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Expresión de receptores de andrógeno en pacientes con carcinoma de mama del subtipo triple negativo. 三阴性乳腺癌患者的雄激素受体表达。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a06
Allen Hung, J. Gutiérrez, Janelle Gasia, Yusmary Gil, José Guanipa, Julio Castro, A. Reigosa, Ángel Fernández
Breast carcinoma of the triple-negative subtype (TNBC) does not express estrogen, progesterone or human epidermal growth factor recep-tor 2 (HER2) receptors. A subclassification of TNBC has been proposed into four subgroups, one of which is the luminal androgen receptor. The objective of this work was to determine the expression of the androgen receptor (AR) in women with TNBC, diagnosed by immunohistochemistry, at the Hospital Metropolitano del Norte, Valencia, Venezuela. The sample consisted of 191 pa-tients who met the inclusion criteria. The mean age of the patients at the time of diagnosis was 54.91 years. Histologically, the majority of the tumors were moderately differentiated or undifferentiated. The percentage of AR expres-sion was 22% (42 of 191). In the association between AR expression and the Ki-67 proliferative index, a greater number of AR positive cases was observed in tumors with Ki-67 expression of less than 40%. The AR positivity found in this study represents an intermediate frequency in relation to other investigations. No statistically significant differences were found with the age of the patients and histological grade of the tumors, while the Ki-67 proliferative index was lower for AR+ tumors, compared to TNBC in general.
三阴性亚型乳腺癌(TNBC)不表达雌激素、孕激素或人类表皮生长因子受体 2(HER2)受体。有人提出将 TNBC 划分为四个亚组,其中一个是腔内雄激素受体亚组。这项研究的目的是确定在委内瑞拉巴伦西亚北大都会医院(Hospital Metropolitano del Norte)通过免疫组化确诊的 TNBC 女性患者中雄激素受体(AR)的表达情况。样本包括191名符合纳入标准的患者。患者确诊时的平均年龄为 54.91 岁。从组织学角度来看,大多数肿瘤属于中度分化或未分化。AR表达率为22%(191例中有42例)。在AR表达与Ki-67增殖指数之间的关系中,Ki-67表达低于40%的肿瘤中AR阳性病例较多。与其他研究相比,本研究发现的 AR 阳性率属于中等水平。与一般TNBC相比,AR+肿瘤的Ki-67增殖指数较低,但与患者的年龄和肿瘤的组织学分级没有统计学差异。
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引用次数: 0
Diagnostic value of abdominal ultrasound in patients with acute appendicitis and analysis of the expression of related inflammatory factors. 腹部超声波对急性阑尾炎患者的诊断价值及相关炎症因子的表达分析。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a03
Siyuan Yang, Mingyan Wang, Linxin Yang, Ning Lin
Appendicitis is an inflammation of the appendix that, if left un-treated, can be life-threatening. Abdominal ultrasound helps diagnose it and differentiate it from other causes of abdominal pain. This study aimed to evalu-ate the diagnostic value of abdominal ultrasound in acute appendicitis (AA) and assess inflammatory factor levels in different types of appendicitis. One hundred patients with AA were selected as the observation group, and 30 pa-tients with simple abdominal pain as the control group. Among the 100 AA patients, 37 (37%) cases had blurred appendiceal boundaries, 24 (24%) cases had fecal calculus in the appendix cavity, 13 (13%) cases had enhanced echo intensity of surrounding fat, 15 (15%) cases presented enlarged outer diameter of the appendix (> 6mm), one (1%) case had peripheral lymphadenopathy, and one (1%) case had peripheral effusion. None of the cases (0%) presented a pe-ripheral mass. The levels of white blood cells (WBC) and inflammatory factors: C-reactive protein (CRP), interleukin-6 (IL -6), and tumor necrosis factor α(TNF-α)) patients with uncomplicated appendicitis were lower than those with suppurative appendicitis, gangrenous appendicitis, or peri-appendiceal abscess (p <0.05). The blurred boundary of the appendix, fecal stones in the appendix cavity, an enlarged outer diameter of the appendix (> 6mm), and an enhanced echogenicity of the surrounding fat are the most common ultrasonic signs of AA. Abdominal ultrasound has an excellent diagnostic value on pathological types of AA. The increase in the level of inflammatory factors can indicate the severity of the disease to a certain extent.
