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Impact of continuous care on cardiac function in patients with lung cancer complicated by coronary heart disease
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作者 Ting Gao Jin-Lan Luo +3 位作者 Pan Guo Xi-Wen Hu Xiao-Yan Wei Yan Hu 《World Journal of Clinical Cases》 SCIE 2024年第2期314-321,共8页
BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly co... BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life. 展开更多
关键词 lung cancer Continuing care coronary heart disease Percutaneous coronary intervention
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Clinical efficacy and significance of serum fibroblast growth factor-21 and ghrelin in the treatment of type 2 diabetes complicated with coronary heart disease with integrated traditional Chinese and western medicine
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作者 Su Gao Xue Tian +1 位作者 Wei-Na Jiang Yao Ma 《Journal of Hainan Medical University》 2018年第22期13-17,共5页
Objective: To treat the patients with type 2 diabetes mellitus complicated with coronary heart disease, to explore the clinical efficacy and mechanism of conventional western medicine combined with Yiqi Yangyin Huoxue... Objective: To treat the patients with type 2 diabetes mellitus complicated with coronary heart disease, to explore the clinical efficacy and mechanism of conventional western medicine combined with Yiqi Yangyin Huoxue herbs, and to detect the level of serum fibroblast growth factor-21 (FGF-21) and Ghrelin. Changes and significance. Methods: A randomized control method was used to collect 100 patients with type 2 diabetes mellitus complicated with coronary heart disease who were diagnosed and treated in our hospital from March 2015 to March 2018.They were randomly divided into two groups according to the random number table method: 50 patients separately. The patients in the control group were treated with conventional western medicine and basic treatment;the observation group was treated with the addition and subtraction of traditional Chinese medicine formulas on the basis of the control group;the clinical curative effect was evaluated after two months of treatment, and the treatment efficiency and scores of traditional Chinese medicine symptoms were observed in the two groups. Basic laboratory indicators were improved, and serum levels of FGF-21 and Ghrelin in patients were measured and the difference between the results of the tests was compared with the condition and efficacy. Results: After treatment, the total effective rate of the observation group (86.0%) was significantly higher than that of the control group (68.0%) (P<0.05), suggesting that the combination of Chinese and Western medicine treatment can significantly improve the clinical efficacy;before treatment,there is no difference between the two groups of Chinese medicine symptom scores (P>0.05). After treatment, the symptom scores of the two groups were significantly improved after treatment (P<0.05). The observation group was better among the two groups (P<0.05).After treatment, the basic biochemical indicators were improved. The observation group was better than the control group (P<0.05);Serum FGF-21 levels were significantly lower in both groups after treatment (P<0.05), and Ghrelin levels were significantly increased. There was a statistically significant difference between the two groups (P<0.05). Conclusion: The use of