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Assessment of a Sudden Death Case due to Coronary Artery Disease Based on the PMCT and Forensic Autopsy 被引量:3
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作者 WAN Lei ZHANG Jian-hua +3 位作者 HUANG Ping YING Chong-liang LIU Ning-guo ZHU Guang-you 《法医学杂志》 CAS CSCD 2012年第5期379-382,共4页
It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography(PMCT).This article reported a case of sudden natural death after the complaint of anterior c... It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography(PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification(CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation(MPR) and volume-rendering reconstruction(VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous;the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity(GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure. 展开更多
关键词 医学研究 法医 医疗卫生行业 医疗工作者
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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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Sudden Cardiac Death in Adult Patients with Stable Ischemic Heart Disease
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作者 C.Richard Conti 《Cardiovascular Innovations and Applications》 2019年第B01期317-319,共3页
There are approximately one half million patients with stable ischemic heart disease(SIHD)in the United States.Patients with stable ischemic heart disease who die suddenly do not maintain a Stable Ischemic profi le.Be... There are approximately one half million patients with stable ischemic heart disease(SIHD)in the United States.Patients with stable ischemic heart disease who die suddenly do not maintain a Stable Ischemic profi le.Benchimol,et al.,reported 319 consecutive stable angina patients without clinical heart failure or a recent myocardial infarction but who had multiple risk factors and proven coronary disease which made them more prone to acute myocardial infarction or unstable angina.In the APSIS(angina prognosis in Stockholm)study,Hjemdahl reported that signs of ischemia or previous manifestations of coronary artery disease,i.e.,myocardial infarction or revascularization,were found in 69%of both male and female patients at baseline.Little,retrospectively reported that minor plaques may disrupt and result in unstable angina or occlusive coronary disease which then may result in acute myocardial infarction.Stable angina patients,by defi nition,are stable and are not high risk unless they have multiple factors or which may make them prone to evolve an acute coronary syndrome or develop a serious arrhythmia but sudden death does occur in some patients. 展开更多
关键词 STABLE ISCHEMIC heart disease sudden CARDIAC death STABLE ANGINA
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Effect of programmed cell death factor 4 on the severity of coronary heart disease and coronary artery disease with blood stasis and toxin
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作者 Meng-Xian Hu Gui-Xin He +5 位作者 Dong-Mei Yuan Yu-Fei Feng Wei-Bin Qin Ming-Yuan Wang Guo-Kun Zheng Zi-Yong Jia 《Journal of Hainan Medical University》 2021年第19期27-32,共6页