阑尾炎是阑尾的一种炎症,如果不及时治疗,可能会危及生命。腹部超声波有助于诊断阑尾炎,并将其与其他原因引起的腹痛区分开来。本研究旨在评估腹部超声波对急性阑尾炎(AA)的诊断价值,并评估不同类型阑尾炎的炎症因子水平。研究选取 100 名急性阑尾炎患者作为观察组,30 名单纯腹痛患者作为对照组。在 100 例 AA 患者中,37 例(37%)阑尾边界模糊,24 例(24%)阑尾腔内有粪便结石,13 例(13%)阑尾周围脂肪回声强度增强,15 例(15%)阑尾外径增大(> 6 毫米),1 例(1%)阑尾周围淋巴结肿大,1 例(1%)阑尾周围渗液。没有一个病例(0%)出现阑尾肿块。白细胞(WBC)和炎症因子的水平:无并发症阑尾炎患者的白细胞(WBC)和炎症因子:C 反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子α(TNF-α)的水平低于化脓性阑尾炎、坏疽性阑尾炎或阑尾周围脓肿患者(P 6mm),周围脂肪的回声增强是 AA 最常见的超声波征象。腹部超声对病理类型的 AA 有很好的诊断价值。炎症因子水平的升高可在一定程度上显示疾病的严重程度。
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引用次数: 0
Microbiota vaginal y cáncer de cuello uterino. 阴道微生物群与宫颈癌
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a10
José Núñez-Troconis, Antonio Molero
This narrative review analyzed the relationship between cervical cancer and the vaginal microbiome. It has been estimated that viruses and bac-teria cause 15% of all cancers. The development of molecular biology, genetics, and the use of high-throughput genomic sequencing techniques has allowed us not only to know the phenotypic component but also the genetic component of the vaginal microbiome and obtain a better knowledge and understanding of the behavior of the vaginal flora that was previously impossible to determine. The relation of the alterations in the vaginal flora by women’s habits, immunological status, and socioeconomic level has been established. Literature searches were performed electronically in PubMed, Medline, ISI, DOAJ, Springer, Embase, Web of Knowledge, and Google Scholar for original articles written in English and Sci-elo, Latindex, Imbiomed-L, Redalyc, and Google Scholar for original articles writ-ten in Spanish. The objective of this narrative review was to examine and analyze the literature on the alterations in the vaginal microbiome, their local protective effect and their possible contribution to the development of cervical cancer.
这篇叙述性综述分析了宫颈癌与阴道微生物组之间的关系。据估计,15% 的癌症是由病毒和细菌引起的。分子生物学、遗传学的发展以及高通量基因组测序技术的使用,使我们不仅能够了解阴道微生物组的表型成分,还能了解其遗传成分,并对以前无法确定的阴道菌群行为有了更好的认识和理解。阴道菌群的改变与妇女的生活习惯、免疫状态和社会经济水平之间的关系已经确定。通过电子方式在 PubMed、Medline、ISI、DOAJ、Springer、Embase、Web of Knowledge 和 Google Scholar 搜索英文原文,并在 Sci-elo、Latindex、Imbiomed-L、Redalyc 和 Google Scholar 搜索西班牙文原文。这篇叙述性综述的目的是研究和分析有关阴道微生物组的改变、其局部保护作用以及可能导致宫颈癌发生的文献。
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引用次数: 0
EDITORIALAlcances de la revista Investigación Clínica durante el año 2023. 编辑2023 年《临床研究》杂志的范围。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a00
E. Ryder
The main achievement of the journal in 2023 was an increase in the number of works received, mainly of foreign origin. The rejection percentage was 36%. The evaluation of the work of the members of the Editorial Committee had the collaboration of external referees from national and foreign institutions, especially Venezuelans living abroad. The magazine fulfilled its frequency of four issues with 41 communications in 559 pages, exceeding the number of pages from the previous year. Among the 41 works, the original works in English predominated, both from Venezuela and Latin America and countries on other continents. In evaluating the magazine by international indices, the increase in the Copernicus Index score stands out due to excellent compliance with their classification patterns. There were discrepancies between the different indexes in the citations; Clarivate reported 204, and Sco-pus only 20. Scopus recognizes only 44 citations in the four years (2019-2022), and Scielo recognizes 498 in that same period. The Crossref report was of more than 13,000 accesses in 2023, with Spanish-language Reviews being the most frequent, which suggests that Latin America is the primary source of readers for the magazine. This observation corroborates the results of our website, where the main accesses come from American countries. We hope that in 2024, Investigación Clínica will increase its national and international recognition; it would be a gift to the memory of its founder, Américo Negrette, who would be celebrating the centenary of his birth in 2024.