conventional western medicine in combination with Yiqi Yangyin Huoxue Chinese medicine for the treatment of type 2 diabetes mellitus patients with coronary heart disease can significantly improve the clinical efficacy, effectively promote the improvement of symptoms, and can be used in clinical work through serum FGF-21, Ghrelin levels combined detection of the value of Abnormal changes to predict the severity of type 2 diabetes mellitus with coronary heart disease severity and treatment effect should be widely used in clinical diagnosis and treatment. 展开更多
关键词 Type 2 diabetes mellitus complicated coronary heart disease INTEGRATED TRADITIONAL Chinese and western medicine FGF-21 GHRELIN
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Nursing care of a patient with programmed cell death protein-1 immunotherapy-related myocarditis combined with coronary heart disease 被引量:1
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作者 Wen-Qi HUANG Yan-Bing QING +2 位作者 Li-Fang MA Zhang-Qi LI Chun-Xiang SU 《Journal of Integrative Nursing》 2021年第2期93-96,共4页
This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1(PD-1)immunotherapy-related myocarditis combined with coronary heart... This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1(PD-1)immunotherapy-related myocarditis combined with coronary heart disease(CHD)after receiving said treatment.In this case,immune myocarditis with CHD occurred shortly after implementing the PD-1 immunotherapy,yet the patient presented no clinical symptoms.Frequent nursing attention and close observation are so required for monitoring the patient’s status and updating the physicians for a swift control of the myocarditis.For this case,nursing care procedures vital for the successful recovery of the patient included condition observation,position management,pre-and postcoronary angiography care,infection prevention,hemorrhage prevention,venous access port maintenance,pain care,trachea care,psychological care,diet care,environment management,and health education.After receiving effective,successful treatment and care,the patient was discharged after 13 days of treatment with generally satisfying overall conditions. 展开更多
关键词 coronary heart disease lung cancer MYOCARDITIS nursing care programmed cell death protein 1
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Coronary artery bypass grafting with concomitant resection for carcinoma of lung 被引量:4
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作者 Yangyang Zhang,Yanhu Wu ,Biao Yuan,Xiang Liu,Sheng Zhao,Zhi Li,Yu Xia Department of Cardiothoracic Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu Province,China 《The Journal of Biomedical Research》 CAS 2010年第1期77-80,共4页
A 69-year-old woman with angina had a lesion in the left lower lobe on chest film. Angiography revealed coronary artery disease in three vessels. Combined off pump coronary artery bypass grafting (CABG) and left low... A 69-year-old woman with angina had a lesion in the left lower lobe on chest film. Angiography revealed coronary artery disease in three vessels. Combined off pump coronary artery bypass grafting (CABG) and left lower lobectomy were performed through median sternotomy. This approach avoids complications due to staged operations and cardiopulmonary bypass (CPB). This report shows that simultaneous off pump CABG and pulmonary operations can be performed safely in patients with coronary artery disease (CAD) associated with lung cancer. 展开更多
