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Effects of large dose of statins on renal function, vascular endothelial function and levels of inflammatory factor in patients with coronary heart disease complicated with renal insufficiency 大剂量他汀类药物对冠心病合并肾功能不全患者肾功能、血管内皮功能及炎症因子水平的影响
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.031
Ai-jie Hou, Wen-guang Li, H. Xue
Objective To analyze the effects of large dose of rosuvastatin on renal function, vascular endothelial function and levels of inflammatory factor in patients with coronary heart disease complicated with renal insufficiency. Methods Sixty patients with coronary heart disease complicated with renal insufficiency admitted to the Second People’s Hospital from January 2015 to December 2018 were randomly divided into the control group and study group by random number table method, with 30 patients in each group. Patients in the control group were treated with conventional dose of rosuvastatin, and patients in the study group were treated with large dose of rosuvastatin. The renal function, vascular endothelial function, levels of inflammatory factor and incidence of adverse reactions were compared between the two groups. Results There was no significant difference in 24 h urinary protein or serum creatinine between the two groups before treatment (P>0.05); after treatment, the levels of 24 h urinary protein and serum creatinie decreased in both groups, and the study group had higher 24 h urinary protein level than the control group (P 0.05). After treatment, Hcy levels decreased, but NO and eNOS levels increased in both groups; compared to control group, and the Hcy levels in the study group were lower, while NO and eNOS levels were higher (P 0.05). The incidence of adverse reaction of the study group was 33.33% (10/30), higher than the 26.67% (8/30) of the control group, but there was no significant difference in incidence of adverse reactions between the two groups (P>0.05). Conclusions Large dose of rosuvastatin in the treatment of patients with coronary heart disease and renal insufficiency can significantly improve renal function and vascular endothelial function, and reduce inflammation levels, without increasing incidence of adverse reactions. Key words: Large dose; Statins; Coronary heart disease; Renal insufficiency; Renal function; Vascular endothelial function; Inflammatory factors
目的分析大剂量瑞舒伐他汀对冠心病合并肾功能不全患者肾功能、血管内皮功能及炎症因子水平的影响。方法选取2015年1月~ 2018年12月第二人民医院收治的冠心病合并肾功能不全患者60例,采用随机数字表法随机分为对照组和研究组,每组30例。对照组给予常规剂量瑞舒伐他汀治疗,研究组给予大剂量瑞舒伐他汀治疗。比较两组患者肾功能、血管内皮功能、炎症因子水平及不良反应发生率。结果两组患者治疗前24 h尿蛋白、血清肌酐比较,差异均无统计学意义(P>0.05);治疗后,两组患者24 h尿蛋白水平和血清肌酐水平均下降,且研究组患者24 h尿蛋白水平高于对照组(P < 0.05)。治疗后,两组患者Hcy水平下降,NO、eNOS水平升高;研究组患者Hcy水平低于对照组,NO、eNOS水平高于对照组(P < 0.05)。研究组不良反应发生率为33.33%(10/30),高于对照组的26.67%(8/30),但两组不良反应发生率比较差异无统计学意义(P>0.05)。结论大剂量瑞舒伐他汀治疗冠心病合并肾功能不全患者可显著改善肾功能和血管内皮功能,降低炎症水平,且不增加不良反应的发生率。关键词:大剂量;他汀类药物;冠心病;肾功能不全;肾功能;血管内皮功能;炎症因子
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引用次数: 0
Comparison of effects of etomidate versus midazolam on hemodynamics and protection of myocardium during tracheal intubation in patients undergoing off-pump coronary artery bypass grafting 非体外循环冠状动脉搭桥术患者气管插管时,咪达唑仑与依咪咪酯对血流动力学及心肌保护的影响比较
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.026
Teng Hu, Zhanjun Zhang, Ren-Chao Liu, Huai-jin Cheng, Ran Li, Jia Shi
Objective To investigate the effects of etomidate and midazolam on hemodynamics and protection of myocardium during tracheal intubation in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Methods Seventy-eight patients with OPCAB hospitalized in Jiaozuo People’s Hospital from January 2017 to July 2019 were selected, and they were divided into etomidate group (group A, 39 cases) and midazolam group (group B, 39 cases) according to the random number table method. Group A and group B were intravenously injected with etomidate and midazolam respectively; and both groups were intravenously injected with fentanyl + pipecuronium bromide for anesthesia induction, and then were given propofol + piperacium bromide + fentanyl for anesthesia maintenance. The hemodynamics, such as heart rate (HR), mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP), pulmonary artery