Résumé
Objective :To explore preventive effect of sodium bicarbonate combined Vit C on contrast-induced nephropathy (CIN) in patients with early diabetic nephropathy (DN) undergoing percutaneous coronary intervention (PCI).Methods : A total of 420 patients with coronary heart disease complicated early DN treated in our department from Sep 2014 to Jul 2016 were selected ,randomly and equally divided into routine PCI group and combined treatment group (received sodium bicarbonate combined Vit C based on routine PCI group ) . Levels of serum creatinine (SCr ) ,glomerular filtration rate (GFR) ,creatinine clearance rate (Ccr) and blood urea nitrogen (BUN) after contrast use and incidence rate of CIN were measured ,recorded and compared between two groups ,and independent risk factors for CIN were analyzed .Results : After contrast use ,compared with routine PCI group ,there were significant reductions in levels of SCr [(110-32 ± 12-35) μmol／L vs.(100-30 ± 9-73) μmol／L] and BUN [ (11-23 ± 2-43) mmol／L vs.(7-16 ± 3-14) mmol／L] ,and significant rise in GFR [ (30-67 ± 9-56) ml·min－1 ·1-73m－2 vs.(37-26 ± 7-69) ml·min－1 ·1-73m－2 ] and Ccr [ (62-31 ± 19-73) ml／min vs.(68-07 ± 21-48) ml／min] in combined treatment group , P＜0-01 all ; percentages of SCr rise ≥44-2μmol／L (6-7% vs.1-9%) and SCr increase ≥25% (9-0% vs.2-9%) significantly reduced in combined treatment group , P＝0-016 ,0-007- Multi-factor Logistic regression analysis indicated that contrast dose was independent risk factor for CIN in DN patients (OR＝1-688 , P＝0-001) , while use of sodium bicarbonate combined Vit C was its independent protective factor (OR＝0-693 , P＝0-021).Conclusion : For patients with early DN undergoing PCI ,sodium bicarbonate combined Vit C can significantly reduce incidence rate of CIN ,effectively protect kidney function ,which is worth extending .
Résumé
Objective :To study correlation between brachial‐ankle pulse wave velocity (baPWV ) and cardiac auto‐nomic nervous function in patients with type 2 diabetes mellitus (T2DM) and its influencing factors .Methods :A to‐tal of 293 T2DM patients ,who hospitalized in our hospital from May 2015 to May 2016 ,were selected .According to baPWV level ,patients were divided into normal baPWV group (n＝198 ,≤1400cm／s) and abnormal baPWV group (n＝95 ,＞1400cm／s).Blood pressure ,heart rate ,blood glucose ,renal function and heart rate variability (HRV) indexes were measured and compared between two groups .Multi‐factor Logistic regression analysis was used to ana‐lyze influencing factors of baPWV .Results :Compared with normal baPWV group , there were significant rise in age ,levels of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,central venons pressure (CVP) , pe‐ripheral arterial pressure (PAP ) , percentage of peripheral neuropathy and mean heart rate and significant reduc‐tions in HRV indexes :lgTF (total frequency) ,lgHF (high frequency) ,lgSDNN (standard deviation of normal to normal RR intervals calculated over the 24 h period) and lgrMSSD (root‐mean square of differences between succes‐sive normal to normal intervals) and slgnificant rise in lgSDANN (standard deviation of normal to normal RR inter‐vals in all 5 min segments of the entire recording ) in abnormal baPWV group , P＜0. 05 or ＜0.01 .Multi‐factor Lo‐gistic regression analysis indicated that SBP ,DBP ,PAP ,CVP , heart rate SDANN and peripheral neuropathy were independent risk factors for baPWV (OR＝1.031－2. 108 , P＜0.05 or ＜0.01) ,while TF ,HF and rMSSD were its independent protective factors (OR＝0. 468－0. 595 , P＜0.05 or ＜0. 01) in T2DM patients .Conclusion :In patients with type 2 diabetes mellitus , abnormal pulse wave velocity is closely correlated with cardiac autonomic nervous function damage ,and it′s affected by blood pressure and blood glucose etc .
Résumé
Objective:To explore correlation among levels of high sensitive C reactive protein (hsCRP),brain natri-uretic peptide (BNP),endothelin 1 (ET-1) and nonvalvular atrial fibrillation (NVAF).Methods:A total of 124 NVAF patients hospitalized in our department of cardiology were selected.According their heart rhythm character-istics,they were divided into paroxysmal NVAF group (n＝56) and chronic NVAF group (n＝68).Another 48 pa-tients with sinus rhythm,corresponding gender,age,disease condition to NVAF group were simultaneously enrolled as sinus rhythm group.Levels of hsCRP,BNP and ET-1 were measured and compared among all groups.Results:Compared with sinus rhythm group,there were significant rise in levels of hsCRP [ (1.52 ± 0.86) mg/L vs.(2.32 ± 1.38) mg/L vs.(3.35 ± 3.02) mg/L],BNP [ (225.31 ± 70.23) pg/ml vs.(352.42 ± 167.02) pg/ml vs.(403.12 ± 132.05) pg/ml] and ET-1 [ (1.42 ± 0.65) ng/ml vs.(1.96 ± 0.76) ng/ml vs.(2.34 ± 1.15) ng/ml] in paroxys-mal NVAF group and chronic NVAF group,and those of chronic NVAF group were significantly higher than those of paroxysmal NVAF group,P＜0.05 or ＜0.01.Pearson correlation analysis indicated that serum BNP level was significant positively correlated with ET-1 level in NVAF patients (r＝0.325,P＝0.001).Logistic regression analy-sis indicated that levels of BNP,hsCRP and left atrial diameter were independent risk factors for NVAF (OR＝1.42,1.21,1.33,P＜0.05 or ＜0.01).Conclusion:Levels of high sensitive C reactive protein,brain natriuretic peptide and endothelin-1 are closely correlated to nonvalvular atrial fibrillation.
Résumé
Myelodysplastic syndromes (MDS) comprises a heterogeneous group of malignant disorders. it has been purified clonal hematopoietic stem cell disorder from the initial initial dysplasia hematopoietic syndrome.The diagnosis of MDS has changed from completely morphological diagnosis to multi-parameter diagnosis. In this review, the laboratory examination and diagnosis technology of MDS are discussed.