ABSTRACT
Objective:To investigate the value of CHA2DS2-VASc score for predicting percutaneous coronary intervention (PCI) prognosis in patients with coronary chronic total occlusion.Methods:The clinical data of 139 patients with coronary chronic total occlusion who underwent PCI at the Second Hospital of Anhui Medical University from January 2019 to December 2020 were retrospectively analyzed. These patients were divided into good prognosis and poor prognosis groups according to prognosis outcomes. Univariate and multivariate Cox regression analysis was performed to evaluate the influential factors of adverse events after PCI in patients with coronary chronic total occlusion. The receiver operating characteristic curves were plotted to evaluate the value of the CHA2DS2-VASc score for predicting the occurrence of adverse events in patients with coronary chronic total occlusion undergoing PCI.Results:Among the 139 patients with coronary chronic total occlusion, the average follow-up time was (19.88 ± 7.90) months, 19 (13.7%) patients had a poor prognosis, and 120 (86.3%) patients had a good prognosis. The age, uric acid, and CHA2DS2-VASc score in the poor prognosis group were 73 (65.0, 77.0) years, (383.26 ± 120.60) μmol/L, and 4 (3, 5) points, respectively, which were significantly higher than 66 (57.0, 71.8) years, (322.68 ± 91.88) μmol/L, and 3 (2, 4) points in the good prognosis group ( U = -2.74, t = 2.24, U = -3.09, all P < 0.05). However, the proportion of patients with the successful opening of the occluded coronary artery and albumin, hemoglobin, and triacylglycerol levels in the poor prognosis group were 11 (57.9%), 36.7 (34.4, 38.3) g/L, (120.26±19.74) g/L, and 1.03 (0.85, 1.49) mmol/L, respectively, which were significantly lower than 98 (81.7%)( χ2 = 4.16, P = 0.041), 39.3 (36.78, 42.1) g/L ( U = -2.85, P = 0.004), (133.62 ± 16.84) g/L ( t = 1.52, P = 0.002), and 1.52 (1.09, 2.25) mmol/L ( U =-2.13, P = 0.033) in the good prognosis group. Multivariate Cox regression analysis showed that CHA2DS2-VASc score was a risk factor for poor prognosis of patients with coronary chronic total occlusion undergoing PCI (95% CI: 1.137-2.274, P = 0.007). The receiver operating characteristic curve analysis results showed that the area under the receiver operating characteristic curve plotted for CHA2DS2-VASc score predicting poor prognosis in patients with coronary chronic total occlusion undergoing PCI was 0.716 (95% CI: 0.588-0.844, P = 0.003), with the cut-off point of 3.5, the sensitivity of 68.4%, and specificity of 66.7%, respectively. Conclusion:Compared with those with a good prognosis, patients with a poor prognosis have a higher CHA2DS2-VASc score. The CHA2DS2-VASc score has a certain application value for predicting mid- and long-term prognosis in patients with coronary chronic total occlusion who undergo PCI.
ABSTRACT
Objective To evaluate the effect of Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule in the treatment of acute lumbar sprain. Methods A total of 102 patients with acute lumbar sprain were randomly divided into two groups, 51 in each group.The control group received ibuprofen sustained-release capsules orally. The study group was treated with Xuefu-Zhuyu decoction combined with interactive acupuncture on the basis of the control group. Both groups were treated for 2 weeks. The degree of low back pain was assessed by VAS and the improvement of lumbar function was assessed by modified Japanese Orthopaedic Association Scores (M-JOA). The Oswestry dysfunction index (ODI) was used to evaluate the degree of lumbar dysfunction. The serum hs-CRP, IL-6, IL-10 and prostaglandin E2 (PGE2) level was detected by ELISA. The clinical efficacy was evaluated. Results The total effective rate was 80.4% (41/51) in the study group and 62.8% (32/51) in the control group. There was significant difference between the two groups (χ2=3.903, P=0.048). After treatment, the VAS (1.85 ± 0.40 vs. 4.06 ± 0.67, t=20.226), M-JOA (4.41 ± 1.35 vs. 11.18 ± 2.25, t=18.426), and ODI (9.66 ± 3.34 vs. 16.37 ± 3.64, t=9.700) in the study group were significantly lower than those in the control group (P<0.01). The serum level of hs-CRP, IL-6, IL-10 and PGE2 in the study group were significantly lower than those in the control group after treatment (t were 6.694, 8.416, 22.110 and 12.137, respectively, all P s<0.01). Conclusions The Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule can improve the degree of lumbago and lumbar dysfunction in patients with acute lumbar sprain, reduce the level of serum inflammatory cytokines, and improve the clinical efficacy.