wedge pressure (PAWP), vascular resistance, such as systemic vascular resistance index (SVRI), pulmonary vascular resistance index (PVRI), and oxygen metabolism, such as mixed venous oxygen saturation (SvO2), oxygen supply index (DO2I), oxygen consumption index (VO2I), were monitored during anesthesia. The above indicators were recorded before tracheal intubation (T0), after intubation immediately (T1), at 1 min after intubation (T2), 5 min after intubation (T3) and 10 min after intubation (T4). Serum cardiac troponin I (cTnI) level was measured before anesthesia, at the end of surgery and at 6, 12 and 24 h after surgery. Results Compared with levels at T0, the HR and MAP were increased at T1 and T2 in both groups, and the HR in group A was lower than that in group B (P 0.05). Compared with levels before anesthesia, the serum cTnI levels in the two groups were increased at the end of surgery and at 6, 12 and 24 h after surgery (P 0.05). Conclusions Compared with midazolam, etomidate is more beneficial to sustaining hemodynamic stability during tracheal intubation in patients with OPCAB during anesthesia induction, and their roles in oxygen metabolism balance and myocardial protection are comparable. Key words: Etomidate; Midazolam; Off-pump coronary artery bypass grafting; Hemodynamics; Vascular resistance; Myocardial injury
目的探讨依托咪酯与咪达唑仑对非体外循环冠状动脉旁路移植术(OPCAB)患者气管插管血流动力学及心肌保护的影响。方法选择2017年1月~ 2019年7月焦作市人民医院住院的OPCAB患者78例,按随机数字表法分为依托咪酯组(A组,39例)和咪达唑仑组(B组,39例)。A组和B组分别静脉注射依托咪酯和咪达唑仑;两组均静脉注射芬太尼+溴化哌库溴铵进行麻醉诱导,再给予异丙酚+溴化哌库溴铵+芬太尼进行麻醉维持。麻醉期间监测心率(HR)、平均动脉压(MAP)、平均肺动脉压(MPAP)、肺动脉wedge压(PAWP)等血流动力学指标,血管阻力(全身血管阻力指数(SVRI)、肺血管阻力指数(PVRI))和氧代谢(混合静脉氧饱和度(SvO2)、供氧指数(DO2I)、耗氧量指数(VO2I)等血管阻力指标。记录气管插管前(T0)、气管插管后立即(T1)、气管插管后1分钟(T2)、气管插管后5分钟(T3)、气管插管后10分钟(T4)。分别于麻醉前、术末及术后6、12、24 h测定血清心肌肌钙蛋白I (cTnI)水平。结果与T0时比较,两组患者T1、T2时HR、MAP均升高,且A组HR低于B组(P < 0.05)。与麻醉前比较,两组患者在手术结束及术后6、12、24 h血清cTnI水平均升高(P < 0.05)。结论与咪达唑仑相比,依咪咪酯更有利于OPCAB患者麻醉诱导气管插管血流动力学稳定,其氧代谢平衡和心肌保护作用具有可比性。关键词:依托咪酯;咪达唑仑;非体外循环冠状动脉旁路移植术;血流动力学;血管阻力;心肌损伤
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引用次数: 0
Value of detection of creatine kinase isoenzyme mass by immunoturbidimetry in the diagnosis of acute myocardial infarction 免疫比浊法检测肌酸激酶同工酶质量在急性心肌梗死诊断中的价值
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.020
Lixia Zhang, Mao Lu, Haixia Du
Objective To investigate the value of determination of creatine kinase isoenzyme (CKMB) mass by immunoturbidimetry in the diagnosis of acute myocardial infarction. Methods A total of 150 patients with acute myocardial infarction (AMI) admitted to Jincheng General Hospital from June 2018 to June 2019 were enrolled into the observation group. And 150 healthy persons who underwent physical examination in the same period were selected as the control group. Serum levels of cardiac troponin T (cTnT), myoglobin (MYO) and CKMB mass in the two groups were compared. CKMB mass levels in the observation group were measured by electrochemiluminescence and immunoturbidimetry. And the positive detection rates of the two methods were compared. Results The serum cTnT, MYO and CKMB mass levels in the observation group were significantly higher than those in the control group (P 0.05). There was no significant difference in positive rate of CKMB mass between electroluminescence (96.00%, 144/150) and immunoturbidimetry (94.67%, 142/150), P>0.05. Conclusions The detection of CKMB mass is of great significance for the diagnosis of AMI. The results of immunoturbidimetric method in detecting CKMB mass are not significantly different from the electrochemical luminescence, but the former is more suitable for the development of primary hospitals and has a high positive detection rate. Key words: Acute myocardial infarction; Creatine kinase isoenzyme mass; Immunoturbidimetry; Electrochemiluminescence
目的探讨免疫比浊法测定肌酸激酶同工酶(CKMB)质量在急性心肌梗死诊断中的价值。方法选择2018年6月~ 2019年6月金城总医院收治的急性心肌梗死(AMI)患者150例作为观察组。选取同期体检的健康人群150人作为对照组。比较两组患者血清心肌肌钙蛋白T (cTnT)、肌红蛋白(MYO)及CKMB质量。观察组采用电化学发光法和免疫比浊法检测CKMB质量水平。并比较两种方法的阳性检出率。结果观察组患者血清cTnT、MYO、CKMB质量水平均显著高于对照组(P < 0.05)。电致发光(96.00%,144/150)与免疫比浊法(94.67%,142/150)CKMB质量阳性率比较,差异无统计学意义(P>0.05)。结论CKMB肿块的检测对AMI的诊断有重要意义。免疫比浊法检测CKMB肿块的结果与电化学发光法无显著差异,但前者更适合基层医院发展,阳性检出率高。关键词:急性心肌梗死;肌酸激酶同工酶质量;Immunoturbidimetry;电化学发光
