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【Objective】 To compare the enhancement effects of lean body weight （LBW） and total body weight （TBW） as indexes to calculate the contrast agent dosage under the condition of energy spectrum CT scanning. 【Methods】 A total of 218 patients who received liver enhancement CT from November 2018 to January 2019 were enrolled in this study. There were 101 patients in LBW group and 117 patients in TBW group. Both groups were scanned by energy spectrum CT， and the parameters of scanning and reconstruction were identical. The contrast agent dose was 500 mgI/kg （LBW） in LBW group and 450 mgI/kg （TBW） in TBW group， and the injection rate was 2.8 mL/s. Images were transferred to a GE AW4.7 workstation and the 50 keV monochromatic images were analyzed. We compared the dosage of contrast medium， CT value of aorta in arterial phase （HU-aorta）， hepatic enhancement CT value in venous phase （-liver）， the rate of reaching the enhancement standard and variability in the two groups. 【Results】 Compared with TBW group， LBW group had lower contrast agent dosage， HU-aorta and ∆-liver （P0.05）. The variation rate of HU-aorta and ∆-liver in LBW group was lower than that in TBW group. Using LBW as an index to calculate the dosage of liver enhanced CT also made the enhancement of liver parenchyma more consistent in different patients. 【Conclusion】 Even on the premise of energy spectrum CT scanning， using LBW-based contrast injection in liver enhanced CT can not only reduce contrast dose， but also make the enhancement in liver parenchyma more consistent among different patients.
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Objective@#The aim of the study was to explore the influencing factors of exercise tolerance in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI) revascularization in acute state.@*Methods@#A total of 112 patients with first MI undergoing PCI revascularization in acute state and completing cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption percentage (VO2 peak%) in CPET. Patients were divided into normal exercise capacity (NEC) group (n=40) and abnormal (AEC) group (n=72) according to VO2 peak% value. Clinical manifestations, histories of hypertension and diabetes, medications, coronary arterial angiography and echocardiography findings of patients were compared. The onsets of diabetes and blood glucose levels during the period of CPET were evaluated in the MI patients with diabetes. The patients were followed up for major adverse cardiovascular events (MACE) (admission due to chest pain, re-revascularization, re-infarction and all-cause death) within 24 months after PCI. Multivariate logistic regression analyses were conducted to examine influencing factors for exercise tolerance.@*Results@#The ratio of diabetes, type C lesions in the AEC group were higher than those in the NEC group (diabetes: 37.5% vs. 17.5%; type C lesions: 69.4% vs. 42.5%, respectively, all P<0.05). The left ventricular ejection fraction (LVEF) in patients in the AEC group was lower than that in the NEC group [(60.6±10.0)% vs. (65.0±8.2)%, P=0.019]. Multivariate logistic regression analyses showed that history of diabetes and history of type C lesions were the independent risk factors for the declined exercise capacity in the MI patients after PCI revascularization (OR=3.14, 95%CI 1.167-8.362, P=0.023; OR=3.32, 95%CI 1.444-7.621, P<0.01). Among the MI patients with diabetes, the duration of diabetes in the AEC group was significantly longer than that in the NEC group[(7.7±3.6)years vs. (5.0±2.4)years] and the proportions of subjects reaching target levels of fasting plasma glucose (40.7% vs. 57.1%) and glycosylated hemoglobin A1c(HbA1c) (55.6% vs. 71.4%) in this group were significantly lower than those in the NEC group (all P<0.05). A multivariate logistic regression analysis showed that reaching HbA1c target was an independent predictor of improved exercise tolerance in MI patients with diabetes who received PCI (OR=2.518, 95%CI 1.395-7.022, P=0.021). No significant differences were observed in incidence of admission due to chest pain, re-revascularization and re-infarction between the two groups within 24 months after PCI between the groups.@*Conclusions@#Diabetes and type C lesions are independent risk factors of declined exercise capacity in patients with first myocardial infarction who received revascularization in acute state. Reaching target HbA1c is independent factor of improved exercise capacity in patients with myocardial infarction and diabetes.