Objective:To explore the diagnostic value of PDCD4 on the degree of arterial stenosis in"blood stasis"coronary heart disease.Methods:Select 80 patients with coronary heart disease in the Second Cardiovascula... Objective:To explore the diagnostic value of PDCD4 on the degree of arterial stenosis in"blood stasis"coronary heart disease.Methods:Select 80 patients with coronary heart disease in the Second Cardiovascular Zone of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine in April 2020,and divide them into the"phlegm toxin"group(n=40)and the"phlegm stasis"group(n=40)based on the dialectics of traditional Chinese medicine.).Record the gender,age,smoking,and alcohol consumption of the subjects between the two groups,and detect their white blood cell count,neutrophil count,platelet count,platelet volume,platelet distribution width,blood creatinine,uric acid,cystatin,and fibrin The expression levels of original,high-sensitivity C-reactive protein,D-dimer,total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein,apolipoprotein a,apolipoprotein b,and PDCD4.Multivariate logistic regression analysis was used to screen out the risk factors that affect coronary plaque formation,and the receiver operating characteristic(ROC)curve of each index was established to evaluate the severity of coronary stenosis in patients with stasis coronary heart disease by each index and combined index Diagnostic efficiency.Results:The two groups of patients were tested in terms of gender,age,smoking,drinking,triglycerides,cholesterol,high-density lipoprotein,low-density lipoprotein,apolipoprotein-a,apolipoprotein-b,white blood cell count,neutrophil The cell count,platelet count,platelet volume width and platelet distribution width were not statistically significant(P>0.05);the expression levels of hypersensitivity-C-reactive protein,serum creatinine,cystatin,uric acid and PDCD4 were statistically significant between the two groups Difference(P<0.05),and the corresponding hypersensitivity-C-reactive protein,creatinine,cystatin,uric acid and PDCD4 expression levels in the blood stasis group were higher than those in the phlegm blood stasis group.After multivariate logistic regression analysis,the level of PDCD4 in peripheral blood[OR=31.088,95%CI(2.498,3.869)]was an independent influencing factor of the"stagnation"type of coronary heart disease,and PDCD4 was diagnosed as the"stagnation"type of coronary heart disease The area under the ROC curve(AUC)is 88.6%,95%CI(1.894,2.532)(P=0.29);the level of PDCD4 in peripheral blood is positively correlated with the number and severity of coronary artery disease,the number of coronary artery disease and stenosis The greater the degree,the higher the detection value of PDCD4,(P<0.05).Conclusion:The expression level of PDCD4 in peripheral blood is closely related to the subtype of"stasis toxin"and the severity of coronary vascular stenosis.It can be used as a quantitative diagnostic index for the diagnosis of"stasis toxin"coronary heart disease and the severity of coronary vascular stenosis. 展开更多
关键词 Programmed death factor 4 Stasis and toxin coronary heart disease Atherosclerosis
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Assessment of Cardiac Autonomic Function by Using Heart Rate Turbulence in Behcet’s Disease 被引量:2
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作者 Onder Akci Mustafa Aldemir +4 位作者 Fatma Yaman Ozlem Solak Sadik Volkan Emren Ersel Onrat Alaeddin Avsar 《World Journal of Cardiovascular Surgery》 2014年第11期193-199,共7页