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引用次数: 0
Non-invasive diagnosis of ulcerative colitis 溃疡性结肠炎的无创诊断
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.035
Lei Lu, Lingbin Kong
Ulcerative colitis (UC) is a kind of chronic and recurrent abnormal immune-mediated intestinal inflammatory enteropathy by various causes. At present, the diagnosis of the disease mainly depends on the clinical manifestations, colonoscopy and biopsy. This diagnosis method is traumatic, time-consuming, expensive, which is difficult to be popularized. The latest research has found that biochemical markers, tomography and gene marker detection have certain diagnostic value for UC, and non-invasive. Now, the non-invasive diagnostic methods of UC are summarized as follows. Key words: Colitis, ulcerative; Biochemical markers; Tomography; Genetic markers; Diagnosis
溃疡性结肠炎(UC)是一种由多种原因引起的慢性、复发性异常免疫介导的肠道炎症性肠病。目前该病的诊断主要依靠临床表现、结肠镜检查和活检。这种诊断方法创伤大,耗时长,费用高,难以推广。最新研究发现生化标志物、断层扫描和基因标记检测对UC有一定的诊断价值,且无创。现将UC的无创诊断方法总结如下:关键词:结肠炎;溃疡性;生化标记;断层扫描;遗传标记;诊断
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引用次数: 0
Effects of aspirin combined with atorvastatin on hypertensive patients with diabetes mellitus 阿司匹林联合阿托伐他汀治疗高血压合并糖尿病的疗效观察
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.033
Hongli Xing, Lifang Wang, Mei Ping, Yongping Jia
Objective To investigate the effects of aspirin combined with atorvastatin on hypertensive patients with diabetes mellitus. Methods One hundred hypertensive patients with diabetes mellitus admitted to the First Hospital of Shanxi Medical University from January 2016 to December 2017 were selected and divided into aspirin group and aspirin combined with atorvastatin group (combined treatment group) according to random number table method, with 50 cases in each group. Patients in aspirin group were treated with aspirin, 100 mg/d; while patients in combined treatment group were treated with aspirin, 100 mg/d, and atorvastatin, 20 mg/d. Blood lipid, urinary albumin, β2-microglobulin (β2-MG), urinary albumin excretion rate (UAER), cardioankle vascular index (CAVI) and ankle brachial index (ABI) of the two groups were measured and compared before and 20 weeks after treatment, and the incidences of non fatal myocardial infarction of the two groups were compared and analyzed by follow-up. Results Compared with preoperative levels, the levels of total cholesterol and low-density lipoprotein cholesterol of the two groups were reduced, and the levels of CAVI and ABI were improved after treatment (P 0.05). However, the urinary albumin, triacylglycerol, UAER and β2-MG in the combined treatment group were decreased after treatment (P<0.05). During the median follow-up period, the incidence of major endpoints in non fatal myocardial infarction in aspirin group was higher than that in combined treatment group (P<0.05). Multiple stepwise regression analysis showed that the risk factors of arterial stiffness and microalbuminuria were diastolic pressure, systolic pressure, 2 h postprandial blood glucose and fasting blood glucose. Conclusions The combined use of aspirin and atorvastatin can significantly reduce the level of urinary microprotein in patients with hypertension and diabetes mellitus, alleviate arterial stiffness, effectively reduce the incidence of non fatal myocardial infarction. And the study finds that arterial stiffness and microalbuminuria are directly related to blood pressure and blood glucose level. Key words: Aspirin; Atorvastatin; Hypertension; Diabetes mellitus; Arterial stiffness; Non fatal myocardial infarction
目的探讨阿司匹林联合阿托伐他汀治疗高血压合并糖尿病的疗效。方法选择2016年1月至2017年12月山西医科大学附属第一医院收治的高血压合并糖尿病患者100例,按随机数字表法分为阿司匹林组和阿司匹林联合阿托伐他汀组(联合治疗组),每组50例。阿司匹林组患者给予阿司匹林100 mg/d;联合治疗组给予阿司匹林100 mg/d,阿托伐他汀20 mg/d。测量两组患者治疗前及治疗后20周的血脂、尿白蛋白、β2-微球蛋白(β2-MG)、尿白蛋白排泄率(UAER)、心踝血管指数(CAVI)、踝肱指数(ABI),并通过随访比较分析两组患者非致死性心肌梗死的发生率。结果与术前比较,两组患者治疗后总胆固醇、低密度脂蛋白胆固醇水平均降低,CAVI、ABI水平均改善(P < 0.05)。联合治疗组治疗后尿白蛋白、甘油三酯、UAER、β2-MG均降低(P<0.05)。中位随访期间,阿司匹林组非致死性心肌梗死主要终点发生率高于联合治疗组(P<0.05)。多元逐步回归分析显示,舒张压、收缩压、餐后2 h血糖和空腹血糖是动脉僵硬度和微量白蛋白尿的危险因素。结论阿司匹林与阿托伐他汀联合应用可显著降低高血压合并糖尿病患者尿微量蛋白水平,缓解动脉僵硬,有效降低非致死性心肌梗死的发生率。研究发现,动脉僵硬度和微量白蛋白尿与血压和血糖水平有直接关系。关键词:阿司匹林;阿托伐他汀;高血压;糖尿病;动脉硬化;非致死性心肌梗死
