目的:同型半胱氨酸(homocysteine,Hcy)与非创伤性股骨头坏死(non-traumatic osteonecrosis of the femoral head,NONFH)发病机制密切相关,然而叶酸和维生素B12(vitamin B12,B12)作为Hcy代谢的重要辅助因子,与NONFH之间的关系尚不清楚。...目的:同型半胱氨酸(homocysteine,Hcy)与非创伤性股骨头坏死(non-traumatic osteonecrosis of the femoral head,NONFH)发病机制密切相关,然而叶酸和维生素B12(vitamin B12,B12)作为Hcy代谢的重要辅助因子,与NONFH之间的关系尚不清楚。本研究旨在探讨血清Hcy、叶酸及B12水平在NONFH疾病进展中的临床价值。方法:选取2019年4月至2022年3月大连大学附属中山医院收治的83例NONFH患者(NONFH组)和58例健康体检者(对照组)作为研究对象,检测2组血清中Hcy、叶酸及B12水平,分析评估各项指标之间及其与国际骨循环研究会(International Society for Researchon the Bone Circulation,ARCO)分期的相关性。采用受试者操作特征(receiver operator characteristic,ROC)曲线评估各项指标对股骨头塌陷的预测价值。结果:与对照组相比,NONFH组血清Hcy水平显著升高,叶酸和B12水平显著降低,差异均有统计学意义(均P<0.05)。Spearman相关性分析表明:血清Hcy水平与NONFH患者ARCO分期呈正相关(r=0.532,P<0.05),血清叶酸、B12水平与ARCO分期呈负相关(r=-0.432、r=-0.483,均P<0.05)。ROC曲线结果表明:Hcy、叶酸和B12及三者联合检测的曲线下面积(area under the curve,AUC)对NONFH股骨头塌陷的预测价值分别为0.800、0.731、0.741、0.869。结论:血清Hcy、叶酸及B12水平与NONFH患者疾病进展之间有相关性,三者联合检测对NONFH股骨头塌陷的预测价值较高。展开更多
Atrial fibrillation(AF)is the most common arrhythmia in elderly population,with age being one of the most important factors involved in its pathogenesis.Conduction disturbances may be present on the surface electrocar...Atrial fibrillation(AF)is the most common arrhythmia in elderly population,with age being one of the most important factors involved in its pathogenesis.Conduction disturbances may be present on the surface electrocardiogram before AF onset in some patients.Once this arrhythmia is diagnosed,antithrombotic therapy is mandatory in most cases,as this is the only treatment that has demonstrated to improve survival.Age increases both the risk of thromboembolic and bleeding complications,while benefits from anticoagulant therapy outweigh that from bleeding in most scenarios,also in very elderly patients.However,elderly patients with AF are often undertreated.Non-vitamin K antagonist oral anticoagulants have emerged as an alternative to vitamin K antagonists,with significant less adverse events and better profile in terms of efficacy and safety.Other conditions related to age should be carefully evaluated in these patients(including frailty,comorbidity and polypharmacy)to ensure an individualized clinical and therapeutic approach.展开更多
文摘目的:同型半胱氨酸(homocysteine,Hcy)与非创伤性股骨头坏死(non-traumatic osteonecrosis of the femoral head,NONFH)发病机制密切相关,然而叶酸和维生素B12(vitamin B12,B12)作为Hcy代谢的重要辅助因子,与NONFH之间的关系尚不清楚。本研究旨在探讨血清Hcy、叶酸及B12水平在NONFH疾病进展中的临床价值。方法:选取2019年4月至2022年3月大连大学附属中山医院收治的83例NONFH患者(NONFH组)和58例健康体检者(对照组)作为研究对象,检测2组血清中Hcy、叶酸及B12水平,分析评估各项指标之间及其与国际骨循环研究会(International Society for Researchon the Bone Circulation,ARCO)分期的相关性。采用受试者操作特征(receiver operator characteristic,ROC)曲线评估各项指标对股骨头塌陷的预测价值。结果:与对照组相比,NONFH组血清Hcy水平显著升高,叶酸和B12水平显著降低,差异均有统计学意义(均P<0.05)。Spearman相关性分析表明:血清Hcy水平与NONFH患者ARCO分期呈正相关(r=0.532,P<0.05),血清叶酸、B12水平与ARCO分期呈负相关(r=-0.432、r=-0.483,均P<0.05)。ROC曲线结果表明:Hcy、叶酸和B12及三者联合检测的曲线下面积(area under the curve,AUC)对NONFH股骨头塌陷的预测价值分别为0.800、0.731、0.741、0.869。结论:血清Hcy、叶酸及B12水平与NONFH患者疾病进展之间有相关性,三者联合检测对NONFH股骨头塌陷的预测价值较高。
文摘Atrial fibrillation(AF)is the most common arrhythmia in elderly population,with age being one of the most important factors involved in its pathogenesis.Conduction disturbances may be present on the surface electrocardiogram before AF onset in some patients.Once this arrhythmia is diagnosed,antithrombotic therapy is mandatory in most cases,as this is the only treatment that has demonstrated to improve survival.Age increases both the risk of thromboembolic and bleeding complications,while benefits from anticoagulant therapy outweigh that from bleeding in most scenarios,also in very elderly patients.However,elderly patients with AF are often undertreated.Non-vitamin K antagonist oral anticoagulants have emerged as an alternative to vitamin K antagonists,with significant less adverse events and better profile in terms of efficacy and safety.Other conditions related to age should be carefully evaluated in these patients(including frailty,comorbidity and polypharmacy)to ensure an individualized clinical and therapeutic approach.