Behcet’s disease (BD) is a chronic inflammatory disorder that can affect many systems in the body. Cardiac involvement increases the risk of cardiovascular mortality and occurs in 1%-5% of patients with BD. Ventricul... Behcet’s disease (BD) is a chronic inflammatory disorder that can affect many systems in the body. Cardiac involvement increases the risk of cardiovascular mortality and occurs in 1%-5% of patients with BD. Ventricular arrythmias are believed to be the cause of this increased risk of cardiovascular mortality and it is also thought to be related with cardiac autonomic dysfunction. Heart rate turbulence (HRT) is a new predictor of cardiac autonomic activity. HRT is an independent and powerful predictor of mortality. In this study, we investigated the cardiac autonomic activity which can be determined by HRT in patients with BD. Forty patients with BD (20 men, mean age: 40 ± 9 years, range: 27-55 years) were diagnosed according to the International Study Group Criteria (ISGC) and gender and age matched healthy volunteers (20 men, mean age: 39 ± 8 years, range: 26-56 years) were included in this study. All of the participants (patients and controls) underwent 24 hours Holter electrocardiogram. HRT parameters, turbulence onset (TO) and turbulence slope (TS) were calculated with HRT (View Version 0.60-0.1 of Software Program). There were no significant differences in TO and TS values between patients with BD and control subject (TO-BD: 0.014 ± 0.03, TO-Control: 0.011 ± 0.04;TS-BD: 7.88 ± 4.9, TS-Control: 9.42 ± 6.7 respectively). Although increased cardiovascular mortality rates in BD have been shown in many studies, HRT values—detecting the risk of sudden death—do not seem to be altered in this disease. 展开更多
关键词 Behcet’s disease heart Rate Turbulence sudden Cardiac death Cardiac Autonomic Activity
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Consideration of the Necessity of Prophylactic Bypass Grafting for Anomalous Origin of the Right Coronary Artery—Based on a Case with Concomitant Left Main Trunk Disease Resuscitated from Cardiopulmonary Arrest
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作者 Hirotaro Sugiyama Keisuke Miyajima +4 位作者 Kazuyoshi Hatada Toshihiro Ishikawa Sawa Matsumoto Shigeo Umezawa Masao Takahashi 《World Journal of Cardiovascular Surgery》 2017年第6期79-85,共7页
Anomalous origin of the right coronary artery is a rare congenital anomaly, but is associated with sudden death. Originating from the opposite sinus of Valsalva, an interarterial?course and an intramural course are es... Anomalous origin of the right coronary artery is a rare congenital anomaly, but is associated with sudden death. Originating from the opposite sinus of Valsalva, an interarterial?course and an intramural course are especially considered as the risk factor for fatal cardiac events. Surgical indication remains controversial because many patients are asymptomatic. A 52-year-old man with anomalous origin of the right coronary artery with an interarterial?course concomitant with the left main trunk disease was resuscitated from cardiopulmonary arrest. It was likely to be attributed to the left main trunk disease, but anatomical structure of the right coronary artery suggests its possible involvement. Prophylactic bypass grafting for the right coronary artery was performed using saphenous vein graft without ligating native vessel to prevent future cardiac events, as well as revascularization of the left main trunk disease. All grafts were patent in one-year follow-up coronary angiography. Any cardiac event has not occurred. 展开更多
关键词 Anomalous Origin of the Right coronary Artery PROPHYLACTIC bypass Grafting Saphenous Vein Graft Left Main TRUNK disease sudden death