关键词 lung cancer coronary artery disease luo- resection off-pump coronary artery bypass grafting
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Blood cellular mutant LXR-α protein stability governs initiation of coronary heart disease 被引量:1
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作者 Mansi Arora Deepak Kaul Yash Paul Sharma 《World Journal of Cardiology》 CAS 2013年第8期305-312,共8页
AIM: To investigate the role of [breast and ovarian cancer susceptibility 1(BRCA1)-associated RING domain 1(BARD1)]/BRCA1 E3-ubiquitin ligase complex in governing the stability of mutant liver X receptor-(LXR-α... AIM: To investigate the role of [breast and ovarian cancer susceptibility 1(BRCA1)-associated RING domain 1(BARD1)]/BRCA1 E3-ubiquitin ligase complex in governing the stability of mutant liver X receptor-(LXR-α) protein in coronary heart disease(CHD) subjects.METHODS: The expression analysis of various genes was carried out by quantitative real time polymerase chain reaction and western blotting within blood mononuclear cells of human CHD subjects at various stages of coronary occlusion and their corresponding normal healthy counterparts.Immunoprecipitation experiments were performed to establish protein interactions between LXR-αand BARD1.Peripheral blood mononuclear cells were cultured and exposed to Vitamin D3 and Cisplatin to validate the degradation of mutant LXR-αprotein in CHD subjects by BARD1/BRCA1 complex.RESULTS: The expression of mutant LXR-αprotein in CHD subjects was found to decrease gradually with the severity of coronary occlusion exhibiting a strong negative correlation,r =-0.975 at P 【 0.001.Further,the expression of BARD1 and BRCA1 also increased with the disease severity,r = 0.895 and 0.873 respectively(P 【 0.001).Immunoprecipitation studies established that BARD1/BRCA1 complex degrades mutant LXR-αvia ubiquitination.The absence of functional LXR-αprotein resulted in increased expression of inflammatory cytokines such as interleukin(IL)-6,IL-8 and interferon-and decreased expression of ABCA1(ATP-binding cassette A1)(r = 0.932,0.949,0.918 and-0.902 with respect to Gensini score;P 【 0.001).Additionally,cell culture experiments proved that Vitamin D3 could prevent the degradation of mutant LXR-αand restore its functional activity to some extent.CONCLUSION: Mutant LXR-αprotein in CHD subjects is degraded by BARD1/BRCA1 complex and Vitamin D3 can rescue and restore its function. 展开更多
关键词 Mutant liver X receptor-1 UBIQUITINATION Breast and ovarian cancer susceptibility 1-associated RING domain 1/breast and ovarian cancer susceptibility 1 Mononuclear Cells coronary heart disease subjects Vitamin D3
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Pulmonary <i>Mycobacterium avium </i>Complex Disease Requiring Differentiation from Recurrence of Lung Cancer during the Follow-Up Period for Lung Cancer
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作者 Yoshihiro Kobashi Masaaki Abe +2 位作者 Daisuke Yoshioka Shigeki Kato Toru Oga 《Journal of Tuberculosis Research》 2019年第4期220-227,共8页
Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies... Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies. The clinical effect was a complete response. Chest CT was performed because of continuous dry cough, and a new tumor shadow was recognized in the lingula portion of the left upper lobe. We performed CT-guided lung biopsy and could aspirate pus-fluid. The culture test for acid-fast bacilli was positive and the causative microorganism was identified as Mycobacterium avium by the DDH method. The final diagnosis was pulmonary abscess due to M. avium. Treatment using combined chemotherapy including CAM was performed and a good clinical response was obtained. Case 2 was a 67-year-old man who had a past history of surgical resection of lung adenocarcinoma eight and two years ago and received several cancer chemotherapies and radiation therapy. Because a new nodular shadow appeared in the right middle lobe one year ago and showed strong positivity on PET/CT, surgical resection was performed with the suspected recurrence of lung cancer. Subsequently, the histological diagnosis was epithelioid granuloma and a culture test of acid-fast bacilli was positive, with the identification of Mycobacterium intracellulare by the DDH method. Combined chemotherapy was not performed because the lesion was completely resected. Afterwards, a new nodular shadow appeared in the left lower lobe again and bronchoscopy was performed. Because M. intracellulare was isolated from the local specimen, we diagnosed the patient with recurrence of pulmonary MAC disease and combined chemotherapy including CAM was performed for one year. Finally, the nodular lesion disappeared. It is difficult to differentiate pulmonary MAC disease from lung cancer. Therefore, careful follow-up of patients with lung cancer while keeping in mind the possible complication of pulmonary MAC disease is necessary. 展开更多
关键词 PULMONARY MYCOBACTERIUM AVIUM Complex (MAC) disease lung cancer Complication
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Risk of cardiovascular,cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease 被引量:58
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作者 Stefano Ballestri Amedeo Lonardo +3 位作者 Stefano Bonapace Christopher D Byrne Paola Loria Giovanni Targher 《World Journal of Gastroenterology》 SCIE CAS 2014年第7期1724-1745,共22页
Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions worldwide.Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with live... Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions worldwide.Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease(CHD),abnormalities of cardiac function and structure(e.g.,left ventricular dysfunction and hypertrophy,and heart failure),valvular heart disease(e.g.,aortic valve sclerosis)and arrhythmias(e.g.,atrial fibrillation).Experimental evidence suggests that NAFLD itself,especially in its more severe forms,exacerbates systemic/hepatic insulin resistance,causes atherogenic dyslipidemia,and releases a variety of pro-inflammatory,pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic complications.Collectively,these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic complications.The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular,cardiac and arrhythmic complications,to briefly examine the putative biological mechanisms underlying this association,and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications. 展开更多
关键词 Non-alcoholic fatty liver disease Cardiovascular disease Cardiac complications coronary heart disease Myocardial dysfunction Valvular heart disease ARRHYTHMIAS Arrhythmic complications
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Effectiveness of chest radiography,lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure 被引量:16
