RESUMEN
Objective:To investigate the relationship between serum lipid levels and the risk of pulmonary embolism in patients with non-valvular atrial fibrillation.Methods:Patients with non-valvular atrial fibrillation admitted to Tianjin Chest Hospital from January 2014 to January 2019 were retrospectively analyzed.According to whether pulmonary embolism was present on CT pulmonary angiography, patients were divided into two groups, the atrial fibrillation with pulmonary embolism group(the AP group)and the control group(the AF group). Clinical data and serum lipid test results were compared between the two groups.The relationship between serum lipid levels and the risk of pulmonary embolism was evaluated.Results:Levels of apolipoprotein A1(ApoA1)and high-density lipoprotein cholesterol(HDL-C)in the AP group were(1.09±0.25)g/L and(1.03±0.28)mmol/L, which were lower than those in the AF group(1.24±0.25)g/L and(1.21±0.37)mmol/L)( t=3.255, P=0.002; t=2.972, P=0.004, respectively). Levels of very low-density lipoprotein cholesterol(VLDL-C)in the AP group were(0.41±0.24)mmol/L, which were higher than those in the AF group(0.26±0.18)mmol/L)( t=-3.761, P=0.000). The grade of cardiac function on admission in the AP group was higher than that in the AF group( χ2=13.074, P=0.004). The proportion of patients treated for atrial fibrillation in the AP group was lower than that in the AF group( χ2=5.445, P=0.020). Logistic regression analysis showed that decreased ApoA1 and left cardiac insufficiency were risk factors for pulmonary embolism in patients with non-valvular atrial fibrillation( OR=8.793, 95% CI: 1.815~42.607, P=0.007; OR=4.388, 95% CI: 1.352~14.244, P=0.014, respectively). Decreased VLDL-C and atrial fibrillation therapy were protective factors for pulmonary embolism( OR=0.180, 95% CI: 0.053~0.610, P=0.006; OR=0.268, 95% CI: 0.072~0.992, P=0.049, respectively). Conclusions:Pulmonary embolism in patients with non-valvular atrial fibrillation is related to serum lipid levels.Regulating levels of serum lipids may reduce the risk of pulmonary embolism in patients with non-valvular atrial fibrillation.
RESUMEN
Objective:To investigate the effect of early acupuncture treatment on limb function in patients with acute cerebral infarction (ACI).Methods:A total of 114 patients with first-episode ACI in our hospital from March 2018 to March 2019 were selected and randomly divided into three groups, 38 cases in each group. The control group was treated with conventional western medicine therapy, while the experimental group A and group B were given acupuncture treatment on the basis of the control group. The group A started treatment at 3rd days and the group B started at 10th day after admission. All three groups were treated for 2 weeks. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit. The Fugl Meyer assessment of motor function (FAM) was used to evaluate the motor function. The Barthel Index (BI) was used to evaluate the activities of daily living, and the rehabilitation status was evaluated according to muscle strength grading. The levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were detected by ELISA to evaluate the clinical efficacy.Results:The total effective rate was 94.7% (36/38) in group A, 84.2% (30/38) in group B and 73.7% (22/38) in control group. The difference was statistically significant ( χ2=14.748, P<0.01). After treatment, NIHSS scores of three groups were significantly decreased ( F=97.619, P<0.01), and the scores of FAM, BI and muscle strength in group A were significantly lower than those in the group B ( t=12.580, P<0.01); FAM, BI scores and muscle strength of three groups were significantly increased ( F=134.525, 35.100, 164.160, all Ps<0.001), and those of group A were significantly higher than those in group B ( t=8.634, 7.260, 20.305, all Ps<0.001). After treatment, serum NGF (148.80 ± 22.17 pg/ml, 132.14 ± 20.40 pg/ml vs. 125.82 ± 18.31 pg/ml, F=12.926), BDNF (5.01 ± 1.14 ng/ml, 4.10 ± 1.09 ng/ml vs. 3.92 ± 0.95 ng/ml, F=11.481) in the group A and group B were significantly higher than those in the control group ( P<0.01), and serum NGF, BDNF in group A were significantly lower than those in the group B ( t=5.046, 5.277, all Ps<0.01). Conclusions:Early acupuncture treatment can increase the levels of serum NGF and BDNF, promote the recovery of nerve factors and limb function, and the curative effect of acupuncture treatment starting at 3rd days after admission is better than 10th day.
RESUMEN
Objective To observe the effect of early pulmonary rehabilitation (PR) on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods AECOPD patients (n=97) were randomly distributed into two groups:control group (n=39) and rehabilitation group (n=58). Patients in both groups were assessed when symptom im?proved from acute phase (baseline, T1). Then patients in control group only received pharmaco-therapy and rehabilitation ed?ucation without PR. When symptom was relieved and stable (T2), they were given 12 weeks PR (T3). On the other hand, pa?tients in rehabilitation group underwent a 12-week PR after T1 directly (T2). The lung function parameters, 6 min walking distance (6MWD), MRC scores and CAT scores were observed and analyzed in two groups. Results Until the end of the 12-weeks observation, the value of lung function showed no statistic differences between two groups(either T1 in control group vs T1 in PR group or T2 in PR group vs T2 and T3 in control group. In control group, the value of 6MWD scores of T3 was bet?ter than that of T1 and T2, in PR group(F6MWD=8.762,FMRC=4.432,FCAT=10.266,P<0.05)while MRC, CAT value in T3 of control group were higher than those in T1 and T2 of PR group. At T1, parameters does not demonstrate significant difference between these two groups. Value of 6MWD was higher while MRC and CAT were lower in T2 of PR group than that in T2 and T3 of control group. Conclusion Early pulmonary rehabilitation could improve the mobility and qulity of life, as well as ameliorate the severity of dyspnea in AECOPD patients.