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Correlation of PDCD4 and telomerase expression with apoptosis molecule and interstitial molecule expression in myocardial tissue of sudden coronary death
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作者 Xu-Ting Wu Gang Chen 《Journal of Hainan Medical University》 2017年第24期21-24,共4页
Objective: To study the correlation of PDCD4 and telomerase expression with the expression of apoptosis molecules and interstitial molecules in myocardial tissue of sudden coronary death. Methods: The sudden death cas... Objective: To study the correlation of PDCD4 and telomerase expression with the expression of apoptosis molecules and interstitial molecules in myocardial tissue of sudden coronary death. Methods: The sudden death cases that underwent autopsy in the Fifth Affiliated Hospital of Southern Medical University between March 2014 and March 2017 were collected and divided into group A with sudden cardiac death of coronary heart disease, group B with sudden non-cardiac death of coronary heart disease and group C without coronary lesions according to the autopsy results and medicolegal expertise report. The myocardial tissue was collected to determine the mRNA expression of PDCD4 and telomerase as well as the protein expression of PDCD4, telomerase, apoptosis molecules and interstitial molecules. Results:The mRNA expression and protein expression of PDCD4 and telomerase in myocardial tissue of group A were significantly higher than those of group B and group C;Bax, p53 and SOCS1 protein expression in myocardial tissue of group A were higher than those in group B and group C and positively correlated with PDCD4 and telomerase protein expression whereas Bcl-2, N-cadherin, Cx40, Cx43, Cx45 and FN protein expression were lower than those of group B and group C and negatively correlated with PDCD4 and telomerase protein expression;the mRNA expression and protein expression of PDCD4 and telomerase as well as the protein expression of Bax, Bcl-2, p53, SOCS1, N-cadherin, Cx40, Cx43, Cx45 and FN in myocardial tissue were not significantly different between group B and Group C. Conclusion:The high expression of PDCD4 and telomerase is related to the sudden cardiac death of coronary heart disease, and it regulates the expression of apoptosis and interstitial molecules in myocardial tissue. 展开更多
关键词 coronary heart disease sudden cardiac death Programmed cell death 4 TELOMERASE APOPTOSIS
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ECG is not a reliable predictor of sudden cardiac death in the general population
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作者 Juliane Theilade Redi Pecini +1 位作者 Jacob L. Marott Gorm B. Jensen 《World Journal of Cardiovascular Diseases》 2013年第2期239-244,共6页
Objectives: To determine the predictive value of the ECG for sudden death in the general population. Design: In the Copenhagen City Heart Study, a randomly selected population sample in Copenhagen, Denmarkhas been fol... Objectives: To determine the predictive value of the ECG for sudden death in the general population. Design: In the Copenhagen City Heart Study, a randomly selected population sample in Copenhagen, Denmarkhas been followed prospectively since 1976. From this population sample, we analyzed ECGs of individuals who had suffered sudden cardiac death (SCD) before the age of 50 years and compared them with ECGs of a randomly selected control individuals from the same population sample. Specific ECG signs that could point toward a condition associated with a risk of SCD were