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Objective To investigate the correlation between serum cystatin-C (Cys-C) levels and cognitive impairment.Methods A perspective study involving 273 patients in our hospital was performed from 2013 to 2015.They were divided into the cognitive impairment group and the control group.Cys-C measurement results and cognitive impairment assessment scores were collected.Possible influence factors were adjusted,and the correlation between Cys-C levels and mild cognitive impairment was analyzed.Results The distribution of age,hypertension,diabetes mellitus,smoking,drinking,dyslipidemia,and creatinine showed significant differences between the groups at different Cys-C levels (all P＜0.05).There was a significant difference in the Cys-C level between the cognitive impairment group and the control group [(0.727±0.082) mg/L vs.(0.514±0.045)mg/L,t=23.68,P＜0.01].The Cys-C level was negatively correlated with the scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MOCA) in the cognitive impairment group (r =-0.318 and -0.572,P＜0.05).The incidence of cognitive impairment was elevated with increasing Cys-C levels (x2 =13.12,P＜0.01).Logistic regression analysis showed that high levels of Cys-C (OR=3.298,95％ CI:1.417-7.675,P=0.001),history of diabetes mellitus (OR=7.971,95％ CI:3.036-31.562,P =0.03),education level (OR =2.237,95 ％ CI:1.022-4.896,),smoking (OR =5.692,95 ％ CI:1.060-2.614),drinking (OR=1.227,95％ CI:0.083-1.228),and dyslipidemia (OR=2.267,95％ CI:1.177-4.366) are independent risk factors for cognitive impairment.Conclusions High serum cystatin C levels are closely correlated with the risk of cognitive impairment occurrence.
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Objective To study the correlation between amino terminal B-type natriuretic peptide precursor(NT-proBNP) and risk factors of acute coronary syndrome (ACS) with elder patients.Methods One hundred and twenty-eight ACS patients were divided into unstable angina pectoris (UAP) group with 52 samples,ST elevation myocardial infarction (STEMI) group with 35 samples and non-ST elevation myocardial infarction (NSTEMI) group with 41 samples.Meanwhile 45 healthy elder people were adopted as control group.Firstly,the subjects of blood pressure,body mass index (BMI) and smoking numbers were measured.Secondly,venous blood was collected to assay NT-proBNP,cardiac troponin Ⅰ (cTn Ⅰ),homocysteine (Hcy),blood-lipoids and C-reactive protein(CRP).Lastly,ultrasonic cardiogram was used to test left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter (LVESD) and left ventricular ejection fraction (LVEF).In addition,correlation analysis was researched between NT-proBNP and other factors.Results NT-proBNP levels of UAP,STEMI and NSTEMI groups were significantly higher than the control group ((794.18±182.64) ng/L,(872.43±245.67) ng/L,(557.25±163.81) ng/L) and (125.84±59.27) ng/L,P ＜ 0.05).NT-proBNP was positive correlation with systolic blood pressure,diastolic blood pressure,Hcy and CRP (r=0.182,0.176,0.281,0.191;P=0.040,0.043,0.001,0.031),however negative with LVEF(r=-0.247,P =0.005).Conclusion NT-proBNP level is sensitive to monitor ACS variety,and it is significant to test NT-proBNP combining Hcy,CRP,and cTn Ⅰ for diagnosing and treating ACS.
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Objective To evaluate the feasibility of community treatment and management mode in elderly patients with hypertension.Methods A total of 286 elderly patients with hypertension were treated with community therapy and management for 6 months.The improvements in life style and hypertension control were observed before and after the community treatment and management.Results There were significant differences in systolic blood pressure and diastolic blood pressure in the elderly patients before and after the treatment and management [(158.4± 11.3) mm Hg vs.(131.3±5.9) mm Hg,(99.6±8.9) mm Hg vs.(81.5±5.6) mm Hg,respectively,both P＜0.05].Compared with pretreatment,the blood pressure control rate,the awareness rate of diagnostic criteria and the drug compliance were significantly increased after the treatment and management [38.5％ (110/286) vs.96.9％ (277/286),66.4％ (190/286) vs.100％ (286/286),49％ (140/286)vs.91.3％ (261/286),x2 =98.87,115.36,122.13,respectively,all P＜0.01].Conclusions The community treatment and management can increase the blood pressure control rate and improve the quality of life in elderly patients with hypertension.It is a feasible method to comprehensively prevent and control hypertension.