该期刊在 2023 年取得的主要成就是收到的作品数量有所增加,其中主要是外国作品。退稿率为 36%。在对编辑委员会成员的作品进行评估时,得到了来自国内外机构的外部评审人的合作,特别是居住在国外的委内瑞拉人。该杂志完成了四期的频率,共发表了 41 篇文章,559 页,超过了上一年的页数。在这 41 篇作品中,以英文原版作品为主,既有委内瑞拉和拉丁美洲的作品,也有其他大洲国家的作品。在用国际指数评估该杂志时,哥白尼指数得分的提高非常明显,因为它非常符合国际 指数的分类模式。不同指数在引文方面存在差异:Clarivate 报告了 204 篇引文,而 Sco-pus 仅报告了 20 篇。Scopus在四年内(2019-2022年)只认可44次引文,而Scielo在同一时期认可498次引文。Crossref 的报告显示,2023 年的访问量超过 13,000 次,其中以西班牙语的 Reviews 最多,这表明拉丁美洲是该杂志的主要读者来源。这一观察结果与我们网站的结果相吻合,我们网站的主要访问量来自美洲国家。我们希望在 2024 年,《临床研究》能够提高其在国内和国际上的知名度;这将是对其创始人 Américo Negrette 的纪念,他将在 2024 年迎来自己的百年诞辰。
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引用次数: 0
Correlation between the degree of cognitive impairment and emotional state in patients with Alzheimer’s disease. 阿尔茨海默病患者认知障碍程度与情绪状态之间的相关性。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a04
Zhichao Qiu, Jingjing Cai, Fanlin Xia
This study aimed to investigate the correlation between cogni-tive dysfunction and emotional state in patients with Alzheimer’s disease and then propose intervention strategies. One hundred twenty-five patients with Alzheimer’s disease from June 2019 to May 2022 were selected as the study subjects and divided into two groups based on the degree of cognitive impair-ment, both receiving routine drug treatment and cognitive rehabilitation in-tervention. The Montreal Cognitive Assessment (MoCA) and the Positive and Negative Affect Scale (PANAS) were used to evaluate the cognitive function and emotional status of two groups of patients before the intervention and four and eight weeks of intervention and to analyze the correlations between the two. The results showed statistically significant differences between the two groups MoCA and PANAS scores (P<0.05). Before the intervention, the patient’s MoCA score was positively correlated with the PANAS positive emo-tion score and negatively correlated with the PANAS negative emotion score (P<0.05). After four and eight weeks of intervention, the patient’s MoCA score was positively correlated with the PANAS positive emotion score (P<0.05) and negatively correlated with the PANAS negative emotion score (P<0.05).
