ABSTRACT
Objective To investigate the relationship between cardiac Tei index and plasma amino terminal brain natriuretic peptide precursor (NT- proBNP), glycosylated hemoglobin (HbA1c) in type 2 diabetes mellitus and its value in predicting the occurrence of major adverse cardiovascular events (MACE). Methods The clinical data of 160 patients with type 2 diabetes mellitus from March 2015 to October 2017 were retrospectively analyzed. The patients were divided into MACE group (45 cases) and non-MACE group (115 cases). The clinical indexes were compared between 2 groups, and the relationship between cardiac Tei index and NT-proBNP, HbA1c was analyzed. Logistic regression analysis was used to analyze the risk factors of MACE in patients with type 2 diabetes mellitus. Results The systolic blood pressure and diastolic blood pressure in MACE group were significantly lower than those in non-MACE group: (109.10 ± 14.53) mmHg (1 mmHg = 0.133 kPa) vs. (120.76 ± 18.74) mmHg and (64.29 ± 9.82) mmHg vs. (73.58 ± 12.11) mmHg, the heart rate, Killip grade > Ⅱ rate, cardiac Tei index and NT- proBNP were significantly higher than those in non- MACE group: (77.56 ± 13.36) times/min vs. (71.68 ± 11.39) times/min, 28.89％ (13/45) vs. 2.61％ (3/115), 0.63 ± 0.12 vs. 0.52 ± 0.08 and (1193.20 ± 145.69) μg/L vs. (823.87 ± 89.22) μg/L, and there were statistical difference (P<0.01). Pearson regression analysis result showed that cardiac Tei index was positively correlated with NT- proBNP and HbA1c (r = 0.817 and 0.793, P < 0.05), and there was positive correlation between NT-proBNP and HbA1c (r = 0.649, P < 0.05). Logistic regression analysis result showed that cardiac Tei index, NT-proBNP and HbA1c were the independent risk factors of MACE in patients with type 2 diabetes mellitus (OR = 1.015, 1.041 and 1.027; 95％ CI 1.005 to 0.213, 1.012 to 7.036 and 1.002 to 4.222; P<0.01 or <0.05). Conclusions The cardiac Tei index has positive correlation with NT- proBNP and HbA1c in patients with type 2 diabetes mellitus, and both are risk factors for the occurrence of MACE. The combination of the 3 indexes can effectively predict the occurrence of MACE and assess the prognosis.
ABSTRACT
BACKGROUND: Nerve root could be directly or indirectly entrapped due to lateral backward prolapse of nucleus pulposus of intervertebral disc, as well as parenchymal inflammatory tumefaction of the soft tissues in nerve root tube. But the factors and their severity related to cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus still need further studies.OBJECTIVE: To investigate the relationship between the occurrence rate of cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus and the severity of cervical syndrome.DESIGN: A single sample study.SETTING: Department of Anatomy, Department of Geriatrics of the Affiliated Hospital, and Department of Teaching Affairs, Chengde Medical College.PARTICIPANTS: The research was conducted in the Department of Anatomy, Chengde Medical College. Totally 120 sides of 60 cadavers(28 males and 32 females) were provided by the Department of Anatomy.METHODS: The outside diameters of cervical intervertebral foramen and spinal nerve root, as well as the width of external opening of spinal nerve sulcus and transverse diameter width of the anterior branch of intra-spinal nerve were measured, and the data were dealt with statistically.MAIN OUTCOME MEASURES: The ratio of transversal diameter of the forepart of cervical nerves to the width of spinal nerve sulcus; the ratio of the peripheral diameter of cervical nerve roots to the size of intervertebral foramen; the occurrence rate where the ratio was ≥ 1.RESULTS: The ratio between cervical nerve root and intervertebral foramen was significantly larger than that between spinal nerve root and spinal nerve sulcus( t = 2.66, P ＜ 0.01 ). The occurrence rate of cervical nerve entrapment at the intervertebral foramen(24.6% ) was higher than that in spinal nerve sulcus(6.3% ), and the difference had a considerable statistical significance(x2 =6.95, P ＜ 0.01).CONCLUSION: It is suggested that the spinal nerve may be entrapped in the cervical intervertebral foramen and the spinal nervous sulcus, and the spinal nerve lesions in the cervical intervertebral foramen was more serious than in the spinal nervous sulcus. Therefore, in clinic, when diagnosing and treating cervical spondylosis, while nerve entrapment at the intervertebral foramen is fully considered, the possibility of nerve entrapment at the spinal nervous sulcus should not be neglected.