Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumon...Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumonia patients.Methods:We initiated an LMWH protocol in Covid-19 patients with increased D-dimer,body mass index>30 kg/m^(2) or a history of diabetes from January 18,2020 at Shanghai Public Health Clinical Center.In this retrospective study,we assigned moderate Covid-19 pneumonia patients admitted between January 18th and April 18,2020 receiving the LMWH protocol to the LMWH group.Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching.General clinical information,indicators for renal function,arterial blood gas analyses,arterial blood lactic acid content(mmol/L),and coagulation indexes at 0 day,3 days,7 days,and 11 days after admission were recorded and compared between the two groups.Results:There were 41 patients in the LMWH group and 82 patients in the control group.General information in both groups were similar.Compared to the control group,the arterial blood lactic acid content(mmol/L)at day 11(1.3[1.1,1.7]vs.1.2[0.9,1.3],P=0.016)was reduced in the LMWH group.The estimated glomerular filtration rate(eGFR)in the LMWH group was higher than that in the control group at day 7(108.54[89.11,128.17]vs.116.85[103.39,133.47],P=0.039)and day 11(113.74[94.49,126.34]vs.128.31[112.75,144.12],P=0.003).The serum creatinine levels(Scr)in the LMWH group were lower than that in the control group at day 7(62.13[51.47,77.64]vs.55.49[49.50,65.75],P=0.038)and day 11(63.35[50.17,75.73]vs.51.62[44.62,61.24],P=0.005).Conclusions:LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients.Randomized controlled trials are warranted to further investigate this issue.展开更多
目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐...目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐动脉血pH值及乳酸水平,并分析各单项指标及不同指标联合诊断新生儿窒息的准确率、灵敏度和特异度.结果研究组1 min Apgar评分、脐动脉血pH值和乳酸水平均高于对照组(均P<0.001).各单项指标中,1 min Apgar评分诊断准确率高于脐动脉血pH值和乳酸(均P<0.01)、灵敏度高于脐动脉血pH值(P<0.05)、特异度高于乳酸(P<0.01);联合指标中,1 min Apgar评分+脐动脉血pH值诊断准确率、灵敏度和特异度分别为80.67%、81.00%和80.50%,1 min Apgar评分+乳酸诊断准确率、灵敏度和特异度分别为80.00%、84.00%和78.00%,1 min Apgar评分+脐动脉血pH值+乳酸诊断准确率、灵敏度和特异度分别为95.00%、100.00%和92.50%,1 min Apgar评分+脐动脉血pH值+乳酸的诊断准确率、灵敏度和特异度高于1 min Apgar评分+脐动脉血pH值和1 min Apgar评分+乳酸(均P<0.001).结论在应用1 min Apgar评分与脐动脉血pH值的基础上联合乳酸检测能够提高新生儿窒息的诊断效果.展开更多
基金supported by grants from the second batch of emergency key scientific and technological project of Shanghai Municipal Committee of Science and Technology(Nos.20411950300,20411950301)the Clinical Research Project of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(No.2018CR004)to EnQiang Mao and the National Natural Science Foundation of China to Jun Huang(No.81870311)。
文摘Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumonia patients.Methods:We initiated an LMWH protocol in Covid-19 patients with increased D-dimer,body mass index>30 kg/m^(2) or a history of diabetes from January 18,2020 at Shanghai Public Health Clinical Center.In this retrospective study,we assigned moderate Covid-19 pneumonia patients admitted between January 18th and April 18,2020 receiving the LMWH protocol to the LMWH group.Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching.General clinical information,indicators for renal function,arterial blood gas analyses,arterial blood lactic acid content(mmol/L),and coagulation indexes at 0 day,3 days,7 days,and 11 days after admission were recorded and compared between the two groups.Results:There were 41 patients in the LMWH group and 82 patients in the control group.General information in both groups were similar.Compared to the control group,the arterial blood lactic acid content(mmol/L)at day 11(1.3[1.1,1.7]vs.1.2[0.9,1.3],P=0.016)was reduced in the LMWH group.The estimated glomerular filtration rate(eGFR)in the LMWH group was higher than that in the control group at day 7(108.54[89.11,128.17]vs.116.85[103.39,133.47],P=0.039)and day 11(113.74[94.49,126.34]vs.128.31[112.75,144.12],P=0.003).The serum creatinine levels(Scr)in the LMWH group were lower than that in the control group at day 7(62.13[51.47,77.64]vs.55.49[49.50,65.75],P=0.038)and day 11(63.35[50.17,75.73]vs.51.62[44.62,61.24],P=0.005).Conclusions:LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients.Randomized controlled trials are warranted to further investigate this issue.
文摘目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐动脉血pH值及乳酸水平,并分析各单项指标及不同指标联合诊断新生儿窒息的准确率、灵敏度和特异度.结果研究组1 min Apgar评分、脐动脉血pH值和乳酸水平均高于对照组(均P<0.001).各单项指标中,1 min Apgar评分诊断准确率高于脐动脉血pH值和乳酸(均P<0.01)、灵敏度高于脐动脉血pH值(P<0.05)、特异度高于乳酸(P<0.01);联合指标中,1 min Apgar评分+脐动脉血pH值诊断准确率、灵敏度和特异度分别为80.67%、81.00%和80.50%,1 min Apgar评分+乳酸诊断准确率、灵敏度和特异度分别为80.00%、84.00%和78.00%,1 min Apgar评分+脐动脉血pH值+乳酸诊断准确率、灵敏度和特异度分别为95.00%、100.00%和92.50%,1 min Apgar评分+脐动脉血pH值+乳酸的诊断准确率、灵敏度和特异度高于1 min Apgar评分+脐动脉血pH值和1 min Apgar评分+乳酸(均P<0.001).结论在应用1 min Apgar评分与脐动脉血pH值的基础上联合乳酸检测能够提高新生儿窒息的诊断效果.
