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OBJECTIVE: To analyze the detection value of glycosylated hemoglobin (HbA1c) in the diagnosis of diabetic microangiopathy. METHODS: A total of 45 diabetic patients with microangiopathy treated in our hospital from January 2017 to December 2017 were enrolled in the study group, and 45 diabetic patients without microangiopathy in the same period were enrolled in the control group. The levels of HbA1c, fasting blood glucose, D-dimer and antithrombin III (AT-III) of patients were compared between the two groups. RESULTS: Compared with the control group, the study group had significantly higher fasting blood glucose (7.42±0.54 mmol/L vs. 11.36±0.83 mmol/L) and glycosylated hemoglobin (7.62±0.32% vs. 10.65±0.72), but significantly lower D-dimer (842.96±195.74 µg/L vs. 511.36±110.25 µg/L) and AT-III levels (73.52±23.69% vs. 73.52±23.69%; all P<0.05). CONCLUSION: Glycosylated hemoglobin level can not only clearly show the specific conditions of microangiopathy, but also help to diagnose, prevent and treat diabetic microangiopathy, which is worthy of promotion in clinic.
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Objective@#To investigate the value and feasibility of C reactive protein (CRP) in predicting postoperative anastomotic leakage in rectal cancer patients with enhanced recovery after surgery (ERAS) for safer implementation of this ERAS.@*Methods@#A cohort study on serum CRP of 455 rectal cancer patients undergoing laparoscopic radical resection according to the ERAS procedure at Gastrointestinal Unit of General Surgery Department, Guangdong General Hospital from August 2014 to June 2017 was retrospectively carried out. The serum CRP level was measured before operation and at postoperative days 1-7, and the serum CRP level of the groups with and without anastomotic leakage was compared to analyze its prediction for anastomotic leakage. Diagnostic standard of anastomotic leakage was based on the definition of postoperative anastomotic leakage in rectal cancer from International Study Group of Rectal Cancer (ISREC) : (1) Postoperative localized or diffuse peritonitis occurred, or fecal liquid was found from the abdominal drainage tube; (2) When anastomotic leakage was uncertain, peritoneal or pelvic computed tomography scan should be used to confirm.@*Results@#All the 455 patients underwent surgery successfully, and 41 patients (9.0%) had anastomotic leakage postoperatively. Patients with anastomotic leakage were diagnosed (4.0 ± 2.0) days postoperatively, of whom 8 cases (19.5%) were diagnosed more than 5 days postoperatively. Serum CRP levels in patients with anastomotic leakage continued to increase within 1-4 days postoperatively[ (50.04 ± 27.98) mg/L to (122.75 ± 52.98) mg/L]and decreased 5 days postoperatively[ (92.02 ± 58.26) mg/L], both were higher than those of non-anastomotic leakage group, and the difference was statistically significant (all P < 0.05, except postoperative day 2) . The serum CRP level of non-anastomotic leakage group reached the peak on the second postoperative day[ (83.10 ± 37.45) mg/L] and decreased 3 days postoperatively[ (48.01 ± 27.59) mg/L]. The ROC curve was drawn with the anastomotic leakage as the state variable, and the CRP level as the detection variable. The area under the curve (AUC) at postoperative 1, 2, 4, 5, 6 and 7 days was 0.74, 0.58, 0.83, 0.82, 0.65, and 0.70, respectively. The maximum was at postoperative day 3[0.93 (95%CI: 0.86-0.99) ]. The Youden index was 0.72, and the threshold of CRP was 80.09 mg/L, as the cut-off point to predict anastomotic leakage, with sensitivity, specificity, and positive predictive value of 79.3%, 92.3%, and 74.2%, respectively.@*Conclusions@#Monitoring the postoperative serum CRP level can help predict the occurrence of anastomotic leakage after laparoscopic surgery for rectal cancer. When the serum CRP level is > 80.09 mg/L on the third postoperative day, the CRP level has the largest value in predicting postoperative anastomotic leakage, and the safety of ERAS has a certain clinical significance as well.
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Objective To detect the change and clinical significance of homocysteine (Hcy),hypersensitivity C response protein (hs-CRP) and hypersensitivity troponin I (hs-TnI) in patients with acute myocardial infarction (AMI).Methods Ninety-six cases of AMI were selected as the research group and 60 cases of coronary heart disease without AMI were enrolled in the control group.Blood samples were collected to measure the contents of serum Hcy,hs-CRP and hs-TnI.ROC curve was drawn and Logistic regression model was established to analyze the role of each index alone and combined detection in the diagnosis of AMI.Results The levels of Hcy,hs-CRP and hs-TnI in the research group were significantly higher than those in the control group (Hcy: (29.29±7.65) mol/L vs.(17.23±4.68) mol/L;hs-CRP: (15.47±5.01) mg/L vs.(9.21±3.15) mg/L;hs-TnI: (40.88±9.18) ng/mL vs.(7.34±2.12) ng/mL,t=2.78,8.66,34.36,P<0.05).The area under the ROC curve of Hcy,hs-CRP,hs-TnI were 0.802 (95%CI(0.729~0.874)),0.71(95%CI(0.62~0.792)),0.929 (95%CI(0.891~0.967)),respectively.The area under the combine detection curve was 0.971 (95%CI,0.950~0.992).The sensitivity of Hcy,hs-CRP and hs-TnI in the diagnosis of AMI were 79%,57%,87%,respectively,the specificity of the three groups were 72%,70%,90%,the sensitivity and specificity of combined detection were 96% and 88%.Conclusion Combined detection of Hcy,hs-CRP and hs-TnI plays a better role in the diagnosis of AMI than that of Hcy,hs-CRP,hs-TnI alone and has a high specificity and sensitivity in the diagnosis of AMI.
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Objective To investigate the functions of blood plasma homocysteine (Hcy) and high sensitivity C-response protein (hs-CRP) in the chronic obstructive pulmonary disease (COPD) in pathogenesis plays,and observe whether there was associations with disease severity and the correlations.Methods Forty-one patients with COPD were collected from August 2010 to February 2011,and 35 healthy persons as control group.Blood plasma Hcy,hs-CRP,forced expiratory volume in one second account predicted (FEV1％ predicted),and arterial pressure of oxygen (PaO2,arterial blood gases analysis) were measured in COPD patients and controls.Results Plasma Hcy concentration was (22.07 ± 12.13) μmol/L in COPD patients,but (9.89 ±4.41) μmol/L in controls,there were significant differences between two subjects (t =1.674,P ＜0.01).COPD patients had a higher serum hs-CRP concentration (8.60±3.85) mg/L than control's (4.24 ±0.57) mg/L (t =1.682,P ＜ 0.01).Along the descent of FEV1％ predicted,plasma Hcy and hs-CRP were elevated gradually,both sides show a negative correlation (r =-0.45,-0.49,P ＜ 0.05).And plasma Hcy and hs-CRP present a positive correlation in COPD patients (r =0.68,P ＜ 0.01).Conclusion Plasma Hcy was significantly elevated in COPD patients,positive correlation related to COPD severity and positive correlation related to serum hs-CRP.
