 J/cm^2,光斑面积0.28 cm^2,患牙每个牙周袋内照射时间15 s)。治疗前、治疗后1周和4周,分别检测对照组和试验组的牙周探诊深度(PD)、临床附着水平(CAL)、龈沟出血指数(SBI),同时收集两组患者的龈沟液,采用酶联免疫吸附测定法检测龈沟液中的碱性成纤维细胞生长因子(b-FGF)水平,采用免疫散射比浊法检测患者的血清超敏C反应蛋白(hs-CRP)水平。结果治疗前两组重度牙周炎患者的年龄、PD、CAL、SBI、b-FGF和hs-CRP水平差异均无统计学意义(均P>0.05)。治疗后1周,两组间PD、CAL、b-FGF和hs-CRP水平差异均无统计学意义(均P>0.05);试验组的SBI低于对照组,差异具有统计学意义(2.43±0.97比4.13±0.78,P<0.05)。治疗后4周,试验组的SBI低于对照组,差异具有统计学意义(2.26±0.96比3.75±0.72,P<0.01);两组间PD、CAL差异均无统计学意义(均P>0.05);试验组的b-FGF水平较对照组升高[(35.28±5.41)pg/30 s比(33.45±2.37)pg/30 s],血清hs-CRP水平较对照组明显降低[(3.23±1.73)mg/L比(5.79±0.63)mg/L],差异均具有统计学意义(均P<0.05)。结论低能量激光疗法可短期内有效降低需要拔除患牙的重度牙周炎患者的SBI,但对减少PD、改善CAL意义不大;同时可降低患者的血清hs-CRP水平,升高患牙龈沟液中的b-FGF水平,有利于重度牙周炎症的控制。

Biomarkers enhance the long-term predictive ability of the KAMIR risk score in Chinese patients with ST-elevation myocardial infarction

Background:The Global Registry of Acute Coronary Events (GRACE) score is recommended by current ST-elevation myocardial infarction (STEMI) guidelines.But it has inherent defects.The present study aimed to investigate the more compatible risk stratification for Chinese patients with STEMI and to determine whether the addition of biomarkers to the Korea Acute Myocardial Infarction Registry (KAMIR) score could enhance its predictive value for long-term outcomes.Methods:A total of 1093 consecutive STEMI patients were included and followed up 48.2 months.Homocysteine,hypersensitive C-reactive protein (hs-CRP),and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The KAMIR score and the GRACE score were calculated.The performance between the KAMIR and the GRACE was compared.The predictive power of the KAMIR alone and combined with biomarkers were assessed by the receiver-operating characteristic (ROC) curve.Results:The KAMIR demonstrated a better risk stratification and predictive ability than the GRACE (death:AUC = 0.802 vs.0.721,P<0.001;major adverse cardiovascular events (MACE):AUC = 0.683 vs.0.656,P<0.001).It showed that the biomarkers could independently predict death [homocysteine:HR= 1.019 (1.015–1.024),P<0.001;hs-CRP:HR= 1.052 (1.000–1.104),P= 0.018;NT-pro BNP:HR= 1.142 (1.004–1.280),P= 0.021] and MACE [homocysteine:HR= 1.019 (1.015–1.024),P<0.001;hs-CRP:HR= 1.012 (1.003–1.021),P= 0.020;NT-pro BNP:HR= 1.136 (1.104–1.168),P= 0.006].When they were used in combination with the KAMIR,the area under the ROC curve (AUC) significantly increased for death [homocysteine:AUC = 0.802 vs.0.890,Z = 5.982,P<0.001;hs-CRP:AUC = 0.802 vs.0.873,Z= 3.721,P<0.001;NT-pro BNP:AUC= 0.802 vs.0.871,Z = 2.187,P= 0.047;homocysteine,hs-CRP and NT-pro BNP:AUC = 0.802 vs.0.940,Z = 6.177,P<0.001] and MACE [homocysteine:AUC = 0.683 vs.0.771,Z= 6.818,P<0.001;hs-CRP:AUC= 0.683 vs.0.712,Z= 2.022,P= 0.031;NT-pro BNP:AUC= 0.683 vs.0.720,Z= 2.974,P= 0.003;homocysteine,hs-CRP and NT-pro BNP:AUC= 0.683 vs.0.789,Z= 6.900,P<0.001].Conclusion:The KAMIR is better than the GRACE in risk stratification and prognosis prediction in Chinese STEMI patients.A combination of above-mentioned biomarkers can develop a more predominant prediction for long-term outcomes.

类风湿关节炎患者血清VEGF与25-(OH)D 水平的影响因素及临床预防研究

目的研究类风湿关节炎患者的血清(vascularerdothelial growth factor,VEGF)与25羟基维生素D[25-(OH)D]的危险因素及预防措施。方法对2016年10月至2018年8月金华文莱医院收治的103例类风湿关节炎(rheumatoid arthritis,RA)患者作为RA组,按相关分期标准将RA组患者分为RA活动期组(43例)、RA缓解期组(60例),另选择同期进行健康体检的141例健康体检者作为对照组。对RA活动期组、RA缓解组、对照组受检者的血清VEGF、25-(OH)D水平以及相关炎性因子进行测定,并对RA组、对照组受检者的相关情况进行问卷调查。结果RA活动期组、RA缓解期组患者的血清VEGF水平以及超敏C反应蛋白(hypresensitive C-reactive protein,hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(interleukin-6,IL-6)水平均高于对照组,RA活动期组患者的血清VEGF水平以及hs-CRP、TNF-α和IL-6水平均明显高于缓解期组,间组比较差异有统计学意义(F=1111.83、367.77、640.49、141.13,P均=0.000)。RA活动期组、RA缓解期组患者的25-(OH)D水平高于对照组,RA活动期组的25-(OH)D水平高于RA缓解期组(F=231.20,P=0.0000),三组的维生素D含量比较差异有统计学意义(χ~2=34.352、8.992、9.950,P=0.000、0.011、0.007)。两组在性别、年龄以及抽烟、喝酒所占比例上比较差异无统计学意义(P均>0.05);RA组患者中居住环境阴冷潮湿、有结核病史、有类风湿性关节炎家族史所占比例高于对照组,RA组女性患者的初潮年龄大于对照组,初孕年龄则低于对照组,差异有统计学意义(t=5.488、3.373、P均<0.05)。结论引起类风湿关节炎的发病因素较多,患者的血清VEGF偏高,25-(OH)D水平偏低,通过检测血清VEGF、25-(OH)D及相关炎性因子水平能够反映出类风湿关节炎的病情活动程度,对于其病情评估及预防治疗均具有重要意义。