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作者 Luciano Cardinale Adriano Massimiliano Priola +1 位作者 Federica Moretti Giovanni Volpicelli 《World Journal of Radiology》 CAS 2014年第6期230-237,共8页
Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of... Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis. 展开更多
关键词 DYSPNEA ULTRASONOGRAPHY Emergency department lung diseases Interstitial/ultrasonography Pulmonary edema/radiography Pulmonary edema/ultrasonography heart failure/complications heart Failure/ultrasonography
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Study on the Establishment of a Rat Model for Transfusion-related Acute Lung Injury with Coronary Heart Disease and its Oxygen Balance
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作者 QIU Qi-dong QIU Xiao-lan CHEN Wei-mei 《Chinese Journal of Biomedical Engineering(English Edition)》 CAS 2022年第4期139-146,共8页
Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old ma... Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old male Wistar rats were purchased,and 35 of them were fed with high-fat diet to establish coronary heart disease rat models,and then 20 of them were selected to establish rat models of transfusion-related acute lung injury with coronary heart disease(model group,10 rats),positive acute lung injury group(positive group,5 rats)and negative acute lung injury group(negative group,5 rats),and the lung histomorphology,pathological score and wet/dry weight ratio were compared.Then,another 15 rats with coronary heart disease were selected and infused with mutant Hb,rHb1.1 and rHb2.0 with the same osmotic pressure through femoral vein catheterization,respectively,and were divided into mutant Hb group,rHb1.1 group and rHb2.0 group,with 5 rats in each group,and 5 healthy rats were combined as control group.The MAP,HR and blood gas values of mesenteric artery of rats were compared at 0,30,60 and 90 min after infusion.Results:(1)Rats in the model group and the positive group showed symptoms such as irregular and shallow breathing,increased oral and nasal secretions,and audible wheezing,which were consistent with the symptoms of acute lung injury.Comparison of lung histological score and lung tissue wet/dry ratio in three groups:There was no significant difference in lung histological score and lung tissue wet/dry ratio(P>0.05),but they were higher than those in the negative group(P<0.05).(2)During hemoglobin infusion,the MAP of mutant Hb group,rHb1.1 group and rHb2.0 group was higher than that of the control group,while the pH and PaCO2were lower than those of the control group(P<0.05),and there was no significant difference in QSMA(P>0.05).In the mutant Hb group,MAP returned to normal at 30-60 min after infusion(P>0.05),but MAP increased again at 90 min after infusion(P<0.05),and QSMA increased significantly at 60 min after transfusion(P<0.05).The pH value was lower than the normal value and the PaCO2was higher than the normal value within 90 min of infusion(P<0.05),and the HCO3-level returned to normal after 30 min of infusion(P>0.05).In rHb 1.1 group,MAP returned to normal,QSMA remained at normal level(P>0.05),and pH,PaCO2and HCO3-returned to normal after 60 min of infusion(P>0.05);In rHb 2.0 group,the levels of MAP,pH,PaCO2and HCO3-returned to normal after 30 min of infusion(P>0.05),and QSMA remained normal during infusion(P>0.05).Conclusion:The rat model of transfusion-relatted acute lung injury with coronary heart disease can be successfully established by injecting LPS into the rat model of coronary heart disease,and the infusion of recombinant hemoglobin can improve the balance of blood supply in rats,in which the infusion of rHb2.0 can better correct the metabolic acidosis. 展开更多
