The value of TG, LDL-C, monocyte/HDL-C ratio in predicting cardiogenic stroke in patients with patent foramen ovale
Author：Pan Liangze，Chen Lang，Zhao Haiyan，Huang Hua
keyword： Patent foramen ovale; Cardiogenic stroke; Monocyte; Triglycerides; Low density lipoprotein cholesterol; High density lipoprotein cholesterol;
To investigate the relationship between triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), monocyte/high-density lipoprotein cholesterol(HDL-C) ratio and cardiac stroke in patients with patent foramen ovale(PFO). Methods The clinical data of 275 patients with PFO diagnosed and treated in Dazhou Central Hospital of Sichuan Province from December 2020 to June 2022 were selected and divided into cardiogenic stroke group(stroke group) of 62 patients and non-cardiogenic stroke group(non stroke group) of 213 patients according to whether the patients were complicated with cardiogenic stroke. The general data, blood routine indexes, TG/HDL-C, LDL-C/HDL-C, and monocyte count(MON)/HDL-C were compared between the two groups. Draw the ROC of subjects to analyze the value of TG/HDL-C, LDL-C/HDL-C, MON/HDL-C in assessing the occurrence of cardiogenic stroke in PFO patients. Results The proportion of stroke group with hypertension is higher than that of non stroke group(χ2/P=7.352/0.007), there was no significant difference between the two groups in gender, age, symptoms, PFO classification, smoking history, drinking history, diabetes, hypercholesterolemia, migraine, PFO family history, and treatment history(P>0.05). The levels of TG/HDL-C, LDL-C/HDL-C, MON/HDL-C in stroke group were higher than those in non stroke group(t=7.644,7.509,7.544,P<0.001). The ROC curve results showed that the area under the curve(AUC) of cardiogenic stroke in PFO patients assessed by TG/HDL-C, LDL-C/HDL-C, MON/HDL-C alone or jointly was 0.813,0.815,0.819,0.904, respectively. The combined predictive value of the three was higher than that of the single prediction(Z/P=2.446/0.014,2.153/0.031,1.974/0.048).Conclusion The increase of TG, LDL-C, MON and HDL-C ratio is related to cardiogenic stroke in PFO patients, which is reliable in predicting cardiogenic stroke in PFO patients.
Expression of serum Cav-1 and FoxO3a mRNA in patients with aneurysmal subarachnoid hemorrhage and its relationship with prognosis
Author： Li Changbao Song Baoxin Shen Junyan Zhang Yunpeng
keyword： Subarachnoid hemorrhage,aneurysmal; Caveolin-1; Forkhead box O3a; Prognosis;
Objective To analyze the expression levels of serum caveolin-1(Cav-1) and forkhead box protein O3a(FoxO3a) messenger RNA(mRNA) in patients with aneurysmal subarachnoid hemorrhage(aSAH) and their relationship with prognosis. Methods One hundred and twenty eight patients with aSAH admitted to Pinggu Hospital of Beijing Friendship Hospital Affiliated to Capital Medical University from November 2018 to December 2021 were selected as the aSAH group, and 95 patients with physical examination in the same period were selected as the health control group. The patients with aSAH were followed up for 6 months after discharge. According to Glasgow Outcome Scale(GOS), they were divided into 87 patients with good prognosis(GOS score>3 points) and 41 patients with poor prognosis(GOS score ≤ 3 points). The expression levels of serum Cav-1, FoxO3a mRNA and clinical data of patients with different prognosis were compared between the aSAH group and the healthy control group; Multivariate logistic regression analysis was used to analyze the risk factors affecting the prognosis of patients with aSAH; The prognostic value of serum Cav-1 and FoxO3a mRNA in patients with aSAH was analyzed by receiver operating characteristic curve(ROC). Results Compared with the healthy control group, the serum Cav-1 expression level of patients in the aSAH group decreased significantly, and the FoxO3a mRNA expression level increased significantly(t/P=12.955/<0.001, 34.392/<0.001). The serum Cav-1 level in patients with poor prognosis was significantly lower than that in patients with good prognosis, and the expression level of FoxO3a mRNA was higher than that in patients with good prognosis(t/P=12.853/<0.001, 20.488/<0.001). The proportion of hypertension history, diabetes history, modified Fisher grade Ⅲ-Ⅳ, Hung Hess grade Ⅲ-Ⅳ, WFNS grade Ⅳ-Ⅴ, aneurysm diameter>10 mm in poor prognosis subgroup was significantly higher than that in good prognosis subgroup(χ2/P=4.748/0.029, 4.579/0.032, 18.361/<0.001、7.634/0.006, 8.388/0.004, 7.255/0.007). Logistic regression analysis showed that high modified Fisher grade, high Hung Hess grade and high level of serum FoxO3a mRNA were risk factors for poor prognosis of patients with aSAH [OR(95%CI)=3.721(1.913-7.253), 3.864(1.730-8.631), 8.291(2.888-23.799)].High level of serum Cav-1 was a protective factor [OR(95% CI)=0.496(0.340-0.723)].The area under the ROC curve of serum Cav-1, FoxO3a mRNA and their combination to evaluate the prognosis of patients with aSAH were 0.855, 0.832 and 0.902 respectively, and their combined evaluation efficiency was higher than that of single prediction(Z/P=2.121/0.034, 2.623/0.009). Conclusion The low expression of serum Cav-1 and high expression of FoxO3a mRNA in patients with aSAH are factors that affect the prognosis of patients with aSAH. The combined detection of the two has certain evaluation value for the prognosis of patients with aSAH.