noted. Results: From a total of 18,974 individuals in the cohort, 207 had died at an age younger than 50 years. Among these, 24 persons with SCD were identified. The most prevalent ECG abnormality was QRS fragmentation. We found no ECGs with long or short QTc, Brugada sign or WPW. The prevalence of signs of left ventricular hyper-trophy, early repolarization, or fragmentation was not different from the prevalence of these signs in the control group. Conclusion: In the Copenhagen City Heart Study, the ECG failed to predict SCD in persons who died before the age of 50 years. 展开更多
关键词 sudden Cardiac death ECG Predictive Value of the ECG General Population Prediction of SCD ARRHYTHMIA CARDIOMYOPATHY Ischemic heart disease Copenhagen City heart Study Prospective
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Analyses of N‑Terminal Pro‑Brain Natriuretic Peptide,Cardiac Troponin T,and Creatine Kinase MB in Pericardial Fluid in Sudden Cardiac Death Caused by Ischemic Heart Disease
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作者 Zhipeng Cao Tianqi Wang +3 位作者 Shao‑Huang Wu Zihan Liao Baoli Zhu Rui Zhao 《Journal of Forensic Science and Medicine》 2022年第4期135-141,共7页
Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden card... Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death(SCD)in previous forensic studies.Aims and Objectives:The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT‑proBNP,cTnT and CK‑MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart disease.Materials and Methods:Levels of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence method.Results:NT‑proBNP,cTnT,and CK‑MB levels were significantly elevated in SCD cases(P<0.05).Receiver‑operating characteristics(ROC)analysis showed that NT‑proBNP,cTnT,and CK‑MB have diagnostic value for the diagnosis of SCD:NT‑proBNP,cutoff value of 2236 pg/ml;cTnT,cutoff value of 199.51 ng/ml;CK‑MB:cutoff value of 2742.5 ng/ml,and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker alone.Moreover,the causes of SCD were sub‑divided into acute ischemic heart disease,acute myocardial infarction(AMI),and recurrent myocardial infarction subgroups for further analysis,which revealed that the ratio of cTnT/CK‑MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC analysis.Conclusion:These observations suggested that the postmortem biochemical analyses of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid may assist to diagnose SCD in forensic practice,and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker alone.On the basis of the postmortem biochemical analyses of NT‑proBNP,cTnT and CK‑MB,combining the ratio of cTnT/CK‑MB could be used to distinguish AMI. 展开更多
关键词 Cardiac troponin T creatine kinase MB ischemic heart disease N‑terminal pro‑brain natriuretic peptide pericardial fluid postmortem biochemistry sudden cardiac death
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Effect of Body Mass Index on All-cause Mortality and Incidence of Cardiovascular Diseases─Report for Meta-Analysis of Prospective Studies on Optimal Cut-off Points of Body Mass Index in Chinese Adults 被引量:58
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作者 ZHOU BEI-FAN 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2002年第3期245-252,共8页
Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases... Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults. 展开更多
关键词 Body mass index (BMI) All-cause mortality coronary heart disease STROKE
