Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in at...Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.展开更多
Resistin is a member of the family of cysteine-rich secretary proteins called resistin-like molecules (RELMs). It is suggested to be involved in inflammatory conditions and atherosclerosis. We have established a signi...Resistin is a member of the family of cysteine-rich secretary proteins called resistin-like molecules (RELMs). It is suggested to be involved in inflammatory conditions and atherosclerosis. We have established a significant correlation between serum resistin levels and coronary artery disease (CAD) in a study was performed between 2011 and 2012 in our institute in two hundred fourteen patients (164 CAD patients and 50 controls). Then the CAD patients were followed up to investigate the relationship between increased serum resistin levels and major adverse cardiac events (MACE) between 2012 and 2016. One hundred fifty-five of 164 patients (95%) were followed up and 9 patients lost to follow up. There were 39 MACE (25%) in four years of follow-up.?There were 16 in-hospital deaths due to cardiac causes, 8 revascularization procedures, and 15 re-hospitalization due to acute coronary syndrome (ACS) or heart failure (HF). The patients with MACE had similar serum resistin level (median: 71.37 pg/ml) compared to patients without MACE (median: 80.23 pg/ml) (p > 0.05).展开更多
Based on an analysis of major recent social events in China,such as the 2008 Beijing Olympic Games,2010 Shanghai World Expo,2014 Nanjing Youth Olympic Games,and 2014 Beijing Asia Pacific Economic Cooperation Conferenc...Based on an analysis of major recent social events in China,such as the 2008 Beijing Olympic Games,2010 Shanghai World Expo,2014 Nanjing Youth Olympic Games,and 2014 Beijing Asia Pacific Economic Cooperation Conference,mandatory,temporary,and indemnificatory quantitative policies aimed at protecting air quality,which were carried out by both central and local governments,made substantial contributions to changes and improvements in air quality.To some extent,the findings show that command and control measures play a significant role in protecting air quality,while the law and economic and voluntary environmental safeguard measures do not during major social events.Therefore,it reminds us the air quality could and will improve not only during major social events but also in the regular days if we implement appropriate environmental policies and safeguard measures.展开更多
目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是...目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是否发生MACE分为MACE组(n=59)与无MACE组(n=61)。在患者行血液透析前佩戴Holter,收集24 h心电活动信息,计算均值(MEAN)、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)和相邻RR间期差值的均方根(r-MSSD)。采用自动血压监测系统记录24 h血压变化,计算白昼收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)和24 h收缩压变异性(24 h SBPV)。Logistic回归分析MHD患者MACE发生的危险因素。调整混杂因素后,采用Cox比例风险模型回归分析24 h SBPV和SDNN与MHD患者MACE发生的关系。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度,分析SDNN和收缩压变异性单独及联合对维持性MHD患者发生MACE的预测价值。根据SDNN和24 h SBPV水平将患者分成3组,绘制Kaplan-Meier生存曲线评价不同SDNN和收缩压变异性的MHD患者MACE发生情况。结果 与无MACE组相比,MACE组年龄较大,24 h SBPV、dSBPV、nSBPV较高,SDNN、SDANN较低,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、Kt/V、24 h SBPV、dSBPV、nSBPV、SDNN、SDANN是MHD患者MACE发生的独立危险因素(P<0.05)。调整混杂因素后,多因素COX比例风险模型回归分析,24 h SBPV为MHD患者发生MACE的危险因素,而SDNN为MHD患者发生MACE的保护性因素(P<0.05)。SDNN与收缩压变异性联合预测MHD患者发生MACE的AUC为0.879,预测效能高于单项检测(P<0.05)。组1随访期间累积MACE发生率显著低于组2和组3(19.15%vs 65.12%vs 73.33%,P<0.001)。结论 MHD不良预后患者中24 h SBPV升高,SDNN降低,24 h SBPV和SDNN单独预测MACE的具体价值尚可,两者联合预测效果更佳,可为临床上及早识别及干预MHD患者MACE发生提供参考依据。展开更多
目的探讨脊柱手术围手术期心血管并发症的发生率和危险因素。方法选择2015年1月~2020年12月在该院接受全身麻醉下脊柱手术的1508例患者作为研究对象,记录患者性别、年龄、体质量指数(body mass index,BMI)、美国麻醉医师协会(American s...目的探讨脊柱手术围手术期心血管并发症的发生率和危险因素。方法选择2015年1月~2020年12月在该院接受全身麻醉下脊柱手术的1508例患者作为研究对象,记录患者性别、年龄、体质量指数(body mass index,BMI)、美国麻醉医师协会(American society of anesthesiologists,ASA)分级、血红蛋白(haemoglobin,Hb)、内生肌酐清除率(endogenous creatinine clearance rate,Ccr)、伴随疾病、手术原因、手术状态、手术方式、融合节段、术中事件、手术医师等等资料,观察围手术期(本研究定义为患者住院期间及术后28 d内)发生的主要心血管不良事件(major adverse cardiovascular events,MACE)发生率。根据是否发生MACE将患者分为两组,采用单因素(卡方检验、t检验)和多因素分析观察影响MACE的风险因素。结果本研究中,共22例患者在研究定义的时间内发生MACE,发生率1.46%。单因素分析显示,MACE和非MACE患者的BMI、Hb、高血压、中风、阻塞性睡眠呼吸暂停、甲状腺疾病、慢性肺疾病、手术状态、手术方式、术中高血压等资料比较,差异均无统计学意义(P>0.05);MACE和非MACE患者的性别、年龄、ASA分级、Ccr、糖尿病、慢性肾脏疾病、慢性心力衰竭、手术原因、融合节段、术中低血压、术中输血等资料比较,差异均存在统计学意义(P<0.05)。多因素Logistic分析结果显示,手术原因为脊柱侧凸、术前有慢性心力衰竭史、术中发生低血压均是影响术后MACE的风险因素(P<0.05)。结论脊柱手术患者围手术期MACE发生率为1.45%,影响MACE发生的风险因素可能包括术前慢性心力衰竭史、脊柱侧凸手术和术中低血压。展开更多
文摘Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.
