ABSTRACT
Objective To study effects of bivalirudin and heparin plus tirofiban on plasma P-selectin in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) and compare the clinical effects on bleeding and thrombosis.Methods 260 hospitalized patients with acute STEMI who accepted emergency PCI were enrolled in the study.They were randomly divided into the bivalirudin group (129 cases) and the heparin plus tirofiban group (131 cases).Blood samples were taken before operation,during operation (about 20 minutes after medicacion injection) and after operation (three hours after the end of operation).Serum P-selectin levels were measured.All patients were followed-up for 30 days.The main events included hemorrhage within 30 days,acquired thrombocytopenia and stent thrombosis.Results The level of P-selectin increased significantly in the heparin group during operation compared to the preoperative level and remained statistically higher at three hours after the end of operation than preoperative level (P ＜ 0.05).Compared with preoperative level,the P-selectin level of the bivalirudin group was significantly lower than that of heparin group (P ＜ 0.05).After 30 days of follow-up,bivalirudin had lower rates bleeding events compared to the heparin group(5.4％ vs.15.3％,P =0.009).The need of medical intervention for bleeding events (BRAC2-5 hemorrhage) was less in the bivalirudin group(0.8％ vs.5.3％,P =0.029).There was no significant difference in the major bleeding events between the 2 groups (BRAC3-5 hemorrhage) (0 vs.0.8％,P =0.32).No significant difference found between the two groups in acquired thrombocytopenia (P ＞ 0.05).Conclusion Bivalirudin may reduce P-selectin levels in STEMI patients undergone emergency PCI during perioperative period.Heparin increases perioperative P-selectin.Bivalirudin may reduce the bleeding events.
ABSTRACT
Objective To explore risk factors for asthma children in Urumqi aged 0-14 years old through the epidemiological survey data.Methods By cluster sampling method,totally 11 939 children were investigated.There were 148 cases of asthma,by using case-control study,the risk factors for asthma were analyzed.Results The total asthma morbidity rate of childhood asthma (aged 0-14 years old) in Urumqi(1.24％,148/11 939 cases) was significantly lower than that of national city incidence (3.02％) based on the third-time national survey;the prevalence rate was obviously rising compared with the region in 2000 (0.61％) and 1990 (0.40％).The prevalence of asthma in male and female children was 1.72％ (104/6 047 cases) and 0.75％ (44/5 892 cases),respectively (x2 =23.081,P ＜0.001).Preschool children had the highest prevalence of asthma (1.33％,36/2 705 cases),which was slightly higher than that of school-age children (1.29％,86/6 690 cases) and that of the infants (1.02％,26/2 544 cases).The prevalence in Han children (1.36％,121/8 895 cases) was higher than that of the minority children (0.89％,27/3 044 cases)(x2 =4.150,P ＜ 0.05).The uni-variate Logistic regression analysis showed that there were 16 significant factors that related to asthma;bv multivariate Logistic regression analysis,the family history of allergies,allergic rhinitis,food allergy history,use of antibiotics and passive smoking were all risk factors associated with childhood asthma.Conclusions The asthma prevalence is significantly different in genders,ages,Han nationality and minority.Active avoidance of risk factors for asthma in children are of great significance in the prevention and control of children asthma.