Résumé
Objective:To investigate the relationship between orthostatic intolerance (OI) and body mass index (BMI), blood lipid and serum protein levels in children and adolescents.Methods:A total of 122 children and adolescents aged from 6 to 17 years old, who were diagnosed with OI at the Department of Pediatric Cardiology, the Second Hospital of Lanzhou University from April 2018 to April 2019, were selected as the subjects.While, 56 children and adolescents in the health management center were selected as the healthy control group during the same period.Subjects were divided into syncope group and non-syncope group according to whether there was syncope in clinical history.The height and body mass of all children were measured, and venous blood were taken to detect blood lipids and serum protein in the morning.Date analysis were conducted with SPSS 22.0 software.Results:(1) The level of triglyceride in the OI group was lower than that in the healthy control group[(0.98±0.45) mmol/L vs. (1.28±1.04) mmol/L], and there was statistically significant( t=2.025, P<0.05); the BMI were respectively (17.56±3.23) kg/m 2 and (16.46±2.58) kg/m 2 in syncope group and non-syncope group, whose result indicated that the BMI in syncope group was higher than that in non-syncope group( t=2.085, P<0.05). (2) The results of binary Logistic regression analysis showed that the triglyceride level was an independent risk factor for OI( OR=0.504, 95% CI: 0.272-0.931, P<0.05). (3) The receiver operating characteristic curve evaluated the predictive value of triacylgly-cerol to OI.Results showed the sensitivity and specificity of OI were respectively 72.1% and 48.2%when the triacylglycerol was 1.09 mmol/L. Conclusions:Low triglyceride level and high BMI may be susceptible factors to OI in children and adolescents.Therefore, the diet of children with OI should be highly valued by clinicians and parents.
Résumé
Objective To evaluate pulmonary protection of dexmedetomidine under general anesthesia in the patients with sepsis.Methods Fifty patients with sepsis,aged 50-64 yr,weighing 50-75 kg,of ASA physical status Ⅲ or Ⅳ,were randomly divided into 2 groups (n =25 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium,and maintained with infusion of remifentanil and propofol and intermittent iv boluses of cisatracurium.The patients were endotracheally intubated and mechanically ventilated.In group D,dexmedetomidine 1.0 μg/kg was infused over 10 min,followed by infusion at 0.4 μg · kg-1 · h-1 for 2 h before induction of anesthesia.While the equal volume of normal saline was given in group C.BIS value was maintained at 40-60.Immediately before skin incision,at 2 h after beginning of skin incision,and at 24 h after operation,arterial and venous blood samples were taken for blood gas analysis and for determination of the concentrations of serum procalitonin,interleukin-6 and tumor necrosis factor-alpha.Oxygenation index was calculated.Results Compared with group C,oxygenation index was significantly increased,the concentrations of serum procalitonin,tumor necrosis factor-alpha and interleukin-6 were decreased,and the rate of improvement of pulmonary function was increased in group D.Conclusion Dexmedetomidine (infusion at 0.4 pg · kg-1 · h 1 for 2 h after infusion of 1.0 μg/kg) before induction of anesthesia provides pulmonary protection under general anesthesia in the patients with sepsis.