Correlation between myocardial ischemia and carotid atherosclerosis in hypertensive patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the correlation between myocardial ischemia and carotid atherosclerosis in hypertensive patients.</p><p><b>METHODS</b>The clinical data were collected from 85 hospitalized hypertensive patients admitted between May 2005 and September 2008 without the complication of coronary artery disease as confirmed by cardiac computed tomographic angiography (CTA). According to the results of treadmill exercise test, the patients were divided myocardial ischemia group and ischemia-free group. Univariate and multivariate analyses were used to screen the risk factors of myocardial ischemia. The correlations were analyzed between myocardial ischemia, common carotid artery intima-media thickness (IMT), Crouse score of the carotid plaque, thickness of the intraventricular septum and left artrium. The receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of IMT and Crouse score in predicting the presence of myocardial ischemia in hypertensive patients.</p><p><b>RESULTS</b>Carotid plaque formation was identified as the major risk factor of myocardial ischemia in hypertensive patients (OR=4.982, P=0.004). The incidence of myocardial ischemia in the hypertensive patients with carotid plaques was significantly higher than that in the patients without the plaque (Chi2=9.317, P=0.002). Myocardial ischemia in hypertensive patients was positively correlated to the thickness of the intraventricular septum (r=0.362, P=0.001) and left artrium (r=0.298, P=0.009), and the IMT of the common carotid artery was positively correlated to the thickness of the intraventricular septum (r=0.231, P=0.045). The area under cure (AUC) of the ROC curve of Crouse score was 0.726-/+0.061 in predicting the presence of myocardial ischemia in the hypertensive patients (P=0.001), and that of IMT was 0.682-/+0.061 (P=0.006).</p><p><b>CONCLUSION</b>Carotid plaque formation is the major risk factor of myocardial ischemia in hypertensive patients and shows a positive correlation to the onset of myocardial ischemia, but both the common carotid artery IMT and the Crouse score of the carotid plaque are not accurate markers for predicting myocardial ischemia in patients with hypertension.</p>

Evaluation of myelin basic protein levels with receiver operating characteristic curves for diagnosis of multiple sclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of cerebral spinal fluid (CSF) and serum myelin basic protein (MBP) levels in the diagnosis of multiple sclerosis (MS).</p><p><b>METHODS</b>Enzyme-linked immunosorbent assay was used to detect the CSF and serum levels of MBP in patients with MS (n=45), patients with Guillain-Barre syndrome (GBS) (n=36) and control subjects (control) (n=33). The sensitivity and specificity of MBP in CSF and serum in the diagnosis of MS were evaluated using the receiver-operating characteristic (ROC) curves.</p><p><b>RESULTS</b>The MBP levels in CSF and serum both increased significantly in MS group as compared with those in GBS (P<0.01) and control groups (P<0.01). The area under the curve (AUC) of the ROC curve of MBP in CSF was 0.853-/+0.037 for MS diagnosis, and with the optimal cut-off value of 0.87 pg/ml, CSF MBP showed a diagnostic sensitivity of 83.7% and specificity of 78.3%. The AUC of the ROC curve of serum MBP was 0.761-/+0.046, and the optimal cut-off value of 0.25 pg/ml resulted in a diagnostic sensitivity of 62.8% and specificity of 73.9%. No statistically significant difference was found between the two AUCs (P>0.05).</p><p><b>CONCLUSION</b>Evaluation of CSF and serum MBP levels allows accurate diagnosis of MS, and MBP level in the CSF has greater diagnostic sensitivity than serum MBP. The combination of both CSF and serum MBP levels may serve as a sensitive index for the diagnosis of MS.</p>

Clinical analysis of the risk factors of carotid atherosclerotic plaque formation / 中华神经医学杂志

Objective To analyze the risk factors for the formation of carotid atherosclerotic plaque. Methods The clinical data of 279 hospitalized patients undergoing carotid artery color Doppler ultrasonography between June 2005 and December 2006 were collected. Multiple regression of the common carotid intimal-medial thickness (IMT) was used to screen the potential risk factors of carotid plaque formation. The patients were divided into two groups according to the presence of carotid plaque, and binary logistic regression and univariate analysis were used to identify the risk factors. The carotid plaque score and index were compared between the subgroups with different risk factors. Results The common carotid IMT was subjected to influences by age (β=0.242, P=0.000), systolic blood pressure (SBP) (β=0.152, P=0.013) and the level of low-density lipoprotein (LDL) (β=0.115, P=0.048). Age (OR=1.087, P=0.000) and SBP (OR=1.036, P=0.000) were identified as the main factors that affected the formation of carotid plaque. In patients above 60 years old, the detection rate of carotid plaque was significantly higher than that in patients below 60 years (X2=58.379, P=0.000), and the rate was significantly higher in hypertensive patients than in the normotensive patients (X2=18.206, P=0.000). The carotid plaque score and index were significantly higher in patients over 60 years old than in those below 60 years (F=69.353, P=0.000;F=64.826, P=0.000, respectively), and also significantly higher in hypertensive patients than in the normohypertensive patients (F=4.866, P=0.028;F=6.927, P=0.009, respectively). Conclusion Age and SBP are the major risk factors of carotid atheroselerotie plaque formation, and LDL is a factor of lesser risk.