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Fatty liver disease:Disparate predictive ability for cardiometabolic risk and all-cause mortality 被引量:1
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作者 Altan Onat Günay Can +5 位作者 Aysem Kaya Tugba Akbas Fatma Ozpamuk-Karadeniz Baris Simsek Hakan Cakir Hüsniye Yüksel 《World Journal of Gastroenterology》 SCIE CAS 2015年第48期13555-13565,共11页
AIM: To assess the association of a surrogate of fatty liver disease(FLD) with incident type-2 diabetes, coronary heart disease, and all-cause mortality.METHODS: In a prospective population-based study on 1822 middle-... AIM: To assess the association of a surrogate of fatty liver disease(FLD) with incident type-2 diabetes, coronary heart disease, and all-cause mortality.METHODS: In a prospective population-based study on 1822 middle-aged adults, stratified to gender, we used an algorithm of fatty liver index(FLI) to identify associations with outcomes. An index ≥ 60 indicated the presence of FLD. In Cox regression models, adjusted for age, smoking status, high-density lipoprotein cholesterol, and systolic blood pressure, we assessed the predictive value of FLI for incident diabetes, coronary heart disease(CHD), and all-cause mortality.RESULTS: At a mean 8 year follow-up, 218 and 285 incident cases of diabetes and CHD, respectively, and 193 deaths were recorded. FLD was significantly associated in each gender with blood pressure, total cholesterol, apolipoprotein B, uric acid, and C-reactive protein; weakly with fasting glucose; and inversely with high-density lipoprotein-cholesterol and sex hormonebinding globulin. In adjusted Cox models, FLD was(with a 5-fold HR) the major determinant of diabetes development. Analyses further disclosed significant independent prediction of CHD by FLD in combined gender [hazard ratio(HR) = 1.72, 95% confidence interval(CI): 1.17-2.53] and men(HR = 2.35, 95%CI: 1.25-4.43). Similarly-adjusted models for all-cause mortality proved, however, not to confer risk, except for a tendency in prediabetics and diabetic women.CONCLUSION: A surrogate of FLD conferred significant high risk of diabetes and coronary heart disease, independent of some metabolic syndrome traits. Allcause mortality was not associated with FLD, except likely in the prediabetic state. Such a FLI may reliably be used in epidemiologic studies. 展开更多
关键词 All-cause death coronary heart disease Hepatic steatosis Metabolic syndrome Turkish adultrisk factor study
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Trends of Ten Leading Causes of Death in Head and Neck Squamous Cell Carcinoma
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作者 Wen-hui LIU Yi-nan LU +2 位作者 Mei-ting SUN De-heng NIE Fu-jun HAN 《Current Medical Science》 SCIE CAS 2022年第1期118-128,共11页
Objective:An understanding of the leading causes of death in patients with head and neck squamous cell carcinoma(HNSCC)would be helpful to inform doctors,patients,and healthcare providers on disease management.This st... Objective:An understanding of the leading causes of death in patients with head and neck squamous cell carcinoma(HNSCC)would be helpful to inform doctors,patients,and healthcare providers on disease management.This study aimed to comprehensively study the leading causes of death in these survivors. 展开更多
关键词 cause of death head and neck heart disease squamous cell carcinoma TREND
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2型糖尿病对冠心病伴HFpEF预后影响及因素分析
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作者 张娟 张艺 +1 位作者 张根生 赵晓宏 《青岛大学学报(医学版)》 CAS 2024年第5期714-718,共5页