关键词 transfusion-related acute lung injury coronary heart disease rat model oxygen supply balance recombinant hemoglobin
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达格列净治疗糖尿病合并冠心病老年患者的效果及对心功能的影响
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作者 王智勇 饶盛环 叶文成 《中国当代医药》 CAS 2024年第8期43-46,共4页
目的探讨达格列净治疗糖尿病合并冠心病老年患者的效果及对心功能的影响。方法选取2021年7月至2022年12月抚州市第一人民医院收治的80例糖尿病合并冠心病老年患者作为研究对象,按照随机数字表法分为观察组(40例)与对照组(40例),观察组... 目的探讨达格列净治疗糖尿病合并冠心病老年患者的效果及对心功能的影响。方法选取2021年7月至2022年12月抚州市第一人民医院收治的80例糖尿病合并冠心病老年患者作为研究对象,按照随机数字表法分为观察组(40例)与对照组(40例),观察组采用达格列净治疗,对照组采用二甲双胍治疗。比较两组的治疗总有效率、氨基末端pro脑钠肽(NT-proBNP)、超敏C反应蛋白(hs-CRP)、心功能水平。结果观察组治疗后总有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后NT-proBNP水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后hs-CRP水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后左室舒张末期内径(LVEDD)低于对照组,观察组治疗后左室射血分数(LVEF)、舒张早期和舒张晚期二尖瓣口最大血流速度之比(E/A)、6 min步行距离高于对照组,差异有统计学意义(P<0.05)。结论达格列净治疗投入临床糖尿病合并冠心病老年患者治疗中,所得干预的评估结果更好。在实施治疗之后,患者的症状得到较好的改善,且NT-proBNP、hs-CRP指数减少,患者心功能水平得到一定的改善,值得被临床应用推广。 展开更多
关键词 达格列净 糖尿病合并冠心病 老年患者 心功能
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地奥心血康软胶囊联合依那普利对冠心病合并心房颤动患者血压测量波动性的影响
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作者 廖然 罗潇 陈玲 《吉林医学》 CAS 2024年第2期404-408,共5页
目的:探讨地奥心血康软胶囊联合依那普利对冠心病合并心房颤动患者血压测量波动性的影响。方法:选取2021年1月~2021年10月就诊于九江市第一人民医院的136例冠心病合并持续性非瓣膜性心房颤动患者,计算分析包括年龄、性别、合并疾病、合... 目的:探讨地奥心血康软胶囊联合依那普利对冠心病合并心房颤动患者血压测量波动性的影响。方法:选取2021年1月~2021年10月就诊于九江市第一人民医院的136例冠心病合并持续性非瓣膜性心房颤动患者,计算分析包括年龄、性别、合并疾病、合并用药等参数在内的各项因素和血压波动的相关性,并就是否联合使用地奥心血康软胶囊在管理血压波动方面的价值进行探索。结果:年龄、性别、合并疾病(高血压、糖尿病、卒中、心力衰竭、高脂血症)、合并用药[血管紧张素转化酶抑制剂(ACEI)、血管紧张素受体拮抗剂(ARB)、β受体阻滞剂、钙离子通道阻滞剂(CCB)、利尿剂、抗凝药、抗血小板药、他汀]与基线水平血压波动之间的相关性差异无统计学意义(P>0.05);在将计算血压波动结点值设置为“6 mmHg”这一前提下,总体研究对象的血压波动达标率为29.4%,联药组在随访过程中的血压波动达标率呈逐渐上升趋势,单药组的血压波动达标率也呈现了波动性,单药组对应时间节点的血压波动达标率较之于联药组均偏低。结论:地奥心血康软胶囊与血压管理具有良好的相关性且能够降低血压的波动性,可以考虑联合依那普利作为降压控压方案。 展开更多
关键词 地奥心血康软胶囊 冠心病合并房颤 血压测量 波动性 新型降压方案
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正念减压疗法在支架植入术治疗晚期肝癌合并冠心病患者中的应用效果
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作者 田书亚 王瑞涛 余阳 《癌症进展》 2024年第13期1448-1450,1469,共4页
目的探讨正念减压疗法(MBSR)在支架植入术治疗晚期肝癌合并冠心病患者中的应用效果。方法根据干预方法的不同将90例晚期肝癌合并冠心病患者分为对照组(n=48)和MBSR组(n=42),对照组患者采取常规干预,MBSR组患者在对照组的基础上采取MBSR... 目的探讨正念减压疗法(MBSR)在支架植入术治疗晚期肝癌合并冠心病患者中的应用效果。方法根据干预方法的不同将90例晚期肝癌合并冠心病患者分为对照组(n=48)和MBSR组(n=42),对照组患者采取常规干预,MBSR组患者在对照组的基础上采取MBSR干预。比较两组患者的自我感受负担[自我感受负担量表(SPBS)]、生活质量[肝病患者生命质量测定量表(LDQOL)]及心血管不良事件发生情况。结果干预后,两组患者SPBS各维度评分均低于本组干预前,MBSR组患者SPBS各维度评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者LDQOL各维度评分均高于本组干预前,MBSR组患者LDQOL各维度评分均高于对照组,差异均有统计学意义(P﹤0.05)。术后3个月,MBSR组患者心血管不良事件总发生率低于对照组,差异有统计学意义(P﹤0.05)。结论MBSR应用于支架植入术治疗的晚期肝癌合并冠心病患者,可降低自我感受负担,提高生活质量,减少心血管不良事件。 展开更多
关键词 正念减压疗法 晚期肝癌 冠心病 支架植入术 自我感受负担 生活质量
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疼痛管理联合加速康复外科理念在肺癌合并冠心病患者围手术期的应用效果
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作者 李慧 宫盼盼 赵丽慧 《癌症进展》 2024年第16期1829-1832,共4页