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Objective The aim of the study was to explore the influencing factors of exercise tolerance in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI) revascularization in acute state. Methods A total of 112 patients with first MI undergoing PCI revascularization in acute state and completing cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption percentage (VO2 peak%) in CPET. Patients were divided into normal exercise capacity (NEC) group (n=40) and abnormal (AEC) group (n=72) according to VO2 peak% value. Clinical manifestations, histories of hypertension and diabetes, medications, coronary arterial angiography and echocardiography findings of patients were compared. The onsets of diabetes and blood glucose levels during the period of CPET were evaluated in the MI patients with diabetes. The patients were followed up for major adverse cardiovascular events (MACE) (admission due to chest pain, re?revascularization, re?infarction and all?cause death) within 24 months after PCI. Multivariate logistic regression analyses were conducted to examine influencing factors for exercise tolerance. Results The ratio of diabetes, type C lesions in the AEC group were higher than those in the NEC group (diabetes: 37.5% vs. 17.5%; type C lesions: 69.4% vs. 42.5%, respectively, all P<0.05). The left ventricular ejection fraction (LVEF) in patients in the AEC group was lower than that in the NEC group [(60.6±10.0) % vs. (65.0±8.2) %, P=0.019]. Multivariate logistic regression analyses showed that history of diabetes and history of type C lesions were the independent risk factors for the declined exercise capacity in the MI patients after PCI revascularization ( OR=3.14, 95%CI 1.167-8.362, P=0.023; OR=3.32, 95%CI 1.444-7.621, P<0.01). Among the MI patients with diabetes, the duration of diabetes in the AEC group was significantly longer than that in the NEC group[ (7.7 ± 3.6)years vs. (5.0 ± 2.4)years] and the proportions of subjects reaching target levels of fasting plasma glucose (40.7% vs. 57.1%) and glycosylated hemoglobin A1c(HbA1c) (55.6% vs. 71.4%) in this group were significantly lower than those in the NEC group (all P<0.05). A multivariate logistic regression analysis showed that reaching HbA1c target was an independent predictor of improved exercise tolerance in MI patients with diabetes who received PCI ( OR=2.518, 95%CI 1.395-7.022, P=0.021). No significant differences were observed in incidence of admission due to chest pain, re?revascularization and re?infarction between the two groups within 24 months after PCI between the groups. Conclusions Diabetes and type C lesions are independent risk factors of declined exercise capacity in patients with first myocardial infarction who received revascularization in acute state. Reaching target HbA1c is independent factor of improved exercise capacity in patients with myocardial infarction and diabetes.
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Objective To investigate the influence factors of Cornell product and its clinical value in pa-tients with left ventricular high voltage.Methods 104 patients with left ventricular high voltage were studied and divided into two groups according to Cornell product:Cornell product normal group(n = 78)and Cornell product abnormal group(n=26). Clinical manifestations ,complicaions and ultracardiographic data in these patients were collected and analyzed. Results Chronic kidney disease(CKD)(OR=4.266,95%CI 1.276-14.257,P=0.018) and left ventricular mass index(LVMI)(OR = 1.023,95%CI 1.004-1.043,P = 0.016)were related to Cornell product. Cornell product was positively correlated LVMI appeared(r=0.497,P<0.001). The correlation of Cor-nell product with left ventricularend-diastolic dimension ,interventricular septal thickness and left ventricular poste-rior wall thickness was weak.ROC-AUC of Cornell product for CKD was 0.634,95%CI=0.506-0.780,P=0.039, sensibility 47.8%,and specificity 81.5%. Conclusions LVMI and CKD are independent influence factors of Cor-nell product. Cornell product has a certain diagnositc value for left ventricular hypertrophy ,but it has no associa-tion with the location of ventricular hypertrophy.
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Objective To determine the median effective target plasma concentration (EC50) of propofol inhibiting the response to laryngeal mask airway (LMA) insertion when combined with dexmedetomidine.Methods ASA Ⅰ or Ⅱ patients of both sexes,aged 20-60 yr,with body mass index 20-25 kg/m2,scheduled for surgeries under general anesthesia,were studied.EC50 of propofol was determined by modified Dixon' s up-and-down sequential experiment.After dexmedetomidine 1.0 μg/kg was infused over 10 min,propofol was infused by targetcontrolled infusion.The initial target plasma concentration of propofol was set at 3.0 μg/ml.LMA was inserted when the target effect-site concentration of propofol and target plasma concentration of propofol reached the balance and BIS value was 50-60.Each time the target concentration increased/decreased by 0.2 μg/ml according to the occurrence of the response to LMA insertion.The response to LMA insertion was defined as the occurrence of coughing,body movement,laryngospasm or systemic voluntary movement.EC50 and 95 ％ confidence interval (CI)of propofol for inhibition of the response to LMA insertion were calculated.Results The EC50 of propofol required for inhibition of the response to LMA insertion was 2.351 (95％ Cl 1.737-2.600) μg/ml when combined with dexmedetomidine 1.0 μg/kg.Conclusion The EC50 of propofol inhibiting the response to LMA insertion is 2.351 μg/ml when combined with dexmedetomidine.