文摘Resistin is a member of the family of cysteine-rich secretary proteins called resistin-like molecules (RELMs). It is suggested to be involved in inflammatory conditions and atherosclerosis. We have established a significant correlation between serum resistin levels and coronary artery disease (CAD) in a study was performed between 2011 and 2012 in our institute in two hundred fourteen patients (164 CAD patients and 50 controls). Then the CAD patients were followed up to investigate the relationship between increased serum resistin levels and major adverse cardiac events (MACE) between 2012 and 2016. One hundred fifty-five of 164 patients (95%) were followed up and 9 patients lost to follow up. There were 39 MACE (25%) in four years of follow-up.?There were 16 in-hospital deaths due to cardiac causes, 8 revascularization procedures, and 15 re-hospitalization due to acute coronary syndrome (ACS) or heart failure (HF). The patients with MACE had similar serum resistin level (median: 71.37 pg/ml) compared to patients without MACE (median: 80.23 pg/ml) (p > 0.05).
基金sponsored by National Social Science Fund [grant number 13&ZD172]
文摘Based on an analysis of major recent social events in China,such as the 2008 Beijing Olympic Games,2010 Shanghai World Expo,2014 Nanjing Youth Olympic Games,and 2014 Beijing Asia Pacific Economic Cooperation Conference,mandatory,temporary,and indemnificatory quantitative policies aimed at protecting air quality,which were carried out by both central and local governments,made substantial contributions to changes and improvements in air quality.To some extent,the findings show that command and control measures play a significant role in protecting air quality,while the law and economic and voluntary environmental safeguard measures do not during major social events.Therefore,it reminds us the air quality could and will improve not only during major social events but also in the regular days if we implement appropriate environmental policies and safeguard measures.
文摘目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是否发生MACE分为MACE组(n=59)与无MACE组(n=61)。在患者行血液透析前佩戴Holter,收集24 h心电活动信息,计算均值(MEAN)、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)和相邻RR间期差值的均方根(r-MSSD)。采用自动血压监测系统记录24 h血压变化,计算白昼收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)和24 h收缩压变异性(24 h SBPV)。Logistic回归分析MHD患者MACE发生的危险因素。调整混杂因素后,采用Cox比例风险模型回归分析24 h SBPV和SDNN与MHD患者MACE发生的关系。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度,分析SDNN和收缩压变异性单独及联合对维持性MHD患者发生MACE的预测价值。根据SDNN和24 h SBPV水平将患者分成3组,绘制Kaplan-Meier生存曲线评价不同SDNN和收缩压变异性的MHD患者MACE发生情况。结果 与无MACE组相比,MACE组年龄较大,24 h SBPV、dSBPV、nSBPV较高,SDNN、SDANN较低,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、Kt/V、24 h SBPV、dSBPV、nSBPV、SDNN、SDANN是MHD患者MACE发生的独立危险因素(P<0.05)。调整混杂因素后,多因素COX比例风险模型回归分析,24 h SBPV为MHD患者发生MACE的危险因素,而SDNN为MHD患者发生MACE的保护性因素(P<0.05)。SDNN与收缩压变异性联合预测MHD患者发生MACE的AUC为0.879,预测效能高于单项检测(P<0.05)。组1随访期间累积MACE发生率显著低于组2和组3(19.15%vs 65.12%vs 73.33%,P<0.001)。结论 MHD不良预后患者中24 h SBPV升高,SDNN降低,24 h SBPV和SDNN单独预测MACE的具体价值尚可,两者联合预测效果更佳,可为临床上及早识别及干预MHD患者MACE发生提供参考依据。
文摘目的探讨脊柱手术围手术期心血管并发症的发生率和危险因素。方法选择2015年1月~2020年12月在该院接受全身麻醉下脊柱手术的1508例患者作为研究对象,记录患者性别、年龄、体质量指数(body mass index,BMI)、美国麻醉医师协会(American society of anesthesiologists,ASA)分级、血红蛋白(haemoglobin,Hb)、内生肌酐清除率(endogenous creatinine clearance rate,Ccr)、伴随疾病、手术原因、手术状态、手术方式、融合节段、术中事件、手术医师等等资料,观察围手术期(本研究定义为患者住院期间及术后28 d内)发生的主要心血管不良事件(major adverse cardiovascular events,MACE)发生率。根据是否发生MACE将患者分为两组,采用单因素(卡方检验、t检验)和多因素分析观察影响MACE的风险因素。结果本研究中,共22例患者在研究定义的时间内发生MACE,发生率1.46%。单因素分析显示,MACE和非MACE患者的BMI、Hb、高血压、中风、阻塞性睡眠呼吸暂停、甲状腺疾病、慢性肺疾病、手术状态、手术方式、术中高血压等资料比较,差异均无统计学意义(P>0.05);MACE和非MACE患者的性别、年龄、ASA分级、Ccr、糖尿病、慢性肾脏疾病、慢性心力衰竭、手术原因、融合节段、术中低血压、术中输血等资料比较,差异均存在统计学意义(P<0.05)。多因素Logistic分析结果显示,手术原因为脊柱侧凸、术前有慢性心力衰竭史、术中发生低血压均是影响术后MACE的风险因素(P<0.05)。结论脊柱手术患者围手术期MACE发生率为1.45%,影响MACE发生的风险因素可能包括术前慢性心力衰竭史、脊柱侧凸手术和术中低血压。