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Objective To study the heart rate variability and arrhythmia characteristics in the elderly patients with unstable angina and negative psychology and to observe the changes before and after treatment. Methods Eighty patients aged ≥ 65 years with unstable angina were recruited in the study, and divided into two groups according to the determination of Hospital Anxiety and Depression Scale: 36 patients in the negative psychology group( NP group) and 44 in the non-negative psychology group ( non-NP group). All patients were monitored by Holter. Results The SDNN, SDANN, SDNNidex, rMSSD and PNN50 in the NP group were (86.8 ±14.1 ) ms, (78.1 ± 11.2 ) ms, (22.9 ± 4.5 ) ms, ( 6.3 ± 1.2 ) % and (40.3 ± 16.4) ms, respectively, which were significantly decreased compared to that in the non-NP group [ ( 138.9 ± 37.1 ) ms, ( 123.3 ± 32.5 ) ms, (25.7 ±12.3)ms,(9.2 ±5.3)% and (47.8 ± 10.7)ms,respectively] (t =4.20,2.52,2.32,2.28 and 2.20,Ps ＜0.05)The prevalence of ventricular arrhythmia, sinus tachycardia, ischemic ST-T changes and heart rate variability (HRV) (55.56%, 13.89%, 33. 33% and 52. 78%, respectively) significantly increased in the NP group,compared to those in the non-NP group(9.09% ,2.27% ,6.82%, 18.18% ,respectively) ( χ2 = 16.89,4.18,4.33 and 4.99, respectively, Ps ＜ 0.05 ). After treatment with Prozac ( fluoxetine hydrochloride scientific name), SDNN,SDANN,rMSSD,PNN50,SDNNindex significantly increased from (84.7 ± 34.0) ms, (79.2 ± 39.6) ms, (23.4 ±7.5)ms,(5.1 ±2.1)% and (38.1 ± 11.8)ms to (102. 1 ±29.6)ms,(94.2 ±26.7)ms,(35.6 ± 10.2)ms,(9.9 ± 7.5 ) % and (63.3 ± 13.8 ) ms ( t = 3.60,2.43,2.34,2.26 and 2.30, P ＜ 0.05 ). After treatment,ventricular arrhythmia,sinus tachycardia,ischemic ST-T changes and HRV significantly decreased compared to that before treatment in the NP group (χ2 = 5.58,4.33,4.24 and 4.06 ,P ＜ 0. 05 ). Conclusions In patients of coronary heart disease with unstable angina and negative psychologically , HRV decreased , and they are prone to ventricular arrhythmias,sinus tachycardia and ischemic ST-T changes. Treatment with Prozac could decrease arrhythmia and improve cardiac ischemia arrhythmias, sinus tachycardia and ischemic ST-T changes. Treatment with Prozac could decrease arrhythmia and improve cardiac ischemia.
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Objective To discuss the relationship between c-reactive protein and prognosis of acute coronary syndrome.Methods C-reactive protein of 60 acute coronary syndrome aged patients was evaluated.The patients were divided into two groups:one group with higher CRP level and another group with normal CRP level.The following-up duration was 6 months.After correct therapy,the morbidity of re-angina,arrbythmia,heart failure,re-infarction and cardiac death was compared.Results The morbidity of re-angina,arrhythmia,heart failure,re-infarction,cardiac death was 46.3%(19/41),43.9%(18/41),9.8%(4/41),22.0%(9/41),7.3%(3/41)respectively in higher Clip levd group;The morbidity of re-angina,arrhythmia,heart failure,re-infarction was 15.8%(3/19),10.5%(2/19),5.3%(1/19),5.3%(1/19)respectively in normal CRP group and there was no cardiac death accident.There was significant difference between the two groups.Conclusion CRP plays an important role in the onset of acute coronary syndrome,and its level is related with the higher morbidity of re-angina,arrbythmia,heart failure,re-infarction and cardiac death.