ABSTRACT
Objective To investigate the value of emergency observation time of chest pain patients for ruling-out myocardial infarction by using high-sensitive troponin T. Method Total 1 687 patients with chest pain from December 2015 to August 2016 visiting Sichuan University Huaxi Hospital emergency department were en-rolled.We included 1082 patients who diagnose with AMI finally.We define the time from the start of the chest pain to visiting the emergency as the onset time.We analyzed the level of high-sensitive troponin T of AMI patients at dif-ferent onset time and calculated the rate of patients with hs-cTnT level lower than the conventional hs-cTnT thresh-old of 14 ng/L. Result Among 1082 cases of AMI patients,32 patients with hs-cTnT level below threshold(14 ng/L).The for whose The onset time over 5h was observed in AMI patients with hs-cTnT level over 14 ng/L.Con-clusion AMI can not be excluded in chest pain patients whose hs-cTnT levels below the conventional threshold value of 14 ng/L,and these people should be dynamically monitored for 5h in emergency department.The patients can exclude AMI if the hs-cTnT levels are below 14 ng/L after 5 hours.
ABSTRACT
Objective The aim of this study was to evaluate the negative predictive value (NPV) and Sensitivity(Sen) of ruling out acute myocardial infarction(AMI) using low risk electrocardiogram(ECG) and baseline high-Sensitivity troponin T(hs-cTnT) immediately in chest pain patients. Methods Patients presenting to chest pain center with complain of chest pain in West China hospital of Sichuan university were enrolled. Clinical data including ECG and hs-cTnT concentration were gained .According to different diagnosis cutoff point, the NPV and Sen of ruling out AMI using low risk ECG and baseline hs-cTnT immediately in chest pain patients were evaluated. Results An hs-cTnT cutoff of 5 ng/L resulted in a NPV of 99.9%ruling out of all non-AMI patients. Adding the information of a low risk ECG resulted in a 100%NPV (19.51%ruled out). At any diagnosis cutoff point, present hs-cTnT concentration can not rule out AMI completely . Adding the information of a low risk ECG , the NPV of present hs-cTnT was improved and more non-AMI patients were ruled out safely. Conclusions It is safe to rule out AMI among the chest pain patients when the level of hs-cTnT less than 5 ng/L combined with low risk electrocardiogram.
ABSTRACT
Objective To explore the surgery and conservative treatment for obstructive sleep apnea hypop -nea syndrome of PSG parameters .Methods According to the treatment method , 60 cases of obstructive sleep apnea syndrome patients for the study were divided into observation group and control group ,the control group were used for non-surgical treatment ,the research group were treated by surgery .PSG monitoring equipment were used to detect the AHI,AHTI,AHT,SAT90%,minimum and average SaO2 so SaO2.Results After treatment,patients were significant-ly lower SAT90%were (38.4 ±13.4)%,(17.5 ±12.5)%,the lowest Sa(O2) were(79.6 ±12.4)%,(83.7 ± 11.2)%,significantly higher average SaO 2 were (85.4 ±16.3)%,(90.8 ±12.4)%,increased significantly com-pared with before treatment difference was statistically significant (t=10.13,22.42,4.76,9.76,3.65,6.65,all P<0.05).And the control group improved more significantly (t=17.32,3.76,3.76,all P<0.05).After treatment,pa-tients were AHI,AHT and AHTI were (22.4 ±3.4)times/h,(14.5 ±2.5)times/h,(9.6 ±2.4)min,(5.7 ±1.2) min,(1.4 ±0.3)min,(0.8 ±0.4)min,significantly reduced compared with before treatment difference was statisti-cally significant(t=9.63,12.12,7.51,19.27,21.42,10.63,all P<0.05).And the control group decreased more significantly,the difference was statistically significant (t=8.97,9.76,6.57,all P<0.05).Conclusion Obstructive sleep apnea syndrome treated by surgery ,each of PSG parameters improved significantly superior to conservative treat-ment,which should be used as their preferred method of treatment .