{"title":"Effects of aspirin combined with atorvastatin on hypertensive patients with diabetes mellitus","authors":"Hongli Xing, Lifang Wang, Mei Ping, Yongping Jia","doi":"10.3760/CMA.J.ISSN.1674-4756.2020.05.033","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-4756.2020.05.033","url":null,"abstract":"Objective \u0000To investigate the effects of aspirin combined with atorvastatin on hypertensive patients with diabetes mellitus. \u0000 \u0000 \u0000Methods \u0000One hundred hypertensive patients with diabetes mellitus admitted to the First Hospital of Shanxi Medical University from January 2016 to December 2017 were selected and divided into aspirin group and aspirin combined with atorvastatin group (combined treatment group) according to random number table method, with 50 cases in each group. Patients in aspirin group were treated with aspirin, 100 mg/d; while patients in combined treatment group were treated with aspirin, 100 mg/d, and atorvastatin, 20 mg/d. Blood lipid, urinary albumin, β2-microglobulin (β2-MG), urinary albumin excretion rate (UAER), cardioankle vascular index (CAVI) and ankle brachial index (ABI) of the two groups were measured and compared before and 20 weeks after treatment, and the incidences of non fatal myocardial infarction of the two groups were compared and analyzed by follow-up. \u0000 \u0000 \u0000Results \u0000Compared with preoperative levels, the levels of total cholesterol and low-density lipoprotein cholesterol of the two groups were reduced, and the levels of CAVI and ABI were improved after treatment (P 0.05). However, the urinary albumin, triacylglycerol, UAER and β2-MG in the combined treatment group were decreased after treatment (P<0.05). During the median follow-up period, the incidence of major endpoints in non fatal myocardial infarction in aspirin group was higher than that in combined treatment group (P<0.05). Multiple stepwise regression analysis showed that the risk factors of arterial stiffness and microalbuminuria were diastolic pressure, systolic pressure, 2 h postprandial blood glucose and fasting blood glucose. \u0000 \u0000 \u0000Conclusions \u0000The combined use of aspirin and atorvastatin can significantly reduce the level of urinary microprotein in patients with hypertension and diabetes mellitus, alleviate arterial stiffness, effectively reduce the incidence of non fatal myocardial infarction. And the study finds that arterial stiffness and microalbuminuria are directly related to blood pressure and blood glucose level. \u0000 \u0000 \u0000Key words: \u0000Aspirin; Atorvastatin; Hypertension; Diabetes mellitus; Arterial stiffness; Non fatal myocardial infarction","PeriodicalId":9667,"journal":{"name":"Central Plains Medical Journal","volume":"82 1","pages":"110-114"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82483734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical analysis of 200 cases of cervical intraepithelial neoplasia 宫颈上皮内瘤变200例临床分析
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.017
Lina Xu
Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Methods The clinical records and data of 200 patients with CIN diagnosed and treated in Shanxi Provincial People’s Hospital from January 2017 to January 2018 were retrospectively analyzed. All patients were diagnosed by three-step screening of the cervix, including thin-prep liquid-based cytology test (TCT) and/or human papilloma virus (HPV) detection, colposcopy and histopathology of the cervix. Loop electrosurgical excision procedure (LEEP) was performed according to patient’swillingness and HPV infection condition to diagnose cervix. For patients with cervical cancer diagnosed by patholgical examination, total laparoscopic extrafascial hysterectomy was performed. The TCT examination of cervix, colposcopy biopsy, operation and 1-year follow-up of all patients were observed. Results A total of 141 cases of low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) were detected by TCT of cervix among 200 CIN patients, and the diagnostic coincidence rate of TCT was 70.50%; while a total of 63 cases of CIN Ⅱ and CIN Ⅲ were detected by histopathology, and 45 cases of HSIL were detected by TCT, the diagnostic coincidence rate of TCT was 