[Value of aVR lead four steps algorithm on differential diagnosis of wide QRS complex tachycardia].

OBJECTIVE: The aVR lead four steps is a new algorithm for differential diagnosis of wide QRS complex tachycardia (WCT). The study explores the clinical value of this new algorithm on differential diagnosis of WCT. METHODS: Application of aVR lead four steps to analysis the electrocardiogram of patients with WCT proved by electrophysiological study. Every step's accuracy rate, sensitivity and specificity to differential diagnosis of ventricular tachycardia (VT) were calculated. The first step diagnosed VT according to presence of an initial R wave in the aVR lead. The second step diagnosed VT according to width of an initial r or q wave > 40 ms in the aVR lead. The third step diagnosed VT according to notching on the initial downstroke of a predominantly negative QRS complex in the aVR lead. The fourth step diagnosis VT according to ventricular activation-velocity ratio (Vi/Vt) in the aVR lead, Vi/Vt ≤ 1 suggested VT. Results derived from aVR lead four steps algorithm were compared with results derived from Brugada and Vereckei four steps algorithm. RESULTS: A total of 113 patients with WCT were analyzed (31 supraventricular tachycardia, SVT and 82 ventricular tachycardia, VT). The accuracy rate of differential diagnosis VT is 91.2%, sensitivity is 90.2% and specificity is 77.4%. The accuracy and sensitivity of the aVR lead four steps algorithm for differential diagnosis of WCT were superior to the Brugada Vereckei four steps algorithm (P < 0.05). The specificity of the Vereckei four steps algorithm was superior to aVR lead and Brugada four steps algorithm (P < 0.05), while the specificity of the aVR lead four steps algorithm was similar as Brugada four steps algorithm (P > 0.05). CONCLUSIONS: The aVR lead four steps algorithm is associated with excellent accuracy rate, sensitivity for differential diagnosis of WCT. This algorithm is simple and could be easily learned and applied by physician.

[Study on the relationship between metabolic syndrome and chronic kidney disease in 1027 patients of Han and Uyguer people].

OBJECTIVE: To investigate the relationship between metabolic syndrome and the chronic kidney disease in both Han and Uyguer populations. METHODS: 1027 cases were enrolled during 2006-3 to 2007-1 from the First Affiliated Hospital, Xinjiang University. According to the identification of chronic kidney disease (CKD) and minor renal dysfunction, these patients were divided into different groups. The correlation between the components of metabolic syndrome and CKD was examined. T test, Chi-square test and logistic regression were used. RESULTS: (1) CKD and mild CKD prevalence were 37.4% and 24.0% in all the cases. (2) The level of age, low-density lipoprotein cholesterol, trigly-caride, high-density lipoprotein cholesterol, uric acid in Han people were higher than those among Uyguer people while body mass index, systolic blood pressure and diastolic blood pressure were lower than those Uyguer people. (3) There were no significant differences found between Han and Uyguer people in different metabolic components. (4) In the group which had only one metabolic component disjunction, the diabetic group accounted for big proportion while in those patients with two or more metabolic component disfunction, hypertension and obesity were significantly high in Han people but diabetes plus obesity were seen in Uyguer people. (5) Diabetes, obesity, metabolic components, uric acid were independent factors associated with CKD and mild CKD. CONCLUSION: There were close connection between metabolic syndrome and CKD found in Xinjiang area.