目的探讨2型糖尿病(T2DM)对冠心病伴射血分数保留心力衰竭(HFpEF)病人预后影响。方法采用病例对照研究方法,选取2021年8月—2023年1月在中国人民解放军第3201医院治疗的合并T2DM的冠心病伴HFpEF病人65例为观察组,同时以年龄、性别配比1... 目的探讨2型糖尿病(T2DM)对冠心病伴射血分数保留心力衰竭(HFpEF)病人预后影响。方法采用病例对照研究方法,选取2021年8月—2023年1月在中国人民解放军第3201医院治疗的合并T2DM的冠心病伴HFpEF病人65例为观察组,同时以年龄、性别配比1∶2选取未合并T2DM的冠心病伴HFpEF病人130例为对照组,比较两组临床基线资料、实验室检查、超声心动图检查以及主要心血管不良事件(MACE)发生率等指标,分析影响MACE发生的危险因素。结果观察组血清甘油三酯(TG)、左室后壁厚度(LVPWD)和MACE发生率等均明显高于对照组(t=4.227、5.508,χ^(2)=10.543,P<0.05)。已发生MACE病人年龄、血清TG和N端脑钠肽的前体(NT-proBNP)含量及并发糖尿病构成比等均明显高于未发生者(t=4.855、5.590,Z=-3.432,χ^(2)=10.543,P<0.05)。Logistic回归分析显示,年龄(OR=2.748,95%CI=1.671~4.521)、NT-proBNP(OR=3.755,95%CI=2.025~6.962)和糖尿病(OR=2.428,95%CI=1.565~3.766)等变量是影响冠心病伴HFpEF病人发生MACE的危险因素(P<0.05)。结论T2DM并发冠心病伴HFpEF病人MACE发生率显著升高,T2DM是影响冠心病伴HFpEF病人不良预后的风险因素,临床应早期干预以降低MACE的发生。 展开更多
关键词 冠心病 糖尿病 2型 心力衰竭 心排血量 预后 影响因素分析
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不稳定冠状动脉粥样斑块病理特征及分类 被引量:1
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作者 邢运虹 李洋 +6 位作者 王文政 王亮亮 孙乐乐 杜秋香 曹洁 何光龙 孙俊红 《法医学杂志》 CAS CSCD 北大核心 2024年第1期59-63,共5页
冠状动脉粥样硬化性心脏病猝死的法医学重要诊断指标如急性或慢性心肌缺血改变,有时由于死亡过程短暂、组织缺少反应时间,使得缺血部位定位困难,部分案件中死者首次发病即猝死,导致法医难以准确作出诊断。然而临床医学对于冠状动脉不稳... 冠状动脉粥样硬化性心脏病猝死的法医学重要诊断指标如急性或慢性心肌缺血改变,有时由于死亡过程短暂、组织缺少反应时间,使得缺血部位定位困难,部分案件中死者首次发病即猝死,导致法医难以准确作出诊断。然而临床医学对于冠状动脉不稳定斑块的研究揭示了其病变引发的冠状动脉痉挛、血栓形成在冠心病猝死过程中所起的关键作用。本文主要归纳整理了基于临床医学研究的不稳定冠状动脉粥样斑块的病理特征,包括斑块破裂、斑块侵蚀和钙化结节,以及导致斑块不稳定的影响因素,并简述粥样斑块研究进展与研究技术方法,以期通过诊断冠状动脉粥样斑块的不同病理状态,完善冠心病猝死死亡机制研究,提高冠心病猝死法医学诊断的准确性。 展开更多
关键词 法医病理学 心脏性猝死 冠状动脉粥样硬化性心脏病 粥样斑块 病理特征 综述
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纤维蛋白原与红细胞计数比值对经皮冠状动脉介入治疗合并糖尿病的冠心病患者死亡的预测价值
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作者 马清玉 马艺萍 +3 位作者 袁玉娟 帕丽达·玉山江 尼格热·阿力木 穆叶赛·尼加提 《新疆医学》 2024年第5期541-545,共5页
目的探讨基线纤维蛋白原与红细胞计数比值(FRR)对经皮冠状动脉介入治疗(PCI)合并糖尿病的冠心病(CHD)患者死亡的预测价值。方法本研究回顾性纳入1027例行PCI治疗的CHD合并糖尿病患者。其中,排除基线资料不全以及失访的患者,最终纳入990... 目的探讨基线纤维蛋白原与红细胞计数比值(FRR)对经皮冠状动脉介入治疗(PCI)合并糖尿病的冠心病(CHD)患者死亡的预测价值。方法本研究回顾性纳入1027例行PCI治疗的CHD合并糖尿病患者。其中,排除基线资料不全以及失访的患者,最终纳入990例。终点事件是全因死亡,平均随访时间为35.1±26.2个月。根据FRR中位数分为2组:低组(FRR<0.666;n=495)和高组(FRR≥0.666;n=495)。利用多元Cox比例风险模型,我们对FRR在追踪期间预测结果的价值进行了评估,并通过Kaplan-Meier方法执行了生存率分析。结果两组间性别、吸烟、饮酒、PT、DBIL、TP、TBIL、ALB和GLO等差异有统计学意义(P<0.05)。高FRR组的死亡率明显高于低FRR组(P=0.001)。多因素Cox比例风险模型,FRR是死亡事件的独立预测因子(校正后的HR为5.740[1.916-17.196],P=0.002)。受试者工作特征曲线(ROC)示,FRR、FIB和RBC的曲线下面积分别为0.658、0.616和0.377。通过结合多因素Cox比例风险模型和生存曲线分析,结果显示,两组间的生存差异显著(P<0.05)。结论FRR与死亡独立相关,并可作为PCI术后CHD合并糖尿病患者不良预后的独立预测因子。 展开更多
关键词 纤维蛋白原 红细胞计数 冠心病 糖尿病 死亡
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终末期肾脏病患者血清FGF23与心衰及死亡发生风险的前瞻性队列研究
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作者 王晓霞 周昕源 +5 位作者 杨相杰 周润哲 孟雨晴 张定欣 张瑾 王盈 《安徽医科大学学报》 CAS 北大核心 2024年第5期874-880,共7页
目的探讨终末期肾脏病(ESRD)患者成纤维细胞生长因子-23(FGF23)血清浓度与心力衰竭及全因死亡的相关性。方法采用前瞻性队列研究,纳入医院肾脏内科收治的无心衰症状的ESRD患者,采用基线问卷和体格检查、超声心动图检查、实验室检查收集... 目的探讨终末期肾脏病(ESRD)患者成纤维细胞生长因子-23(FGF23)血清浓度与心力衰竭及全因死亡的相关性。方法采用前瞻性队列研究,纳入医院肾脏内科收治的无心衰症状的ESRD患者,采用基线问卷和体格检查、超声心动图检查、实验室检查收集患者数据,采用酶联免疫吸附法(ELISA)检测患者血清FGF23浓度。随访时间2年,以随访发生新发的心力衰竭(ACC/AHA stage C-D)和全因死亡为复合终点结局事件,采用Cox比例风险模型分析患者发生结局事件的危险因素,通过亚组分析和交互作用分析,进一步探讨FGF23与结局事件的关联在不同亚组中是否存在异质性。结果该研究最终纳入ESRD患者107例,平均年龄(52.00±12.51)岁,男性39(36.45%)例,中位随访时间为23个月(21,25个月),出现结局事件32(29.9%)例,其中新发心衰22(20.6%)例,全因死亡10(9.3%)例。该研究结果显示结局事件组患者血清FGF23浓度显著高于非事件组[(4.40±1.16)pmol/ml vs(3.85±0.82)pmol/ml,P<0.05]。Cox比例风险模型结果显示升高的FGF23可以增加ESRD患者发生结局事件的风险(HR=1.730,95%CI:1.164~2.570,P=0.007)。亚组分析显示FGF23水平与性别对于结局事件发生风险存在交互作用,尤其在男性ESRD患者中升高的FGF23风险更高(P_(-交互作用)<0.05)。结论升高的血清FGF23是ESRD患者发生心衰和全因死亡的独立危险因素,尤其在男性患者中风险更高。 展开更多
