ABSTRACT
Objective To summarize risk factors for clinical outcomes in heart transplantation patients, evaluate the characters of Chinese patients by comparing with international data, and introduce new clinical strategies. Methods We performed 200 heart transplantations from Jun. 2004 to May 2010. The clinical information was recorded and all patients were followed up. By analyzing 160 patients with a follow-up period of more than one year, we summarized clinical outcomes and risk factors of early and late results of heart transplant patients. Results Of 160 patients, 8. 1 % received postoperative extracorporeal membrane oxygenation (ECMO) support and 10% continuous renal replacement therapy. In 550 cases/times of endomyocardial biopsies, the incidence of rejection with grades more than Ⅱ (concluding grade Ⅱ ) was 14. 9%. In-hospital mortality was 3. 8%. Smoking,preoperative diastolic pulmonary arterial pressure, PAWP, total serum protein level and albumin level were risk factors of peri-operative mortality, and preoperative diastolic pulmonary arterial pressure,primary heart diseases, pulmonary hypertension and implantations of ICD, MCS and ECMO were risk factors of late mortality. Postoperatively, 1-, 3- and 5-year survival rate was 94. 4%, 91.9% and 88. 8%, respectively. Compared with UNOS data, the rate of primary heart diseases, pulmonary hypertension, and implantation of ICD, MCS and ECMO were different, and the long-term survival rate of 160 patients was higher than that reported by ISHLT. Conclusion The risk factors of mortality of Chinese heart transplant patients are different with their counterparts from western countries. Our corresponding peri-operative treatments and clinical strategies have produced satisfactory clinical outcomes.
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AIM: To investigate the relationship between serum soluble E-selectin (sE-selectin) and insulin resistance, serum uric acid, serum lipid in essential hypertension patients. METHODS: Fasting serum sE-selectin concentration, plasma glucose, serum insulin, serum uric acid, total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol were determined in 186 patients with essential hypertension (75 males, 111 females). Homeostasis model assessment was applied to assess the status of insulin resistance (HOMA-IR). RESULTS: Based on the HOMA-IR, the essential hypertension patients were divided into insulin-sensitive individuals (IS) and insulin resistant subjects (IR). The serum sE-selectin concentration was significantly higher in male group [(50.1?17.8)?g/L] than in female group [(40.6?16.6)?g/L] (P
ABSTRACT
AIM: To investigate the effects of internal change of serum insulin and plasma glucose levels on serum free fatty acid (FFA) concentrations after glucose loading. METHODS: Serum insulin, plasma glucose and FFA concentrations were measured simultaneously in 234 essential hypertension patients who were undergoing oral glucose tolerance test (OGTT) [ including 20 cases with 2 type diabetes mellitus (DM), 74 impaired glucose tolerance (IGT), 140 normal glucose tolerance (NGT); 98 males, 136 females]. RESULTS: Fasting serum FFA concentration (?mol/L) in DM ((1 048.47)?481.6) was higher than that in IGT (760.1?332.1) (P