目的探讨疼痛管理联合加速康复外科理念在肺癌合并冠心病患者围手术期的应用效果。方法根据干预方式的不同将62例肺癌合并冠心病手术患者分为观察组(n=33)和对照组(n=29),对照组患者围手术期给予常规干预,观察组患者在对照组的基础上给... 目的探讨疼痛管理联合加速康复外科理念在肺癌合并冠心病患者围手术期的应用效果。方法根据干预方式的不同将62例肺癌合并冠心病手术患者分为观察组(n=33)和对照组(n=29),对照组患者围手术期给予常规干预,观察组患者在对照组的基础上给予疼痛管理联合加速康复外科理念。比较两组患者的围手术期指标、疼痛情况[视觉模拟评分法(VAS)]、负性情绪[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]及术后并发症发生情况。结果观察组患者首次排气时间、首次排便时间、引流管拔除时间、住院时间均短于对照组,术后并发症总发生率低于对照组,差异均有统计学意义(P﹤0.05)。术后1天、3天、1周,两组患者VAS评分均呈下降趋势,且观察组患者VAS评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者HAMA、HAMD评分均低于本组干预前,观察组患者HAMA、HAMD评分均低于对照组,差异均有统计学意义(P﹤0.05)。结论疼痛管理联合加速康复外科理念应用于肺癌合并冠心病患者围手术期,能够减轻术后疼痛、改善负性情绪、降低术后并发症发生率,并且促进患者术后恢复。 展开更多
关键词 疼痛管理 加速康复外科理念 肺癌合并冠心病 围手术期
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腹腔镜下胃癌根治术和内镜黏膜下剥离术治疗早期胃癌合并冠心病患者的效果比较
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作者 朱琳 张毅 《癌症进展》 2024年第13期1504-1508,共5页
目的比较腹腔镜下胃癌根治术(LRG)和内镜黏膜下剥离术(ESD)治疗早期胃癌合并冠心病患者的效果。方法根据治疗方式的不同将98例早期胃癌合并冠心病患者分为LRG组(n=47,LRG治疗)和ESD组(n=51,ESD治疗),比较两组患者的围手术期指标、疼痛情... 目的比较腹腔镜下胃癌根治术(LRG)和内镜黏膜下剥离术(ESD)治疗早期胃癌合并冠心病患者的效果。方法根据治疗方式的不同将98例早期胃癌合并冠心病患者分为LRG组(n=47,LRG治疗)和ESD组(n=51,ESD治疗),比较两组患者的围手术期指标、疼痛情况[视觉模拟评分法(VAS)]、心功能指标[肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白(ⅠcTnⅠ)、左室射血分数(LVEF)、心脏指数(CI)、心排血量(CO)]、应激反应指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)、肾上腺素(EP)]以及术后心脏并发症发生情况。结果ESD组患者手术时间、首次排气时间、胃管拔除时间、进食恢复时间、住院时间均短于LRG组,术中出血量少于LRG组,术后心脏并发症总发生率低于LRG组,差异均有统计学意义(P﹤0.05)。术后6 h、1天、3天、7天,两组患者VAS评分均低于本组术前,ESD组患者VAS评分均低于LGR组,差异均有统计学意义(P﹤0.05)。术后12 h,两组患者CK-MB、cTnⅠ、hs-CRP、TNF-α、IL-6、Cor、ACTH、EP均高于本组术前,LRG组患者LVEF、CI、CO均低于本组术前,ESD组患者CK-MB、cTnⅠ、hs-CRP、TNF-α、IL-6、Cor、ACTH、EP均低于LRG组,LVEF、CI、CO均高于LRG组,差异均有统计学意义(P﹤0.05)。结论与LRG比较,ESD治疗早期胃癌合并冠心病患者的安全性高、手术时间短、术中出血量少、手术创伤小、术后疼痛程度轻,因此患者术后应激反应更轻,对患者心功能的不良影响更小,术后恢复更快。 展开更多
关键词 早期胃癌 冠心病 腹腔镜下胃癌根治术 内镜黏膜下剥离术 效果
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基于隐结构模型探讨冠心病合并高血压糖尿病患者中医证候特征 被引量:2
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作者 肖欣昂 李洁韵 +3 位作者 夏雨墨 许朝霞 林洁琪 王忆勤 《中国中医药信息杂志》 CAS CSCD 2024年第7期141-147,共7页
目的基于隐结构模型探讨冠心病合并高血压糖尿病患者的中医证候特征。方法采用多中心横断面研究的方法,使用本课题组研制的《冠心病中医四诊采集量表》收集患者中医四诊信息,建立临床数据库。结合频次分析和专家意见筛选四诊信息构建隐... 目的基于隐结构模型探讨冠心病合并高血压糖尿病患者的中医证候特征。方法采用多中心横断面研究的方法,使用本课题组研制的《冠心病中医四诊采集量表》收集患者中医四诊信息,建立临床数据库。结合频次分析和专家意见筛选四诊信息构建隐结构模型。结果共收集冠心病合并高血压糖尿病患者702例,筛选得到高频四诊症状40个,隐结构模型分析得到18个隐变量,模型贝叶斯信息准则评分为-17604.38。对模型中隐变量进行综合聚类,发现冠心病合并高血压糖尿病患者病位证素主要有心、肝、肾等,病性证素主要有气虚、阴虚、气滞、痰浊、血瘀等,归纳其证型主要有痰瘀互结证、脾肾阳虚证、肝郁气滞证、肝肾阴虚证、湿热内蕴证5类,并提示各证型与四诊信息间的互信息及信息覆盖度。结论隐结构模型分析可为冠心病合并高血压糖尿病患者的证候分类提供一定的定性定量依据。 展开更多
关键词 冠心病 合并病 隐结构模型 证候特征
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冠心病合并2型糖尿病患者血清HMGB1、hs-CRP与冠状动脉病变的相关性研究 被引量:1
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作者 吴蓉 邓云霞 唐湘宇 《现代医药卫生》 2024年第12期2007-2012,共6页
目的 探讨冠心病合并2型糖尿病(CDM)患者血清高迁移率族蛋白B1(HMGB1)、超敏C反应蛋白(hs-CRP)水平与冠状动脉(冠脉)病变的相关性。方法 选取2021年6月至2022年9月在该院心内科住院行冠脉造影患者309例作为研究对象。根据是否诊断为冠... 目的 探讨冠心病合并2型糖尿病(CDM)患者血清高迁移率族蛋白B1(HMGB1)、超敏C反应蛋白(hs-CRP)水平与冠状动脉(冠脉)病变的相关性。方法 选取2021年6月至2022年9月在该院心内科住院行冠脉造影患者309例作为研究对象。根据是否诊断为冠心病、T2DM分为对照组[无冠心病及2型糖尿病(T2DM),82例]、冠心病组(75例)、T2DM组(50例)和CDM组(102例)。比较4组患者生化指标[包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等]及HMGB1、hs-CRP水平的差异。根据不同冠脉造影SYNTAX评分将CDM组分为低分组(<22分,29例)、中分组(22~33分,35例)和高分组(>33分,38例)。比较3组不同SYNTAX评分CDM患者HMGB1、hs-CRP水平,并分析其与冠脉病变的相关性。结果 4组患者性别、年龄、吸烟史、高血压病史、体重指数比较,差异均无统计学意义(P>0.05);CDM组患者TG、TC、LDL-C、hs-CRP、HMGB1水平均明显高于冠心病组、T2DM组及对照组,HDL-C水平均明显低于冠心病组、T2DM组及对照组,差异均有统计学意义(P<0.05)。3组不同SYNTAX评分CDM患者性别、年龄、吸烟史、高血压病史、体重指数比较,差异均无统计学意义(P>0.05);高分组患者TG、TC、LDL-C、HMGB1、hs-CRP水平均明显高于中分组及低分组,HDL-C水平均明显低于中分组及低分组,差异均有统计学意义(P<0.05)。HMGB1、hs-CRP水平与SYNTAX评分均呈正相关[相关系数(r)=0.455、0.449,P<0.05]。HMGB1与hs-CRP也呈正相关(r=0.282,P<0.05)。HMGB1、hs-CRP联合诊断CDM患者冠脉病变程度的受试者工作特征曲线下面积(0.873)均明显大于HMGB1、hs-CRP单独检测(分别为0.848、0.725)。结论 CDM患者体内存在更为严重的脂代谢紊乱与复杂的炎症反应,可能加速了冠脉病变的进展。CDM患者HMGB1、hs-CRP水平与SYNTAX评分均呈正相关,且二者联合检测可能对CDM患者冠脉病变的预测及诊断价值更高。 展开更多
