RESUMO
Objective:To investigate the diagnostic efficacy of inflammatory biomarkers [neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR)] combined with tumor markers [carbohydrate antigen (CA)125, CA199] in mature cystic teratoma (MCT) patients possess torsion.Methods:The clinical data of patients with MCT diagnosed by surgery and pathology in the third Affiliated Hospital of Sun Yat-Sen University from March 2013 to October 2019 were retrospectively analyzed. A total of 31 MCT patients with torsion were included in observation group , another 101 MCT patients without torsion were assigned to the control group.Clinical characteristics and the levels of NLR, MLR, PLR, CA125, CA199 were assessed and analyzed.Results:The inflammatory biomarkers (NLR, MLR, PLR) and tumor markers (CA125) in the observation group were higher than those in the control group ( P<0.05). Univariate regression analysis was used to screen variables with statistical significance, including NLR, PLR, CA125 and CA199 ( P<0.05), and multivariate logistic regression was used to construct a prediction model for diagnose MCT patients with torsion , which combined NLR and CA199 ( P<0.05). The area under curve (AUC) of NLR, PLR, CA125, CA199 and the combined prediction models of NLR and CA199 were 0.83, 0.72, 0.69, 0.60 and 0.86, respectively. Among them, the joint prediction model of NLR and CA199 had the highest diagnostic efficiency, with a sensitivity of 77.42% and a specificity of 82.18% ( P<0.05). In the observation group, the accuracy of combined prediction model of NLR and CA199 in the diagnosis of MCT pedicle torsion was higher than that of ultrasound (87.10% vs 61.29%), but according to the clinical symptoms and ultrasonic examination, 90.32% of the patients were diagnosed as MCT pedicle torsion. Conclusions:The inflammatory biomarkers and tumor markers have useful clinical significance in the diagnosis of MCT with torsion, especially the combine measurement of NLR and CA199. Associated with the patient's symptoms, signs, examination included doppler ultrasound may assist in improving the diagnostic accuracy .
RESUMO
Objective To investigate the effect of percutaneous coronary intervention (PCI) guided by blood flow reserve score (FFR) on the prognosis of patients with acute coronary syndrome (ACS) with multiple vessel lesions.Methods From April 2015 to April 2017,three hundred and twenty patients with ACS complicated with multi-vessel disease in the Department of Cardiology,Shanghai Tenth People's Hospital were randomly divided into two groups,160 cases in each group.Flow reserve fraction (FFR) and coronary arteriography alone (CAG) were used to guide PCI treatment (CAG group).The basic data,the success rate of PCI and the number of stent implantation were compared between the two groups.The patients were followed up for 6 months and the incidence of major adverse cardiovascular events (MACE) was compared between the two groups.Results There was no significant difference in sex,age,type of lesion,risk factors,coexisting diseases,number of lesion vessels and preoperative left ventricular ejection fraction (LEVF) between the two groups (P＞0.05).There were no significant differences in the success rate of PCI between FFR group and CAG group (97.7％ (127/130) vs.(99.2％ (129/130)),the time of PCI operation ((95.43±36.24) min vs.(101.36±28.16) min),the length of hospitalization ((6.12±1.74) d vs.(5.94± 1.55) d) ((x2 =1.02,t =1.47,t =1.01,P＞0.05).Compared with CAG group,the number of stents in FFR group ((1.79±0.25) vs.(2.15±0.34)),the amount of contrast agent ((143.42±27.42) ml vs.(184.11± 31.05) ml) were significantly reduced (t =9.73,t =11.22,P ＜ 0.05).Six months after operation,the incidence of target vessel revascularization and major adverse cardiovascular events in FFR group was 3.1％ (4/130).The total incidence of major adverse cardiovascular events was 6.9％ (9/130),significantly lower than that of CAG group (9.2％ (12/130) vs.16.2％ (21/130).The difference was statistically significant (x2 =4.26,x2 =5.43,P ＜ 0.05).Conclusion FFR-guided PCI can reduce unnecessary stent implantation,reduce major adverse cardiovascular events and improve the prognosis of ACS patients with multi-vessel disease.