本研究旨在探讨阿尔茨海默病患者认知功能障碍与情绪状态的相关性,进而提出干预策略。选取2019年6月至2022年5月的125例阿尔茨海默病患者作为研究对象,根据认知障碍程度分为两组,均接受常规药物治疗和认知康复干预。采用蒙特利尔认知评估(MoCA)和正负情量表(PANAS)对两组患者干预前、干预4周和8周的认知功能和情绪状态进行评估,并分析两者之间的相关性。结果显示,两组患者的 MoCA 和 PANAS 评分差异有统计学意义(P<0.05)。干预前,患者的MoCA得分与PANAS的积极情绪得分呈正相关,与PANAS的消极情绪得分呈负相关(P<0.05)。干预四周和八周后,患者的 MoCA 评分与 PANAS 积极情绪评分呈正相关(P<0.05),与 PANAS 消极情绪评分呈负相关(P<0.05)。
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引用次数: 0
Pulmonary toxicity associated with high-dose favipiravir and treatment options: biochemical and histopathological evaluation. 与大剂量法非拉韦相关的肺部毒性和治疗方案:生化和组织病理学评估。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a08
B. Elma, B. Suleyman, R. Mammadov, B. Yavuzer, Edhem Unver, D. Altuner, T. Coban, Behzat Mokhtare, H. Suleyman
Favipiravir is a broad-spectrum antiviral drug that is a viral RNA-dependent RNA polymerase inhibitor. Favipiravir is used in high doses to treat COVID-19 but has a side effect on humans at high doses. The side effects of favipiravir have been associated with oxidative stress in the literature. In this trial, we investigated the biochemical and histopathological effects of lacidip-ine, thiamine pyrophosphate (TTP), and adenosine triphosphate (ATP), drugs with antioxidant properties, on the lung toxicity caused by high-dose favipiravir in rats. The rats were classified into five groups: healthy (HG), favipiravir alone (Fav), lacidipine+favipiravir (LFav), TPP+favipiravir (TFav), and ATP+favipiravir (AFav). Favipiravir (800 mg/kg) was administered twice daily for seven days. Laci-dipine (4 mg/kg), TPP (20 mg/kg), and ATP (25 mg/kg) were administered once daily for seven days. Oxidant (malondialdehyde), non-enzymatic (total glutathi-one), and enzymatic (superoxide dismutase and catalase) antioxidant levels were measured in the excised lung tissues. Furthermore, the tissues were histopatho-logically examined. The systemic administration of high doses of favipiravir in-creased oxidant levels and decreased antioxidant levels in the lung tissue of rats. In parallel, the histopathological examination of the lung tissue revealed the presence of severe mononuclear cell infiltrations in interstitial areas and pronounced lymphoid hyperplasia. Lacidipine exhibited superior efficacy in mit-igating oxidative stress and preventing the decline of antioxidants induced by favipiravir compared with TPP and ATP. Histopathologically, the lacidipine admin-istration significantly reduced lung oxidative damage. TTP moderately reduced severe favipiravir-associated lung injury. However, ATP was ineffective against fa-vipiravir-associated lung injury. Lacidipine offers more therapeutic benefits than TPP in treating oxidative lung injury caused by high doses of favipiravir.
法维拉韦是一种广谱抗病毒药物,是病毒 RNA 依赖性 RNA 聚合酶抑制剂。法维拉韦被大剂量用于治疗 COVID-19,但大剂量使用会对人体产生副作用。在文献中,法维拉韦的副作用与氧化应激有关。在本试验中,我们研究了拉西地平、焦磷酸硫胺素(TTP)和三磷酸腺苷(ATP)这些具有抗氧化作用的药物对大鼠因大剂量法匹拉韦而引起的肺毒性的生化和组织病理学影响。大鼠被分为五组:健康组(HG)、单用法比拉韦组(Fav)、拉西地平+法比拉韦组(LFav)、TPP+法比拉韦组(TFav)和ATP+法比拉韦组(AFav)。法维拉韦(800 毫克/千克)每天给药两次,连续给药七天。拉西地平(4 毫克/千克)、TPP(20 毫克/千克)和 ATP(25 毫克/千克)每天用药一次,连续用药七天。在切除的肺组织中测量氧化剂(丙二醛)、非酶(总谷胱甘肽)和酶(超氧化物歧化酶和过氧化氢酶)的抗氧化水平。此外,还对组织进行了组织病理学检查。大剂量法非拉韦的全身给药会增加大鼠肺组织中的氧化剂水平,降低抗氧化剂水平。同时,肺组织的组织病理学检查显示,肺间质区域存在严重的单核细胞浸润和明显的淋巴细胞增生。与 TPP 和 ATP 相比,拉西地平在减轻氧化应激和防止法非比拉韦引起的抗氧化剂下降方面表现出更强的功效。从组织病理学角度看,服用拉西地平能明显减轻肺部氧化损伤。TTP可适度减轻严重的法非拉韦相关肺损伤。然而,ATP对法维拉韦相关肺损伤无效。在治疗大剂量法非拉韦引起的肺氧化损伤方面,拉西地平比TPP更有疗效。
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引用次数: 0
Effect of fractional exhaled carbon monoxide on patients with sleep apnea-hypopnea syndrome and its mechanism. 分量呼出一氧化碳对睡眠呼吸暂停-低通气综合征患者的影响及其机制。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a09
Quanlin Jia, Li Guo, Xinhua Zheng, Guangwei Li, Lu Liu