关键词 冠心病 2型糖尿病 合并症 炎症因子 SYNTAX评分
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中医药治疗糖尿病合并冠心病研究进展 被引量:1
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作者 梁晶晶 李小娟 《中国中医药现代远程教育》 2024年第10期164-167,共4页
糖尿病合并冠心病在糖尿病合并心血管疾病中最为多见,发病率高,严重危害人们的健康,有效应对糖尿病合并冠心病发生发展意义重大。现代医学治疗糖尿病合并冠心病存在一系列的弊端,而中医药能够进行有效治疗。文章通过分析近年来中医药治... 糖尿病合并冠心病在糖尿病合并心血管疾病中最为多见,发病率高,严重危害人们的健康,有效应对糖尿病合并冠心病发生发展意义重大。现代医学治疗糖尿病合并冠心病存在一系列的弊端,而中医药能够进行有效治疗。文章通过分析近年来中医药治疗糖尿病合并冠心病的文献,为中医药治疗此病的临床应用及深入研究提供依据。 展开更多
关键词 消渴 糖尿病 胸痹 冠心病 并发症 中医药疗法 综述
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基于“诸气膹郁,皆属于肺”理论探讨冠心病合并焦虑抑郁的辨治
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作者 周凌风 牛增辉 +4 位作者 付莹坤 王佳丽 崔美玉 雷燕 杨静 《辽宁中医杂志》 CAS 北大核心 2024年第10期47-50,共4页
基于《黄帝内经》“诸气膹郁,皆属于肺”探讨治疗冠心病合并焦虑抑郁的思路与方法。通过分别探究冠心病(胸痹)、焦虑抑郁(郁证)等病因,认为冠心病合并抑郁焦虑的病因应为“气机失调,气血失和”。故通过中医学整体辨证论治可分为“气滞... 基于《黄帝内经》“诸气膹郁,皆属于肺”探讨治疗冠心病合并焦虑抑郁的思路与方法。通过分别探究冠心病(胸痹)、焦虑抑郁(郁证)等病因,认为冠心病合并抑郁焦虑的病因应为“气机失调,气血失和”。故通过中医学整体辨证论治可分为“气滞血瘀证、气虚血瘀证、痰阻心脉证、气阴两虚证”四种主要证型,均以“肺—气主攻之”的治疗思路,分别提出“宣肺理气、补益肺气、温肺化饮、益肺养阴”等四种主要治法,以期为指导临床应用提供诊疗思路和方法。 展开更多
关键词 焦虑抑郁 冠心病 黄帝内经 脏腑辨证
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黄芪治疗糖尿病合并冠心病的作用机制探讨 被引量:1
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作者 张瑞林 郑曙琴 《中医药临床杂志》 2024年第5期918-924,共7页
目的:运用网络药理学分析方法探究黄芪治疗糖尿病合并冠心病的可能性作用靶点以及其作用机制。方法:借助TCMSP平台及Uniprot数据库检索筛选黄芪的活性成分及其相应靶点;在GeneCards数据库、OMIM数据库中检索糖尿病合并冠心病的疾病靶点... 目的:运用网络药理学分析方法探究黄芪治疗糖尿病合并冠心病的可能性作用靶点以及其作用机制。方法:借助TCMSP平台及Uniprot数据库检索筛选黄芪的活性成分及其相应靶点;在GeneCards数据库、OMIM数据库中检索糖尿病合并冠心病的疾病靶点,通过Cytoscape 3.9.1得到黄芪-活性成分-靶基因的可视化网络图;将疾病与药物对应靶点共同提交Venny2.1.0生成相交靶点,并通过蛋白质相互作用(STRING)平台构建蛋白质相互作用(PPI)网络。基于Metascape 3.9.1数据库进行GO富集分析和KEGG通路富集分析明确可能涉及到的生物进程及信号通路。最后应用分子对接技术对上述猜想进行粗浅验证。结果:共获取黄芪的关键化合物17个,对应靶点195个,疾病相关靶点3815个,导入Venny2.1.0中生成163个交集靶点。富集分析结果表明:黄芪治疗糖尿病合并冠心病主要涉及激素反应(response to hormone)、细胞有机循环化合物反应(cellular response to organic cyclic compound)、细胞脂质反应(cellular response to lipid)、无机物反应(response to inorganic substance)等生物进程;可能涉及到癌症通路(Pathways in cancer)、脂质及动脉硬化通路(Lipid and atheroscierosis)、糖尿病并发症中的AGE-RAGE信号通路(AGE-RAGE signaling pathway in diabetic complications)、P13K-AKT信号通路(P13K-AKt signaling pathway)等信号通路。分子对接结果提示药物活性分子与核心靶点有较好的结合。结论:该研究揭示了黄芪在机体内可能参与抑制胰岛素抵抗、糖脂代谢调控等众多生物进程,以多成分、多靶点、多通路实现对糖尿病合并冠心病的治疗作用。 展开更多
关键词 黄芪 糖尿病合并冠心病 网络药理学
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右美托咪定联合艾司氯胺酮麻醉在冠心病非心脏手术中效果研究
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作者 汪东升 张从利 +2 位作者 张阳 庄芹 李晓红 《沈阳医学院学报》 2024年第3期261-266,共6页
目的:分析右美托咪定联合艾司氯胺酮麻醉对冠心病非心脏手术效果及对患者血流动力学、应激反应与术后并发症的影响。方法:选取2021年10月至2022年11月在我院拟行腔镜下腹部手术治疗的106例冠心病患者为研究对象,将其随机分为对照组和观... 目的:分析右美托咪定联合艾司氯胺酮麻醉对冠心病非心脏手术效果及对患者血流动力学、应激反应与术后并发症的影响。方法:选取2021年10月至2022年11月在我院拟行腔镜下腹部手术治疗的106例冠心病患者为研究对象,将其随机分为对照组和观察组,各53例,均行常规手术治疗。对照组麻醉药物选用右美托咪定,观察组选用右美托咪定联合艾司氯胺酮麻醉,对比2组患者手术指标、术后并发症与不同时点呼吸频率(RR)、心率(HR)、舒张压(DBP)、收缩压(SBP)、疼痛视觉模拟评分(VAS)、Ramsay镇静评分、超氧化物歧化酶(SOD)、丙二醛(MDA)、皮质醇(Cor)、血糖(GLU)水平。结果:2组患者的手术时间差异无统计学意义(P>0.05),但观察组术后舒芬太尼用量低于对照组、有效按压次数高于对照组(P<0.05)。术后12 h,2组VAS评分、Ramsay镇静评分比较差异均无统计学意义(P>0.05),术后4、8h观察组VAS评分、Ramsay镇静评分均优于对照组(P<0.05)。2组患者术后4h的MDA、GLU、Cor水平均升高,SOD水平均降低(P<0.05),且术后4h观察组SOD水平高于对照组,MDA、GLU、Cor水平均低于对照组(P<0.05)。麻醉前,2组血流动力学指标差异均无统计学意义(P>0.05);与麻醉前相比,2组术毕、术后24 h的HR、SBP、DBP、RR均存在改变(P<0.05),但观察组术毕、术后24 h的HR、SBP、DBP、RR均优于对照组(P<0.05)。观察组的术后并发症发生率低于对照组(P<0.05)。结论:右美托咪定联合艾司氯胺酮能够有效稳定患者的血流动力学,降低患者术后应激反应,并减少术后并发症的发生。 展开更多
关键词 右美托咪定 艾司氯胺酮 冠心病 血流动力学 应激反应 并发症
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