Establishment and evaluation of risk model of idiopathic pulmonary interstitial fibrosis complicated with emphysema
Author： Kang Dongmei ;Gao Yong; Ma Jifang ;Zhao Hai
keyword： Idiopathic pulmonary fibrosis; Emphysema; Clinical features; Influence factor; Nomogram;
Objective To explore the clinical characteristics of idiopathic pulmonary fibrosis(IPF) complicated with emphysema and build a risk prediction model.Methods From June 2017 to April 2021, 66 patients with IPF complicated with emphysema who were treated in the Department of Respiratory and Critical Care Medicine of Sinopharm Tongmei General Hospital were selected as the observation group, and 72 patients with simple IPF who were treated in the same period were selected as the control group. The clinical data, arterial blood gas index and pulmonary function index of the two groups were compared; Multivariate logistic regression was used to analyze the risk factors of IPF complicated with emphysema, and the nomogram prediction model was constructed using the selected valuable variables and the model was evaluated. All patients were followed up for 1 year, and the survival of the two groups was compared. Results The proportion of smoking, reflux esophagitis, dry cough, interleukin-4(IL-4) and tumor necrosis factor in the observation groupα(TNF-α), The level of arterial partial pressure of oxygen(PaO2), total lung capacity(TLC) and vital capacity(VC) were higher than those in the control group [t(χ2)/P=7.845/0.005, 6.661/0.010, 4.246/0.039, 2.313/0.022, 3.011/0.003, 2.911/0.004, 3.744/<0.001, 2.016/<0.046],while carbon monoxide dispersion(DLCO) was lower than that in the control group(t/P=3.653/<0.001). Multivariate logistic regression analysis showed that smoking, reflux esophagitis, high IL-4, TNF-α High PaO2, high TLC are independent risk factors of IPF complicated with emphysema [OR(95%CI)=1.509(1.117-2.941), 2.746(1.968-3.535), 1.262(1.021-3.517), 2.158(1.469-3.998), 1.724(1.055-2.653), 1.396(1.116-2.240), all P<0.05], and high DLCO is a protective factor [OR(95%CI)=0.717(0.346-0.966),P=0.018]. The validation results of the nomogram model based on seven independent predictors showed that the area under the working characteristic curve of the subjects was 0.846, the C-index was 0.835, and the Hosmer Lemeshow goodness of fit test showed a good degree of fit(P=0.832), with a high net benefit value. The follow-up results showed that there was no significant difference in 1-year survival rate between the two groups(P>0.05). Conclusion Smoking, reflux esophagitis, IL-4, TNF-α, PaO2, TLC and DLCO are the influencing factors of IPF complicated with emphysema, and the nomogram prediction model constructed by them can simply and quickly predict the risk of complicated emphysema.