71.42%; 137 cases of CIN Ⅰ were detected by histopathology, 96 cases of LSIL were detected by TCT, and the diagnostic coincidence rate of TCT was 70.07%. A total of 163 cases of LSIL and HSIL were determined by colposcopy in 200 CIN patients, with the diagnostic accuracy of 81.50%; 63 cases of CIN Ⅱ and CIN Ⅲ were determined by histopathology, while 50 cases of HSIL were determined by colposcopy, with the diagnostic accuracy of 79.36%; 137 cases of CIN Ⅰ were determined by histopathology, and 113 cases of LSIL were determined by colposcopy, with the diagnostic accuracy of 82.48%. Among the 137 LSIL patients confirmed by histopathology, with cytological examination results showing cannot exlude high-grade squamous intraepithe lial lesion, aged over 45 years, and with lesions lasting for over 1 year, 52 patients underwent diagnostic LEEP operation. Among the 63 cases of HSIL confirmed by histopathology, 58 cases were treated by LEEP. Among the 63 HSIL patients, 5 patients with positive examination results in margin were given cytology + HPV + colposcopy every 6 months; and 4 of 5 patients were diagnosed as cervical cancer IA 1 stage by pathology, then the 4 patients were treated by total laparoscopic extrafascial hysterectomy after LEEP. Up to the end of 12-month follow-up, no CIN residue or cervical cancer recurrence was detected, but there were 8 cases of CIN recurrence. Conclusions Early diagnosis of precancerous cervical lesions and timely development of reasonable treatment are the key points to prevent and treat cervical cancer. Key words: Diagnosis; Precancerous cervical lesions; Treatment; Clinical analysis
目的探讨宫颈上皮内瘤变(CIN)的诊断和治疗方法。方法回顾性分析2017年1月至2018年1月山西省人民医院诊治的200例CIN患者的临床记录和资料。所有患者均通过宫颈三步筛查确诊,包括薄膜液基细胞学检查(TCT)和/或人乳头瘤病毒(HPV)检测、阴道镜检查和宫颈组织病理学检查。根据患者意愿及HPV感染情况行环电切术(LEEP)诊断宫颈病变。对经病理检查确诊为宫颈癌的患者,行腹腔镜筋膜外全子宫切除术。观察所有患者宫颈TCT检查、阴道镜活检、手术及1年随访情况。结果200例CIN患者中,宫颈TCT共检出低级别鳞状上皮内病变(LSIL)和高级别鳞状上皮内病变(HSIL) 141例,TCT诊断符合率为70.50%;组织病理学检出CINⅡ、CINⅢ共63例,TCT检出HSIL 45例,TCT诊断符合率为71.42%;组织病理学检出CINⅠ137例,TCT检出LSIL 96例,TCT诊断符合率为70.07%。200例CIN患者经阴道镜共检测LSIL和HSIL 163例,诊断准确率为81.50%;组织病理学检查CINⅡ、CINⅢ63例,阴道镜检查HSIL 50例,诊断准确率为79.36%;组织病理学检查CINⅠ137例,阴道镜检查LSIL 113例,诊断准确率为82.48%。137例经组织病理学证实的LSIL患者,细胞学检查结果不能排除高级别鳞状上皮内病变,年龄大于45岁,病变持续1年以上,52例行诊断性LEEP手术。经组织病理学证实的63例HSIL中,58例采用LEEP治疗。63例HSIL患者中,5例边缘检查阳性的患者每6个月行细胞学+ HPV +阴道镜检查;5例患者中4例经病理诊断为宫颈癌IA 1期,4例患者经LEEP后行腹腔镜筋膜外全子宫切除术。随访12个月,未发现CIN残留,未发现宫颈癌复发,但有8例CIN复发。结论早期诊断宫颈癌前病变,及时开展合理治疗是预防和治疗宫颈癌的关键。关键词:诊断;宫颈癌前病变;治疗;临床分析
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引用次数: 0
Levels and significance of pepsinogen, gastrin 17 in serum in patients with chronic atrophic gastritis 慢性萎缩性胃炎患者血清胃蛋白酶原、胃泌素17水平及意义
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.010
H. Su
Objective To analyze the levels of serum pepsinogen, gastrin 17 (G-17) in patients with chronic atrophic gastritis and their clinical significance. Methods A total of 196 patients with gastroduodenal disease who underwent gastroscopy in Linfen Central Hospital from January 2016 to January 2019 were selected as the study objects. According to the results of gastroscopy, they were divided into chronic atrophic gastritis group and non-atrophic gastritis group, with 98 cases in each group. The patients in chronic atrophic gastritis group were further divided into atrophic gastric body inflammation group (34 cases), atrophic gastric antrum inflammation group (42 cases), and the whole atrophic gastric multifocal gastritis group (22 cases) according to the lesion sites. The levels of serum pepsinogen Ⅰ (PG Ⅰ), pepsinogen Ⅱ (PG Ⅱ) and G-17 were measured by enzyme-linked immunosorbent assay. And pepsinogen ratio (PGR), PG Ⅰ/PG Ⅱ, was calculated. Qualitative detection of Helicobacter pylori (Hp) was performed by 13C urea breath test. The levels of PGⅠ, PGⅡ, PGR, and G-17 in each group were analyzed and compared among groups. Results The levels of serum PG Ⅰ and G-17 in the chronic atrophic gastritis group were significantly lower than those in the non-atrophic gastritis group (P 0.05), the difference in PGR between the two groups was statistically significant (P 0.05). Conclusions Decreased levels of PGⅠ, PGR and G-17 are biological markers of chronic atrophic gastritis. Large-scale population screening and screening for chronic atrophic gastritis can be performed based on serum PGⅠ and PGR cutoffs, and further examination with gastroscopy can improve the early diagnostic rate of gastric cancer. Key words: Stomach neoplasms; Chronic atrophic gastritis; Pepsinogen I; Pepsinogen Ⅱ; Gastrin 17; Pepsinogen ratio