Sleep-disordered breathing (SDB) is a common sleep disorder as-sociated with chronic airway inflammation and lung function impairment. This article aimed to investigate the fractional exhaled carbon monoxide (FeCO) expression level in obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with disease indicators. Subjects with OSAHS, asthma, chronic obstructive pulmonary disease (COPD), and healthy subjects were selected to collect clinical data. FeCO concentration, eosinophil (Eos), erythrocyte sed-imentation rate (ESR), C-reactive protein (CRP), FEV1, and FEV1/FVC were measured. The Pearson correlation coefficient and receiver operating charac-teristic (ROC) curve were used for statistical analysis. The FeCO concentra-tion, Eos count, ESR and CRP levels, and lung function in the OSAHS group were higher than the healthy and COPD groups (p<0.05) and slightly lower than the asthma group. FeCO was positively correlated with Eos, ESR, and CRP (p<0.05), but there was no apparent correlation between FeCO and lung func-tion. FeCO has a high sensitivity and specificity in the diagnosis of OSAHS. There is chronic airway inflammation and systemic inflammation in patients with OSAHS. Lung function impairment in patients with OSAHS is mild, but some limitations remain. FeCO may be an auxiliary diagnostic index particu-larly valuable in diagnosing OSAHS.
睡眠呼吸障碍(SDB)是一种常见的睡眠障碍,与慢性气道炎症和肺功能损害有关。本文旨在研究阻塞性睡眠呼吸暂停-低通气综合征(OSAHS)患者呼出一氧化碳(FeCO)的表达水平及其与疾病指标的相关性。研究人员选取了患有 OSAHS、哮喘、慢性阻塞性肺疾病(COPD)和健康的受试者,收集他们的临床数据。研究人员测量了FeCO浓度、嗜酸性粒细胞(Eos)、红细胞沉降率(ESR)、C反应蛋白(CRP)、FEV1和FEV1/FVC。采用皮尔逊相关系数和接收者操作特征曲线(ROC)进行统计分析。OSAHS 组的 FeCO 浓度、Eos 计数、血沉和 CRP 水平以及肺功能均高于健康组和 COPD 组(P<0.05),略低于哮喘组。FeCO 与 Eos、ESR 和 CRP 呈正相关(P<0.05),但 FeCO 与肺功能无明显相关性。在诊断 OSAHS 时,FeCO 具有较高的敏感性和特异性。OSAHS 患者存在慢性气道炎症和全身炎症。OSAHS 患者的肺功能损伤较轻,但仍存在一些局限性。FeCO可能是一种辅助诊断指标,尤其对诊断OSAHS有重要价值。
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引用次数: 0
The mechanism of folic acid on N-methyl-N’-nitro-N-nitrosoguanidine-induced chronic atrophic gastritis through the PI3K/Akt pathway. 叶酸通过PI3K/Akt途径对N-甲基-N'-硝基-N-亚硝基胍诱导的慢性萎缩性胃炎的作用机制
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a05
Yun An, Weigang Chen, Yong Cao, Boshen Chen, Qiangbin Li, Xia Zhou, Weihan Huang
Chronic atrophic gastritis (CAG) is a precancerous atrophic gastritis of the stomach, which generates an urge to develop novel therapeu-tic schedules. This study aimed to investigate the effect of experimental folic acid administration on N-methyl-N’-nitro-N-nitrosoguanidine (MNNG)-induced CAG through the PI3K/Akt pathway in rats. The rats were divided into a Model Group, a Folic Acid Group and a Blank Group. Rats in the Model Group were induced by MNNG and given 10 mL/kg/d distilled water by gavage, while rats in the Folic Acid Group were induced by MNNG and given 5 mg/kg/d folic acid suspension by gavage. As a control, rats in the Blank Group were given the same amount of distilled water as MNNG and 10 mL/kg/d distilled water by gavage. The levels of gastrin (GAS) and motilin (MTL) in serum were measured by enzyme-linked immunosorbent assay (ELISA), and the mRNA and protein ex-pressions were detected by quantitative polymerase chain reaction (q-PCR) and Western blot. According to hematoxylin and eosin (H&E) pathological analysis, there were inflammatory factors infiltration and derangement of mucosal epi-thelial cells in the model group, while the gastric tissue injury in the folic acid group was improved. Folic acid could decrease the content of GAS, increase the content of MTL in the serum of the rats, and regulate the expression of PI3K and AKT signal pathways. Folic acid can have a therapeutic effect on CAG by reducing the concentration of GAS in serum and increasing the concentration of MLT in serum. Our study would lay a theoretical foundation for using folic acid to investigate new therapies for CAG in humans.
