ABSTRACT
Objective:To investigate the clinical characteristics and risk factors of paroxysmal atrial fibrillation(AF)and persistent atrial fibrillation in elderly patients, in order to provide a theoretical basis for clinical diagnosis and treatment and risk assessment of adverse prognosis.Methods:A total of 201 non-valvular AF patients aged 60-90 years admitted to Heji Hospital from Jan.2017 to Aug.2019 were enrolled in this retrospective study.Of the 201 patients, 102 cases met the diagnostic criteria for paroxysmal AF and 99 cases met the diagnostic criteria for persistent AF.During the same period, 100 healthy elderly people from the physical examination center were included.Clinical data, laboratory test results and echocardiography data were collected.Differences in clinical parameter values between the two groups were analyzed by Hotelling's Trace multivariate analysis.Risk factors for AF were analyzed by comparison of correlation factors, single factor analysis and unconditional logistic regression multivariate analysis.Results:The paroxysmal AF group had a mean age of (70.2±6.5) years old, with 73 males(73.7.6%)and 26 females(26.3%), while the persistent AF group’s mean age was (65.3±5.23), with 61 males(59.8%)and 41 females(40.2%). There were a significant difference in age between the paroxysmal AF group and the persistent AF group( t=5.99, χ2=4.39, P<0.05). Hotelling's Trace multivariate analysis indicated differences in clinical parameter values between the two groups( F=6.26, P<0.01). Levels of serum uric acid, homocysteine(Hcy), high sensitivity C-reactive protein(hs-CRP)and D-dimer, and anterior and posterior diameter of the left atrium were higher in the persistent AF group than in the paroxysmal AF group( P<0.05), while levels of total cholesterol, platelet count and left ventricular ejection fraction(LVEF)were higher in the paroxysmal AF group than in the persistent AF group( P<0.05). History of hypertension( OR=8.92, 95% CI: 4.18-19.05)and smoking history( OR=4.47, 95% CI: 1.87-10.71)were risk factors for persistent AF, while history of hypertension( OR=9.11, 95% CI: 4.21-19.69), smoking history( OR=3.56, 95% CI: 1.44-8.81)and drinking history( OR=9.32, 95% CI: 2.49-34.96)were risk factors for paroxysmal AF. Conclusions:The incidences of AF can be significantly reduced by controlling hypertension within an ideal range and quitting smoking and drinking.High concentrations of serum Hcy, D-dimer, hs-CRP and uric acid and increased anterior and posterior diameter of the left atrium may contribute to the persistence of AF.
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Objective To study the diagnostic value of computed tomographic virtual endoscopy versus electronic colonoscopy for colon cancer in elderly patients.Methods The 69 cases of elderly patients with colon cancer received CTVE and electronic colonoscopy before surgery to compare achievement rates,sensitivities,and endoscopy coincidence rate with pathologic classification between the two methods.Results For a definite diagnosis of colon cancer in elderly patients,achievement ratio was 98.6％ (68/69) in CTVE and 62.3％ (43/69) in electronic colonoscopy(x2 =14.72,P＜ 0.05);sensitivity was 95.6％ (65/68) in CTVE and 97.7％ (42/43) in electronic eolonoscopy(x2=0.003,P ＞ 0.05);endoscopy coincidence rate with pathologic classification was 95.4％ (62/65) in C-TVE and 95.2％(40/42) in electronic colonoscopy.Conclusions CT virtual endoscopy may be one of examination methods in elderly patients with colon cancer.
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Objective To explore short-term prognosis of patients with acute coronary syndrome (ACS) and prognostic risk factors, and to provide information for prognostic risk assessment. Methods A total of 156 patients with acute coronary syndrome were enrolled. The correlations of baseline characteristics with 30-day improvement, death, angina pectoris and heart failure were analyzed using unordered multivariate logistic regression. Results Logistic regression analysis showed that the independent risk factors for 30-day death included age (OR=1.20, 95%CI: 1.07-1.34), diabetes (OR=19.41, 95%CI: 3.02-124.70), leukocytosis (OR=11.36, 95%CI: 1.87-69.11) and increased platelet (OR=7.72, 95%CI: 1.29-46.15). The independent risk factors for 30-day angina pectoris included leukocytosis (OR=2.35, 95%CI: 0.89-6.17) and dyslipidemia (OR=6.25, 95%CI: 2.11-18.48). The independent risk factors for the occurrence of heart failure during 30-day post-ACS included age (OR=1.10, 95%CI: 1.03-1.17), male (OR=4.18, 95%CI: 0.81-21.51), leukocytosis (OR=2.97, 95%CI: 1.09-8.14) and dyslipidemia (OR=7.69, 95%CI: 2.39-24.76). Conclusions Age, diabetes, leukocytosis and increased platelet are independent risk factors associated with 30-day death; Leukocytosis and dyslipidemia are independent risk factors associated with 30-day angina pectoris; Age, male, leukocytosis and dyslipidemia are the independent risk factors associated with 30-day heart failure.