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Objective:To establish a nomogram model for predicting the risk of coronary artery disease in elderly patients with acute myocardial infarction (AMI).Methods:The clinical data of elderly patients with AMI who underwent coronary angiography in the department of cardiology of Cangzhou Central Hospital from July 2015 to March 2020 were analyzed, including age, gender, smoking history, underlying diseases, family history, blood pressure, left ventricular ejection fraction (LVEF), and several biochemical indicators at admission, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein [Lp(a)], apolipoproteins (ApoA, ApoB), ApoA/B ratio, total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil), fasting blood glucose (FBG) and uric acid (UA). Patients were divided into model group (2 484 cases) and validation group (683 cases) according to the ratio of 8∶2. According to Gensini score, the model group and validation group were divided into mild lesion group (0-20 points) and severe lesion group (≥81 points). The differences of each index between different coronary lesion degree groups were compared. Lasso regression and Logistic regression were used to analyze the risk factors of aggravating coronary lesion risk in elderly patients with AMI, and then the nomogram prediction model was established for evaluation and external validation.Results:① In the model group, there were significant differences in the family history of coronary heart disease, FBG and HDL-C between the mild lesion group (411 cases) and the severe lesion group (417 cases) [family history of coronary heart disease: 3.6% vs. 7.7%, FBG (mmol/L): 5.88±1.74 vs. 6.43±2.06, HDL-C (mmol/L): 1.48±0.69 vs. 1.28±0.28, all P < 0.05]. In the validation group, there were significant differences between the mild lesion group (153 cases) and the severe lesion group [132 cases; FBG (mmol/L): 5.58±0.88 vs. 6.85±0.79, HDL-C (mmol/L): 1.59±0.32 vs. 1.16±0.21, both P < 0.05]. ② Lasso regression analysis showed that family history of coronary heart disease, FBG, and HDL-C were risk factors of coronary artery disease in elderly patients with AMI, with coefficients 0.118, 0.767, and -0.558, respectively. Logistic regression analysis showed that FBG [odds ratio ( OR) = 1.479, 95% confidence interval (95% CI) was 1.051-2.082, P = 0.025] and HDL-C ( OR = 0.386, 95% CI was 0.270-0.553, P < 0.001] were independent risk factors of coronary artery disease in elderly patients with AMI. ③ According to the rank score of FBG and HDL-C, the nomogram prediction risk model of aggravating coronary artery disease degree was established for each patient. It was concluded that the risk of coronary artery disease in elderly people with higher FBG level and (or) lower HDL-C level was significantly increased. ④ The nomogram model constructed with the model group data predicted the risk concordance index (C-index) was 0.689, and the C-index of the external validation group was 0.709. Conclusions:FBG and HDL-C are independent risk factors for aggravating coronary artery disease in elderly patients with AMI. The nomogram model of aggravating coronary artery disease in elderly patients with AMI has good predictive ability, which can provide more intuitive research methods and clinical value for preventing the aggravation of coronary artery disease in elderly patients.
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@# ObjectiveTo study the relationship between the incidence of cervical osteophytosis and the age.MethodsThree hundred X-ray films (male 159, female 141) on lateral cervical position were observed. The patients were divided as group A (age <30), group B (age 30～39), group C (age 40～49), group D (age 50～59), group E (age 60～69) and group F (age 70～90). The osteophytosis on superior or inferior cervical vertebral body were marked.ResultsThe incidences of osteophytosis were group A 0%, group B 4.0%～4.7%, group C 20.0%～23.3%, group D 38.7%～39.2%, group E 56.7%～60.0%, group F 72.7%～80.9%. There was significant differences between the group B and group C, group C and group D, group D and group E, group E and group F (P<0.05～0.01). The common places of the osteophytosis were C5 and C6, while often on C6 in male and on C5 in female.ConclusionThe incidence of cervical osteophytosis increases following age increasing. The most place of the osteophytosis is on C5 and C6.
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@#ObjectiveTo study the histological change of cervical body osteophytosis. Methods7 specimens of osteophytosis were sectioned from the cadavers'cervical vertebrae for histological observation.Results and ConclusionThere are five phases of the progress of the osteophytosis, i.e.,ossified in cartilage, precalcified, calcified, preossified and ossified.
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@#ObjectiveTo study the relationship between the shape and area of cervical zygapophysial joint facet and cervical vertebral disease. MethodsThe hyperosteogency rate of both cervical vertebral body and the susceptible site on the same cervical vertebral body were investigated on 50 sets of cervical vertebrae with hyperosteogency.The shape and area of cervical zygapophysial joint facet were observed on other 45 sets of normal adult cervical vertebrae. ResultsThe cervical vertebral zygapophysial joint facet showed mainly three shapes: round, elliptic and irregular, with elliptic shape predominate all. There is significance only on inferior facet on C4-5 and C5-6 joints (P<0.05).Conclusions There is some relationship between the shape and area of the cervical zygapophysial joint facet and the cervical hyperosteogency.