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Objective To observe the incidence,clinical characteristics,related factors,adverse events during hospitalization and short-term prognosis of postprandial hypotension (PPH) in elderly patients with coronary heart disease.Methods One hundred and sixty-eight elderly patients with coronary heart disease hospitalized in the Department of Cardiology,Second Hospital of Hebei Medical University from January 2014 to January 2015 were selected as the research subjects.They were monitored by 24 h ambulatory blood pressure monitoring.According to the diagnostic criteria of PPH,they were divided into postprandial hypotension group (PPH group) 34 cases and non-postprandial hypotension group (NPPH group) 134 cases.The clinical characteristics,risk factors related to PPH,occurrence of adverse events and prognosis of all-cause death,cardiovascular and cerebrovascular adverse events were compared between the two groups.Results Among 168 elderly patients with coronary heart disease,thirty-four patients had PPH,and the incidence rate was 20.2％ (34/168).The average systolic blood pressure before meals in PPH group was (139.8± 18.6) mmHg (1 mmHg =0.133 kPa).The proportion of taking calcium antagonists was 50.0％ (17/34) higher than that in NPPH group (127.4± 13.2) mmHg,27.6％ (37/134).The difference between the two groups was statistically significant (t =6.463,x2=6.232,P＜ 0.05).PPH was higher in breakfast and dinner than in lunch;the higher the basal systolic blood pressure level,the higher the incidence of PPH.Logistic regression analysis showed that the basal systolic blood pressure level and age were positively correlated with the occurrence of PPH (r =0.301,r =0.208,P＜ 0.05).Follow-up for 26 months showed that the incidence of all-cause death and cerebrovascular events in PPH group was higher than that in NPPH group (x2 =5.800,11.560,P＜ 0.05).Conclusion The incidence of PPH in elderly patients with coronary heart disease during hospitalization is 20.2％.Breakfast and dinner at three meals are prone to PPH.Older age and high systolic blood pressure level will increase the incidence of PPH.PPH will increase the incidence of mid-term all-cause death and cerebrovascular events.
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Objective To explore the influence of Multi-slice spiral CT combined with plasma carbohydrate antigen 199 (CA199) ,carbohydrate antigen 242 (CA242) ,carbohydrate antigen 50 (CA50) levels detection on diagnostic accuracy of pancreatic cancer .Methods 77 cases of patients with pancreatic lesion treated in our hospital were studied ,and all were confirmed by surgery ,there were 48 cases of pancreatic carcinoma ,29 cases of pancreatic benign diseases .All the patients were undergoing CT testing .Plasma CA199 ,CA50 and CA242 levels were detected by using Radioimmunoassay method ,and plasma CA199 ,CA50 ,CA242 levels ,CT test re-sults ,and the efficacy of single test diagnosis were contrasted .Results After CT diagnosis ,there were 8 cases positive in the benign group ,39 cases positive in the pancreatic cancer group ,with the overall positive rate of 61 .04%,and the coincidence rate was 77 .92% when compared with the operation and pathological results . Plasma CA199 ,CA50 and CA242 in the pancreatic cancer group were higher than those in the benign group , the difference was statistically significant (P＜0 .05) .Surgical pathological diagnosis was as the gold stand-ard ,the coincidence rate of CA199 was 75 .32% in the highest ,and the coincidence rate of CA242 was 45 .75%in the lowest .Compared with those in the single plasma CA199 ,CA50 ,CA242 detection ,the accuracy and sen-sitivity of combined diagnosis ,and missed diagnosis rate decreased ,the difference was statistically significant (P＜0 .05) .Those were slightly higher than those of CT detection ,but without statistically significant differ-ence (P＞0 .05) .There was no significant difference in specificity and misdiagnosis rate among different diag- nostic ways (P＞0 .05) .Conclusion The accuracy and sensitivity of multi-slice spiral CT is higher in diagnosis of pancreatic cancer ,but combined detection of plasma CA199 ,CA50 and CA242 can further improve diagnosis efficiency ,and provide a reference for clinical treatment of pancreatic cancer .
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Objective To observe the relationship between C-reactive protein (CRP) and the stability of coronary artery lesions and major adverse cardiac events.Methods By using coronary arteriography,coronary heart disease was diagnosed in 30 stable angina patients and 45 unstable ones.serum CRP and troponin T (cTnT) levels were measured on 0hs,6hs,24hs,48hs and 7days after hospital admission.The patients were divided into two groups according to the absence or presence of major adverse cardiac events.Results There was no relationship between CRP level and the severity of coronary artery lesions,whereas the CRP level of unstable angina(3.9?0.4 mg/L)was much higher than that of stable angina(2.2?0.3 mg/L),P