关键词 终末期肾脏病 血清成纤维细胞生长因子-23 心力衰竭 全因死亡 前瞻性队列研究
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基于心肺运动试验康复方案对冠心病慢性心衰患者心肺功能及生活质量的影响 被引量:3
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作者 王丽媛 朱伟宁 姜坤 《中国医药科学》 2024年第8期148-151,194,共5页
目的探讨基于心肺运动试验(CPET)康复方案对冠心病慢性心衰患者心肺功能及生活质量的影响。方法选取2021年6月至2022年6月威海市中医院收治的60例冠心病慢性心衰患者进行回顾性分析,按康复方案不同分为两组,每组各30例。对照组给予常规... 目的探讨基于心肺运动试验(CPET)康复方案对冠心病慢性心衰患者心肺功能及生活质量的影响。方法选取2021年6月至2022年6月威海市中医院收治的60例冠心病慢性心衰患者进行回顾性分析,按康复方案不同分为两组,每组各30例。对照组给予常规康复运动方案;干预组以CPET测试为基础制订康复方案。干预12周,比较两组患者干预前及干预后4、8、12周的心肺功能、生活质量评分、心血管事件。结果干预前两组心肺功能、生活质量量表(SF-36)评分比较,差异无统计学意义(P>0.05);干预后4、8、12周,干预组6分钟步行试验(6MWT)距离、左心室射血分数(LVEF)、峰值摄氧量(PeakVO2/kg)、SF-36评分高于对照组,代谢当量(METs)、脑钠肽前体(ProBNP)水平、超敏C反应蛋白(hs-CRP)水平低于对照组,差异有统计学意义(P<0.05)。干预组不良心血管事件发生率低于对照组,差异有统计学意义(χ^(2)=8.477,P=0.004)。结论基于CEPT为核心的康复方案能够促进冠心病慢性心衰患者心功能恢复,增强其运动能力,提高生活质量,降低不良心血管事件发生风险。 展开更多
关键词 心肺运动试验 冠心病慢性心衰 心肺功能 生活质量
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麝香保心丸对冠心病心绞痛患者冠脉血流及心率变异性的影响
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作者 王康力 《中外医学研究》 2024年第32期41-45,共5页
目的:探究麝香保心丸对冠心病心绞痛患者冠脉血流及心率变异性的影响。方法:选取2021年11月-2023年6月常州市第三人民医院收治的110例冠心病心绞痛患者。根据随机数表法将其分为对照组(55例)和观察组(55例)。对照组给予常规冠心病心绞... 目的:探究麝香保心丸对冠心病心绞痛患者冠脉血流及心率变异性的影响。方法:选取2021年11月-2023年6月常州市第三人民医院收治的110例冠心病心绞痛患者。根据随机数表法将其分为对照组(55例)和观察组(55例)。对照组给予常规冠心病心绞痛治疗,观察组在对照组基础上给予麝香保心丸。比较两组治疗后临床疗效,不良反应,治疗前、治疗2周及4周后冠脉血流指标、心率变异性。结果:观察组治疗总有效率显著高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。治疗2周及4周后,观察组收缩期峰流速(SPV)、舒张期峰流速(DPV)及时间速度积分(CTVI)均显著高于对照组,治疗4周后,两组SPV、DPV及CTVI均显著高于治疗前及治疗2周后,治疗2周后,两组SPV、DPV及CTVI均显著高于治疗前,差异有统计学意义(P<0.05)。治疗2周及4周后,观察组全部正常窦性心搏间期的标准差(SDNN)、RR间期平均值标准差(SDANN)、相邻的RR间期差值>50 ms者占分析总心搏数量的百分比(PNN50)及相邻RR间期差值的均方根(RMSSD)均显著高于对照组,治疗4周后,两组SDNN、SDANN、PNN50、RMSSD均显著高于治疗前及治疗2周后,治疗2周后,两组SDNN、SDANN、PNN50、RMSSD均显著高于治疗前,差异有统计学意义(P<0.05)。治疗2周及4周后,观察组低频功率(LF)及高频功率(HF)均显著高于对照组,治疗4周后,两组LF、HF均显著高于治疗前及治疗2周后,治疗2周后,两组LF、HF均显著高于治疗前,差异有统计学意义(P<0.05)。结论:麝香保心丸在冠心病心绞痛患者中的应用效果较好,且可显著改善患者的冠脉血流及心率变异性。 展开更多
关键词 麝香保心丸 冠心病心绞痛 冠脉血流 心率变异性
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线粒体心肌病猝死1例
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作者 乔燕 蔡佳 +3 位作者 曾璟 李瑞珍 张惠娟 张小明 《临床荟萃》 CAS 2024年第5期445-449,共5页
目的报道1例线粒体心肌病(mitochondrial cardiomyopathy,MCM)罕见病例,以提高临床医师对此病诊疗的重视,以免漏诊误诊。方法分析本例患者的临床资料及诊治过程,并复习相关文献进行讨论。结果本例青年女性患者以意识障碍就诊,肌电图、... 目的报道1例线粒体心肌病(mitochondrial cardiomyopathy,MCM)罕见病例,以提高临床医师对此病诊疗的重视,以免漏诊误诊。方法分析本例患者的临床资料及诊治过程,并复习相关文献进行讨论。结果本例青年女性患者以意识障碍就诊,肌电图、脑电图和脑磁共振成像均为阴性,因左心室肥大和心肌损伤标志物升高,心脏核磁提示心肌损伤,转至心内科以“病毒性心肌炎”治疗,后复查心肌标记物仍未恢复正常,心肌损伤范围增加,至上级医院完善基因检测和心肌活检提示MCM后明确诊断,后因剧烈活动后突发胸闷气短,猝死。结论MCM临床罕见,应熟悉其不典型临床表现及阳性体征,有多系统损害的患者,据临床表现及辅助检查等应考虑到此病的可能,需进一步行基因检测和心肌活检等,以免误诊和漏诊,并应积极随访,避免相关诱因,以提高患者的生存率。 展开更多
关键词 线粒体疾病 线粒体 心脏 猝死
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冠心病患者PCI术后基线外周血循环MO水平对患者长期死亡风险的影响
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作者 武秀丽 司晶 张鑫 《中国处方药》 2024年第2期23-25,共3页
目的探讨冠心病患者PCI术后基线外周血循环单核细胞(MO)水平对患者长期死亡风险的影响。方法回顾性分析2021年3月~2022年3月行PCI术的80例冠心病患者的临床资料,按照基线外周血循环MO水平分为A组、B组及C组。A组25例MO水平<0.40×... 目的探讨冠心病患者PCI术后基线外周血循环单核细胞(MO)水平对患者长期死亡风险的影响。方法回顾性分析2021年3月~2022年3月行PCI术的80例冠心病患者的临床资料,按照基线外周血循环MO水平分为A组、B组及C组。A组25例MO水平<0.40×10^(9)/L,B组27例0.40×10^(9)/L≤MO水平≤0.56×10^(9)/L,C组28例MO水平>0.56×10^(9)/L。采用回归分析法分析基线外周血循环MO水平和长期死亡风险的相关性。结果C组的全因死亡(ACM)和心脏死亡(CM)发生率为14.29%和7.14%,A组的ACM和CM发生率均为0,B组的ACM和CM发生率为0和3.70%,与A、B两组相比,C组的ACM发生率明显更高(P<0.05),但是三组间CM发生率差异无统计学意义(P>0.05)。基线外周血循环MO水平与ACM呈显著独立正相关(P<0.05)。结论基线外周血循环MO水平与PCI术后冠心病患者的长期全因死亡风险独立相关,循环MO水平较高的患者长期全因死亡风险也较高。 展开更多
关键词 冠心病 PCI术后 外周血循环MO 死亡风险
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