慢性萎缩性胃炎(CAG)是一种胃癌前萎缩性胃炎,它催生了开发新型治疗方案的冲动。本研究旨在探讨实验性服用叶酸通过PI3K/Akt途径对N-甲基-N'-硝基-N-亚硝基胍(MNNG)诱导的大鼠CAG的影响。大鼠被分为模型组、叶酸组和空白组。模型组大鼠由 MNNG 诱导,并通过灌胃给予 10 mL/kg/d 蒸馏水;叶酸组大鼠由 MNNG 诱导,并通过灌胃给予 5 mg/kg/d 叶酸混悬液。作为对照,空白组大鼠灌胃与 MNNG 相同量的蒸馏水和 10 mL/kg/d 蒸馏水。通过酶联免疫吸附试验(ELISA)检测血清中胃泌素(GAS)和动情素(MTL)的水平,并通过定量聚合酶链反应(q-PCR)和 Western 印迹检测 mRNA 和蛋白质的表达。根据苏木精和伊红(H&E)病理分析,模型组存在炎症因子浸润和粘膜上皮细胞失调,而叶酸组的胃组织损伤有所改善。叶酸能降低大鼠血清中GAS的含量,增加MTL的含量,调节PI3K和AKT信号通路的表达。叶酸可通过降低血清中GAS的浓度和增加血清中MLT的浓度对CAG产生治疗作用。我们的研究将为利用叶酸研究治疗人类CAG的新疗法奠定理论基础。
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引用次数: 0
Predictive value of intracranial pressure-related parameters and coagulation on the prognosis in patients with traumatic brain injury. 颅内压相关参数和凝血功能对脑外伤患者预后的预测价值。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a02
Linna Shen, Haibin Lu, Shuibo Yang, Feixiong Chen
This study investigated the factors affecting the prognosis of patients with traumatic brain injury (TBI) and assessed the predictive value of intracranial pressure-related parameters and coagulation on prognosis. Seventy TBI patients admitted between January 2020 and January 2021 were catego-rized into good prognosis (n=42) and poor prognosis (n=28) groups according to the Glasgow Outcome Scale (GOS) score upon discharge. Factors affecting prognosis were analyzed, and differences in intracranial pressure and coagula-tion between the two groups were compared. The receiver operating charac-teristic curve (ROC) was used to calculate the predictive value of intracranial pressure-related parameters and coagulation function on prognosis. Within 24 h postoperatively, the good prognosis group had lower levels of intracra-nial pressure (ICP) and partial pressure of oxygen in brain tissue (PbtO2) and higher cerebral perfusion pressure (CPP) and cerebral hemodynamic param-eters than the poor prognosis group (p<0.05). The good prognosis group had significantly lower prothrombin time (PT), activated partial thromboplastin time (aPTT),and prothrombin time (TT) levels and higher platelets (PLT) and fibrinogen (Fib) levels than the poor prognosis group (p<0.05). Regression analysis revealed that CPP, systolic blood flow velocity (Vs), end-diastolic blood flow velocity (Vd), mean blood flow velocity (Vm), PLT, Fib were independent protective factors for the prognosis, and ICP, PbtO2, PT, APTT, and TT were risk factors for prognosis. The ROC revealed that ICP, CPP, PbtO2, Vs, Vd, Vm, APTT, PLT, Fib exhibited high diagnostic value for poor prognosis (AUC=0.732, 0.940, 0.796, 0.706, 0.914, 0.729, 0.876, 0.709, 0.866), with ICP showing the highest diagnostic sensitivity and Vd showing the highest diagnostic specificity. Intracranial pressure-related parameters and coagulation indicators are prog-nosis-related indexes in patients with TBI, and the prognosis and survival can be improved by controlling intracranial pressure and improving coagulation.