目的分析慢性萎缩性胃炎患者血清胃蛋白酶原、胃泌素17 (G-17)水平及其临床意义。方法选取2016年1月至2019年1月在临汾市中心医院行胃镜检查的胃十二指肠疾病患者196例作为研究对象。根据胃镜检查结果将患者分为慢性萎缩性胃炎组和非萎缩性胃炎组,每组98例。慢性萎缩性胃炎组根据病变部位进一步分为萎缩性胃体炎组(34例)、萎缩性胃窦炎组(42例)和全萎缩性胃多灶性胃炎组(22例)。采用酶联免疫吸附法测定血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)和G-17的水平。计算胃蛋白酶原比值(PGR), PGⅠ/PGⅡ。13C尿素呼气试验定性检测幽门螺杆菌(Hp)。分析各组PGⅠ、PGⅡ、PGR、G-17水平,并进行组间比较。结果慢性萎缩性胃炎组血清PGⅠ、G-17水平显著低于非萎缩性胃炎组(P < 0.05),两组间PGR差异有统计学意义(P < 0.05)。结论PGⅠ、PGR、G-17水平降低是慢性萎缩性胃炎的生物学标志物。可根据血清PGⅠ和PGR截止值进行大规模人群筛查和慢性萎缩性胃炎筛查,进一步胃镜检查可提高胃癌的早期诊断率。关键词:胃肿瘤;慢性萎缩性胃炎;胃蛋白酶原我;胃蛋白酶原Ⅱ;胃泌激素17;胃蛋白酶原比例
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引用次数: 0
Relationship between bacterial infection and pancreatic leakage after pancreaticoduodenectomy 胰十二指肠切除术后细菌感染与胰漏的关系
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.005
Xu Jian, Miao Yu, Quan Shen, Jia Meng
Objective To analyze the relationship between postoperative infection and pancreatic leakage after pancreaticoduodenectomy, and to provide a reference and guidance for the application of antibiotics postoperative. Methods A total of 400 patients treated by pancreaticoduodenectomy from July 2014 to December 2018 in Henan Provincial People’s Hospital were enrolled. According to the severity of pancreatic leakage and pancreatic fistula, all patients were divided into non pancreatic fistula group (250 cases), biochemical leakage group (98 cases) and B/C pancreatic fistula group (52 cases). The postoperative infection, occurrence and severity of pancreatic leakage were counted. And the relationship between bacterial infection and pancreatic leakage was analyzed. Results Among the three groups, the bacterial infection rate was 4.00% (10/250) in the non pancreatic fistula group, 18.36% (18/98) in the biochemical leakage group, and 90.38% (47/52) in the B/C pancreatic fistula group, and the difference was statistically significant among the three groups (all P<0.05). In the B/C pancreatic fistula group, there were 40 patients with B-level pancreatic leakage, of which 36 patients had positive bacterial culture; and 12 patients in this group were with C-level pancreatic leakage, of which 11 patients were with positive bacterial culture. There was a significant difference in bacterial infection between B-level and C-level pancreatic fistula patients (P<0.05). Among the patients with positive result of bacterial culture within one week after operation, there were 15 cases with grade B pancreatic leakage and 9 cases with grade C pancreatic leakage; among the patients with positive result of bacterial culture one week after operation, 21 patients had grade B pancreatic leakage and 2 patients had grade C pancreatic leakage. There was no significant difference in the bacterial spectrum of patients with pancreatic leakage at different stages. Conclusions Bacterial infection is a risk factor for pancreatic leakage after pancreaticoduodenectomy, and the earlier the bacterial infection occurs, the worse the pancreatic leakage progress. Key words: Pancreaticoduodenectomy; Bacteria infection; Pancreatic leakage
目的分析胰十二指肠切除术后感染与胰漏的关系,为术后抗生素的应用提供参考和指导。方法选取2014年7月至2018年12月在河南省人民医院行胰十二指肠切除术的患者400例。根据胰漏和胰瘘的严重程度,将所有患者分为非胰瘘组(250例)、生化渗漏组(98例)和B/C胰瘘组(52例)。统计术后感染情况、胰漏发生率及严重程度。并分析细菌感染与胰漏的关系。结果三组患者中,非胰瘘组细菌感染率为4.00%(10/250),生化渗漏组为18.36% (18/98),B/C胰瘘组为90.38%(47/52),三组间差异均有统计学意义(均P<0.05)。B/C胰瘘组B级胰漏40例,其中细菌培养阳性36例;本组12例为c级胰漏,其中11例细菌培养阳性。b级胰瘘患者与c级胰瘘患者细菌感染差异有统计学意义(P<0.05)。术后1周内细菌培养结果阳性的患者中,B级胰漏15例,C级胰漏9例;术后1周细菌培养阳性患者中,B级胰漏21例,C级胰漏2例。不同阶段胰漏患者的细菌谱差异无统计学意义。结论细菌感染是胰十二指肠切除术后发生胰漏的危险因素,细菌感染发生越早,胰漏进展越严重。关键词:胰十二指肠切除术;细菌感染;胰漏