Effects of atorvastatin on serum Hb, NLR, PLR and bone metabolism in elderly type 2 diabetes patients with osteoporosis
Author： Zhao Haiyan; Zhang Huili; Wang Xiaomei; Ma Kaixia
keyword： Diabetes,type 2; Osteoporosis; Atorvastatin; Zoledronic acid sodium; Elderly;
Objective To observe the effects of atorvastatin on serum hemoglobin(Hb), neutrophil/lymphocyte ratio(NLR), platelet lymphocyte ratio(PLR), bone mineral density(BMD) and bone metabolism in elderly patients with type 2 diabetes mellitus(T2DM) and osteoporosis(OP). Methods One hundred and forty two patients with T2DM combined with OP were selected from November 2020 to December 2021 in the Department of Endocrinology and Metabolism of the Affiliated Hospital of Qinghai University. They were divided into the control group and the observation group according to the random number table method, with 71 patients in each group. The control group was treated with zoledronic acid(ZOL), and the observation group was treated with ZOL combined with atorvastatin. The serum Hb, NLR, PLR, bone metabolic indicators(BGP, B-ALP, S-Ca, N-MID-OT), BMD, and bone pain VAS scores of the patients in the two groups were measured before and after treatment, and the adverse reactions in the two groups were compared. Results After 6 months of treatment, the serum Hb in the observation group was higher than that in the control group, and the levels of NLR and PLR were lower than those in the control group(t/P=-5.250/<0.001, 2.870/0.002, 6.910/0.001). B-ALP and N-MID-OT in the observation group were lower than those in the control group, while the BGP level was higher than that in the control group(t=7.450, 8.696, 14.376, P<0.001). BMD of lumbar spine(L2-4) and hip joint in the observation group were higher than those in the control group, and VAS scores were lower than those in the control group(t/P=2.009/0.039, 2.099/0.019, 21.921/<0.001). There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05). Conclusion Atorvastatin has clear efficacy and good safety in the treatment of elderly T2DM patients with OP, which can significantly reduce the degree of bone pain, increase BMD, improve bone metabolism indicators and serum Hb, NLR, PLR levels.
Correlation between serum TG, TPOAb expression and type 2 diabetes nephropathy and long-term prognosis
Author： Yan Chong; Wang Yang; Zhang Linghui
keyword： Type 2 diabetic nephropathy; Triglycerides; Thyroid peroxidase antibody; Prognosis; Correlation;
Objective To explore the correlation between serum triglyceride(TG), thyroid peroxidase antibody(TPOAb) levels and type 2 diabetes nephropathy(T2DKD) and its long-term prognosis. Methods One hundred and forty eight patients with T2DKD(T2DKD group) and 148 patients with simple type 2 diabetes(T2 DM group) diagnosed and treated by the Department of Endocrinology, Zhongshan Hospital, Hubei Province from December 2016 to January 2019 were selected. According to the 3-year follow-up prognosis of patients in T2DKD group, 86 patients with good prognosis and 62 patients with poor prognosis were divided into two subgroups. 148 healthy people in the same period were included in the health control group. The levels of serum TG and TPOAb in each group and T2DKD patients with different degrees of renal injury were compared. Logistic regression analysis was used to analyze the prognostic factors of T2DKD patients. The prognostic value of serum TG and TPOAb in T2DKD patients was evaluated by ROC. Results Compared the levels of serum TG and TPOAb, T2DKD group>T2 DM group>healthy control group(F/P=131.577/<0.001, 323.503/<0.001). The levels of serum TG and TPOAb in patients with T2DKD of grade Ⅰ, Ⅱ, Ⅲ and Ⅳ renal injury increased in turn(F/P=32.595/<0.001, 33.347/<0.001). Compared with the subgroup with good prognosis, the course of DM, urinary protein, fasting blood glucose, serum TG and TPOAb levels in T2DKD patients with poor prognosis subgroup increased(t/P=6.212/<0.001, 6.733/<0.001, 8.257/<0.001, 5.639/<0.001, 5.468/<0.001), and eGFR level decreased(t/P=3.289/0.001). Logistic regression analysis showed that high eGFR was a protective factor for poor prognosis of T2DKD patients [OR(95%CI)=0.547(0.449-0.667)],and long duration of DM, high urine protein, high fasting blood glucose, high TG and high TPOAb were risk factors for poor prognosis of T2DKD patients [OR(95%CI)=2.621(1.680-4.090), 2.372(1.593-3.531), 2.460(1.639-3.704), 2.513(1.652-3.823) 2.829(1.781-4.493)]. The AUC of serum TG, TPOAb and their combination in predicting the prognosis of T2DKD patients were 0.838, 0.842 and 0.923, respectively, and their combined prediction efficiency was higher than that of single prediction(Z/P=2.083/0.037, 1.985/0.047). Conclusion The serum TG and TPOAb levels in patients with T2DKD are higher, and the combination of the two may be more helpful to determine the long-term prognosis of patients with T2DKD.