本研究调查了影响创伤性脑损伤(TBI)患者预后的因素,并评估了颅内压相关参数和凝血功能对预后的预测价值。根据出院时的格拉斯哥结果量表(GOS)评分,将2020年1月至2021年1月期间收治的70例创伤性脑损伤患者分为预后良好组(42例)和预后不良组(28例)。分析了影响预后的因素,并比较了两组患者颅内压和凝血功能的差异。采用接收者操作特征曲线(ROC)计算颅内压相关参数和凝血功能对预后的预测价值。术后 24 小时内,预后良好组的颅内压(ICP)和脑组织氧分压(PbtO2)水平低于预后不良组,脑灌注压(CPP)和脑血流动力学参数高于预后不良组(P<0.05)。预后良好组的凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)和凝血酶原时间(TT)水平明显低于预后不良组,血小板(PLT)和纤维蛋白原(Fib)水平高于预后不良组(P<0.05)。回归分析显示,CPP、收缩期血流速度(Vs)、舒张末期血流速度(Vd)、平均血流速度(Vm)、PLT、Fib 是预后的独立保护因素,ICP、PbtO2、PT、APTT 和 TT 是预后的危险因素。ROC显示,ICP、CPP、PbtO2、Vs、Vd、Vm、APTT、PLT、Fib对不良预后具有很高的诊断价值(AUC=0.732、0.940、0.796、0.706、0.914、0.729、0.876、0.709、0.866),其中ICP的诊断敏感性最高,Vd的诊断特异性最高。颅内压相关指标和凝血指标是创伤性脑损伤患者的预后相关指标,通过控制颅内压和改善凝血功能可以改善预后和提高生存率。
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引用次数: 0
Comparison of clinical efficacy and prognosis between interventional occlusion and surgical treatment for acute myocardial infarction with ventricular septal perforation. 急性心肌梗死伴室间隔穿孔的介入性闭塞与手术治疗的临床疗效和预后比较。
Pub Date : 2024-02-17 DOI: 10.54817/ic.v65n1a07
Chenyao Ni, Peng Hu, Yiming Ni
This retrospective study compared the clinical outcomes and prognostic factors in acute myocardial infarction-related patients with inter-ventricular septal perforation (AMI-VSP) who underwent interventional occlu-sion (IO group) or surgical intervention (SI group). Forty-six patients were ana-lyzed based on comprehensive clinical data, laboratory results, and follow-up evaluations. The SI group had higher EuroScore II scores and more patients in Killip class IV. Both treatments showed improved laboratory indices, but the IO group had higher left ventricular ejection fraction and lower levels of specific biomarkers. The postoperative hospital stay and total hospitalization time were shorter in the IO group. Survival rates did not significantly differ between the two groups during the follow-up period. Logistic regression analysis identified a history of coronary heart disease as a significant risk factor affecting progno-sis and survival rates. Both interventional occlusion and surgical intervention proved effective, with IO showing faster recovery and more favorable prognoses, while surgery was preferred for severe cases. Coronary heart disease was a key factor influencing postoperative survival in AMI-VSP patients.
这项回顾性研究比较了急性心肌梗死相关的室间隔穿孔(AMI-VSP)患者接受介入性闭塞(IO 组)或外科干预(SI 组)后的临床疗效和预后因素。根据全面的临床数据、实验室结果和随访评估,对 46 名患者进行了分析。SI组的EuroScore II评分更高,Killip IV级患者更多。两种治疗方法都改善了实验室指标,但 IO 组的左心室射血分数更高,特定生物标志物水平更低。IO 组的术后住院时间和总住院时间更短。两组患者在随访期间的存活率无明显差异。逻辑回归分析发现,冠心病史是影响预后和存活率的重要风险因素。事实证明,介入性闭塞治疗和手术治疗均有效,其中介入性闭塞治疗恢复更快,预后更佳,而手术治疗则更适用于严重病例。冠心病是影响 AMI-VSP 患者术后存活率的关键因素。
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Investigación Clínica
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