{"title":"Relationship between bacterial infection and pancreatic leakage after pancreaticoduodenectomy","authors":"Xu Jian, Miao Yu, Quan Shen, Jia Meng","doi":"10.3760/CMA.J.ISSN.1674-4756.2020.05.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-4756.2020.05.005","url":null,"abstract":"Objective \u0000To analyze the relationship between postoperative infection and pancreatic leakage after pancreaticoduodenectomy, and to provide a reference and guidance for the application of antibiotics postoperative. \u0000 \u0000 \u0000Methods \u0000A total of 400 patients treated by pancreaticoduodenectomy from July 2014 to December 2018 in Henan Provincial People’s Hospital were enrolled. According to the severity of pancreatic leakage and pancreatic fistula, all patients were divided into non pancreatic fistula group (250 cases), biochemical leakage group (98 cases) and B/C pancreatic fistula group (52 cases). The postoperative infection, occurrence and severity of pancreatic leakage were counted. And the relationship between bacterial infection and pancreatic leakage was analyzed. \u0000 \u0000 \u0000Results \u0000Among the three groups, the bacterial infection rate was 4.00% (10/250) in the non pancreatic fistula group, 18.36% (18/98) in the biochemical leakage group, and 90.38% (47/52) in the B/C pancreatic fistula group, and the difference was statistically significant among the three groups (all P<0.05). In the B/C pancreatic fistula group, there were 40 patients with B-level pancreatic leakage, of which 36 patients had positive bacterial culture; and 12 patients in this group were with C-level pancreatic leakage, of which 11 patients were with positive bacterial culture. There was a significant difference in bacterial infection between B-level and C-level pancreatic fistula patients (P<0.05). Among the patients with positive result of bacterial culture within one week after operation, there were 15 cases with grade B pancreatic leakage and 9 cases with grade C pancreatic leakage; among the patients with positive result of bacterial culture one week after operation, 21 patients had grade B pancreatic leakage and 2 patients had grade C pancreatic leakage. There was no significant difference in the bacterial spectrum of patients with pancreatic leakage at different stages. \u0000 \u0000 \u0000Conclusions \u0000Bacterial infection is a risk factor for pancreatic leakage after pancreaticoduodenectomy, and the earlier the bacterial infection occurs, the worse the pancreatic leakage progress. \u0000 \u0000 \u0000Key words: \u0000Pancreaticoduodenectomy; Bacteria infection; Pancreatic leakage","PeriodicalId":9667,"journal":{"name":"Central Plains Medical Journal","volume":"46 1","pages":"16-18"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85464145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic management of foreign bodies in the upper gastrointestinal tract: a retrospective study on 570 cases 上消化道异物的内镜治疗:570例回顾性研究
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.007
Xiaodi Jing, Xuexiu Zhang, Xiaofang Guo, B. Gao, Jianning Yao, Chunfeng Wang, Lian-feng Zhang
Objective To investigate the pathogenesis and treatment of foreign bodies in the upper digestive tract in the Central Plain of China. Methods A total of 570 patients with foreign bodies in the upper gastrointestinal tract treated in the First Affiliated Hospital of Zhengzhou University from March 2015 to March 2019 were selected. The types of foreign bodies, location of impaction, complications, selection of instruments and methods of removal of them were analyzed retrospectively. Results Among the 570 patients, 323 persons were males and 247 persons were females, with an average age of 47 years. Date pits were the most common ingested foreign bodies (24.2%, 138/570), and the esophagus was the most common lodgment site (73.2%, 417/570). Time from foreign incarceration to treatment was 6 h to 30 d, and the average hospitalization rate was 62.3% (339/570). The primary clinical symptom was retrosternal pain. The complication rate was (58.1%, 331/570), which was relatively high. Two patients underwent surgery to remove foreign bodies for esophageal perforation, and one pationt died due to treatment failure. Conclusions Endoscopic management is a safe and highly effective procedure for extracting ingested foreign bodies. Rapid endoscopic intervention should be provided to reduce the risk of complications. Key words: Foreign body; Upper digestive tract; Endoscopy
