Correlation analysis between adiponectin and HMGB1 in patients with acute cerebral infarction complicated by myocardial infarction / 中国基层医药

Objective:To investigate the level of serum adiponectin (APN), high mobility group box 1 (HMGB1) and insulin resistance in patients with acute cerebral infarction complicated by myocardial infarction, and try to investigate the correlation between them.Methods:From January 2016 to June 2019, 448 patients who diagnosed as acute cerebral infarction in Haiyang People's Hospital were selected.The patients were divided into myocardial infarction(MI) group (36 cases) and non-MI group (412 cases) based on whether they complicated with MI.And 50 healthy people were selected as healthy control group.Fasting venous blood was collected from all subjects, and the adiponectin, HMGB1, coagulation indicators, inflammatory indicators, myocardial infarction markers and insulin resistance were measured.Results:The markers of myocardial infarction (CK-MB, cTnⅠ, Mb), coagulation indicators (APTT, PT, AT-Ⅲ, ACT), inflammatory levels (HMGB1, APN, CRP, IL-6)and insulin resistance related indicators (FPG, FINS, HOMA-IR, ISI)in patients with MI were different from patients with non-MI [CK-MB: (25.33±4.61)μg/L vs.(21.85±4.73)μg/L, t=6.028, P<0.001; cTnⅠ: (7.96±0.98)μg/L vs.(4.89±1.05)μg/L, t=24.135, P<0.001; Mb: (91.07±15.21)g/L vs.(147.53±16.04)g/L, t=28.981, P<0.001; APTT: (34.02±6.12)s vs.(37.21±6.31)s, t=4.144, P=0.005; PT: (14.32±1.21)s vs.(12.94±1.37)s, t=8.390, P<0.001; AT-Ⅲ: (144.62±18.35)s vs.(167.53±20.04)s, t=9.382, P<0.001; ACT: (135.84±15.21)s vs.(145.06±16.02)s, t=4.711, P<0.001; HMGB1: (25.61±3.84)μg/mL vs.(19.27±4.21)μg/mL, t=12.456, P<0.001; APN: (6.03±0.78)mg/L vs.(9.16±0.97)mg/L, t=26.995, P<0.001; CRP: (46.12±2.87)mg/L vs.(39.36±3.21)mg/L, t=17.608, P<0.001; IL-6: (8.76±1.42)mg/L vs.(5.04±1.22)mg/L, t=25.238, P<0.001; FPG: (6.27±0.98)mmol/L vs.(5.62±1.05)mmol/L, t=5.106, P<0.001; FINS: (24.07±4.25)mIU/L vs.(15.84±4.46)mIU/L, t=15.235, P<0.001; HOMA-IR: (6.68±0.68)vs.(3.96±0.84), t=27.217, P<0.001; ISI: (-5.03±0.84)vs.(-4.57±0.97), t=3.963, P<0.001] and the healthy controls [CK-MB: (25.33±4.61)μg/L vs.(20.04±4.52)μg/L, t=7.280, P<0.001; cTnⅠ: (7.96±0.98)μg/L vs.(4.04±0.95)μg/L, t=24.482, P<0.001; Mb: (91.07±15.21)g/L vs.(194.23±14.79)g/L, t=42.067, P<0.001; APTT: (34.02±6.12)s vs.(40.89±6.02)s, t=7.090, P<0.001; PT: (14.32±1.21)s vs.(10.94±1.15)s, t=16.326, P<0.001; AT-Ⅲ: (144.62±18.35)s vs.(225.31±19.64)s, t=26.249, P<0.001; ACT: (135.84±15.21)s vs.(161.32±15.77)s, t=10.342, P<0.001; HMGB1: (25.61±3.84)μg/mL vs.(6.72±3.78)μg/mL, t=29.484, P<0.001; APN: (6.03±0.78)mg/L vs.(12.54±0.82)mg/L, t=44.604, P<0.001; CRP: (46.12±2.87)mg/L vs.(7.64±2.52)mg/L, t=79.626, P<0.001; IL-6: (8.76±1.42)mg/L vs.(2.22±1.29)mg/L, t=35.249, P<0.001; FPG: (6.27±0.98)mmol/L vs.(5.15±0.96)mmol/L, t=6.989, P<0.001; FINS: (24.07±4.25)mIU/L vs.(10.64±3.96)mIU/L, t=19.751, P<0.001; HOMA-IR: (6.68±0.68)vs.(2.44±0.66), t=33.705, P<0.001; ISI: (-5.03±0.84)vs.(-3.94±0.79), t=7.460, P<0.001]. The incidence of acute cerebral infarction complicated with myocardial infarction was negatively correlated with APN and AT-Ⅲ(APN: r=-0.405, P=0.001; AT-Ⅲ: r=-0.554, P<0.001), and positively correlated with HMGB1 and HOMA-IR(HMGB1: r=0.624, P=0.005; HOMA-IR: r=0.667, P<0.001). Conclusion:There is a significant negative correlation between the occurrence of acute cerebral infarction complicated with MI and the level of APN, and positive correlations between HMGB1 and insulin resistance.

Application of APACHE Ⅱ scoring system in severe cerebral hemorrhage / 中国综合临床

Objective To evaluatethe application value of APACHE Ⅱ on the prognoses in prediction of pin hole multi-directional intracranial hematoma aspiration to cure severe cerebral hemorrhage.Methods APACHE Ⅱ scoring system was conducted in randomly collected 58 severe cerebral hemorrhage patients' data (30 patients underwent surgical treatment,28 patients underwent conservative treatment)to evaluate the disease severity,prognosis and effect of the pin hole multi-directional intracranial hematoma aspiration.Results The APACHE Ⅱ score of treatment group on the first day was 28.00 ± 1.92 and the predicted mortality was 0.86 ±0.03.The score was decreased obviously on the tenth day(8.20 ± 0.76)and the predicted mortality was 0.57 ± 0.05.The actual mortality was 33.33％.Conclusion APACHE Ⅱ scoring system is suitable for judging the disease severity and predicting the prognosis of severe cerebral hemorrhage patients,it proves that surgical treatment effect of the pin hole multi-directional intracranial hematoma aspiration is remarkable.