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Objective To explore the role of remote ischemic preconditioning(RIPC)in prevention of contrast -induced nephropathy(CIN)in elderly patients undergoing coronary artery angiography(CAA).Methods 106 elderly patients were enrolled in this randomized control trial.According to random number table,the patients were randomized into control group (n =53)and RIPC group(n =53).All of the patients received 1 000mL of 0.9% sodium chloride injection before CAA.The RIPC group patients underwent RIPC in their right arms with sphygmomanometer cuff infla-tion for 5 minutes prior to the CAA,three cycles were repeated.Serum creatinine was detected before and 48 hours after CAA.Results CIN was reported in 10 cases in the control group and 3 cases in the RIPC group(χ2 =4.30, P =0.04).The levels of serum creatinine were increased[(96.38 ±9.50)μmol/L vs (88.87 ±10.24)μmol/L] after CAA in the control group(t =2.28,P =0.03),and there was no difference in the RIPC group(t =1.17,P =0.24).Conclusion RIPC has a protective effect on CIN in elderly patients in our study.Since this method is harm-less and cost effective,further studies is required to popularize PIPC to our clinical practice for prevention of CIN.
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Objective To observe the effect of strengthen rosuvastatin in the treatment of patients with paroxysmal atrial fibrillation in coronary artery disease and the influence on serum inflammatory factor, to provide reference for clinical treatment.Methods 176 coronary artery disease patients with paroxysmal atrial fibrillation were randomly divided into observation group and control group, 88 cases in each group.The control group was given rosuvastatin,10mg/d,qd.The observation group was given rosuvastatin,20mg/d,qd.The LAD and LVEF were detected by color-Doppler before treatment and after 6 months treatment.The fasting blood was exsanguinated for testing BNP,hs-CRP,TNF-α,IL-6.The incidence rates of sinus rhythm maintenance and embolic events were recorded. Results After treatment,the LAD of the observation group and control group were (41.50 ±4.61)mm and (42.21 ± 5.20)mm respectively,which were significantly lower than before treatment (t=3.959,3.863,all P0.05).The BNP,hs-CRP,TNF-α,IL-6 levels of the observation group and control group after treatment were (173.44 ±32.45)ng/L and (203.33 ±42.16)ng/L,(4.54 ±1.34)mg/L and (5.44 ± 1.35)mg/L,(15.34 ±3.26) ng/L and (19.45 ±2.23) ng/L,(10.85 ±0.77) ng/L and (13.27 ±1.23) ng/L respectively,which were significantly lower than before treatment (t=5.855 and 3.533,3.857 and 3.534,6.436 and 4.545,5.743 and 3.925,all P<0.05),the BNP,hs-CRP,TNF-α,IL-6 levels of the observation group after treatment were significantly lower than the control group(t=3.546,3.214,3.176,3.414,all P<0.05).The total effective rate,sinus rhythm maintenance rate,embolic events incidence rate of the observation group and the control group were 93.18%(82/88) vs 79.55% (70/88),68.18% (60/88) vs 43.18% (38 /88),2.27%(2/88) vs 18.18%(16/88).The total effective rate,sinus rhythm maintenance rate of the observation group were significantly higher than the control group (χ2 =11.965,11.144,all P<0.01),the embolic event incidence rate was significantly lower than the control group (χ2 =12.129,P<0.01).Conclusion Strengthen rosuvastatin can effectively reduce the serum inflammatory factors and BNP,improve left atrial remodeling and left atrial function,the clinical efficacy and prognosis are significantly improved, it is worthy of clinical use in the treatment of patients with paroxysmal atrial fibrillation in coronary artery disease.
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Objective To investigate the clinical pathological features of IgA nephropathy with nephrotic syndrome and risk factors for impairment of renal pathology.Methods 121 cases of IgA nephropathy with nephrotic syndrome were selected,all patients had been diagnosed with biopsy.The clinical pathological features wer analyzed, they were divided into two groups according to different kidney disease.The minor pathological changes which Leeˊs classification grade Ⅰ and grade Ⅱ patients belong to group A,with a total of 36 cases,while Leeˊs pathology heavier grade for grade Ⅲ,Ⅳ and Ⅴ grade level in patients belonging to group B,with a total of 85 cases.Clinical character-istics and clinical laboratory indicators of two groups were compared,and risk factors for renal pathological damage were analyzed in multivariate analysis.Results The average duration of group B was significantly longer than the average duration of group A,the difference was statistically significant (t =12.74,P 5.0 ×107 /Lwere dangerous aggravating factors.Conclusion Hemoglobin protective factors for IgA nephropathy with nephrotic syndrome,the mean arterial pressure,24h urinary protein excretion and urine red blood cells are their risk aggravating factors,they can make a more accurate judgment of the patientˊs condition.