目的探讨中原地区上消化道异物的发病机制及治疗方法。方法选取2015年3月至2019年3月郑州大学第一附属医院收治的上消化道异物患者570例。回顾性分析异物类型、嵌塞部位、并发症、器械选择及取出方法。结果570例患者中,男性323例,女性247例,平均年龄47岁。枣核是最常见的摄入异物(24.2%,138/570),食道是最常见的沉积部位(73.2%,417/570)。从外国监禁到治疗的时间为6 h ~ 30 d,平均住院率为62.3%(339/570)。主要临床症状为胸骨后疼痛。并发症发生率(58.1%,331/570)较高。2例患者因食管穿孔接受手术清除异物,1例患者因治疗失败死亡。结论内镜下处理是一种安全、高效的异物取出方法。应提供快速内镜干预以减少并发症的风险。关键词:异物;上消化道;内窥镜检查
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引用次数: 1
Comparison of detection values of acid-fast bacilli in sputum by direct smear versus liquid-based cytology smear 直接涂片法与液基细胞学涂片法痰中抗酸杆菌检出值的比较
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.ISSN.1674-4756.2020.05.018
Wenzhe Wu, X. Tian
Objective To compare the detection values of direct smear and liquid-based cytology smear in the detection of acid-fast bacilli in sputum. Methods A total of 4 000 patients with tuberculosis admitted to Binzhou Central Hospital from May 2018 to May 2019 were selected. One sputum sample at night and one sputum sample at morning were collected from every patients. Finally, 8 000 specimens were enrolled in the study in total. Direct smear method and liquid-based cytology smear method were used to detect the 8 000 specimens. And the positive detection rates of acid-fast bacilli in sputum by two methods were recorded. Results The positive detection rates of acid-fast bacilli in the morning sputum sample by liquid-based cytology smear and direct smear were 30.33% (2 426/4 000) and 21.55% (1 724/4 000), respectively, and the positive detection rates of the night sputum samples by the two methods were 22.34% (1 787/4 000) and 12.40% (992/4 000) respectively. Compared with the night sputum samples, the positive detection rates of acid-fast bacilli in the morning sputum samples by two detection methods were higher, and the difference was statistically significant (P<0.05). Compared with direct smear method, the positive rates of acid-fast bacilli in the morning sputum samples and in the night sputum samples detected by liquid-based cytology smear method were higher, and the difference was statistically significant (P<0.05). Among the 8 000 specimens, the positive rates of salivary sputum, mucus sputum, blood sputum and purulent sputum detected by liquid-based cytology smear method were 14.52% (108/744), 12.09% (429/3 548), 65.49% (334/510) and 49.00% (1 567/3 198), respectively, And the positive detection rates of salivary sputum, mucus sputum, blood sputum and purulent sputum detected by direct smear method were 2.96% (22/744), 8.26% (293/3 548), 42.35% (216/510) and 36.34% (1 162/3 198), respectively. Compared with salivary sputum, mucus sputum and purulent sputum, the positive detection rates of acid-fast bacilli in blood sputum by the two methods were higher, and the difference was statistically significant (P<0.05). Compared with the direct smear method, the positive detection rates of sputum, mucus sputum, blood sputum and purulent sputum by liquid based cytology smear method were higher, and the difference was statistically significant (P<0.05). Conclusions The application of liquid-based cytology smear in the detection of acid-fast bacilli in sputum can effectively diagnose pulmonary tuberculosis and provide a basis for clinical diagnosis and treatment. Key words: Tuberculosis; Mycobacterium tuberculosis; Liquid-based cytology smear; Detection technology of acid-fast bacilli
目的比较直接涂片法和液基细胞学涂片法对痰中抗酸杆菌的检测价值。方法选择2018年5月至2019年5月滨州市中心医院收治的结核病患者4000例。每例患者采集1份夜间痰液和1份早晨痰液。最后,总共有8000个标本被纳入研究。采用直接涂片法和液基细胞学涂片法对8 000例标本进行检测。并记录两种方法对痰中抗酸杆菌的检出率。结果液基细胞学涂片和直接涂片对晨痰标本抗酸杆菌检出率分别为30.33%(2 426/4 000)和21.55%(1 724/4 000),两种方法对夜痰标本抗酸杆菌检出率分别为22.34%(1 787/4 000)和12.40%(992/4 000)。与夜间痰液标本相比,两种检测方法对清晨痰液标本中抗酸杆菌的阳性率均较高,差异有统计学意义(P<0.05)。与直接涂片法相比,液基细胞学涂片法检测早晨痰液标本和夜间痰液标本中抗酸杆菌阳性率较高,差异有统计学意义(P<0.05)。8 000份标本中,液基细胞学涂片法检测唾液、粘液、血、化脓的阳性率分别为14.52%(108/744)、12.09%(429/3 548)、65.49%(334/510)、49.00%(1 567/3 198),直接涂片法检测唾液、粘液、血、化脓的阳性率分别为2.96%(22/744)、8.26%(293/3 548)、42.35%(216/510)、36.34%(1 162/3 198)。两种方法痰中抗酸杆菌检出率均高于唾液痰、黏液痰和化脓痰,差异有统计学意义(P<0.05)。与直接涂片法相比,液基细胞学涂片法痰、黏液痰、血痰、化脓痰的阳性检出率较高,差异有统计学意义(P<0.05)。结论应用液基细胞学涂片检测痰中抗酸杆菌可有效诊断肺结核,为临床诊治提供依据。关键词:肺结核;结核分枝杆菌;液体细胞学涂片;抗酸杆菌检测技术
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引用次数: 0
期刊
Central Plains Medical Journal
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