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1.
目的:探讨胃内容物潜血阳性患者血红蛋白( Hb)的含量高低与其凝血指标检测结果的关系。方法选择379例胃内容物潜血阳性患者,分为男、女2组,根据男女Hb正常参考范围,将男性患者分为Hb≥120 g/L( Hb正常组)及Hb<120 g/L(贫血组)2组;将女性患者分为Hb≥110 g/L(Hb正常组)及Hb<110 g/L(贫血组)2组;同时男女各设对照组。检测各组血浆凝血酶原时间( PT)、活化部分凝血活酶时间( APTT)及D-二聚体( D-dimer)水平,分别观察上述三种检测指标在男女相应各组间有无差异。结果男女患者各组PT检测结果与对照组比较差异无统计学意义( P >0.05)。 APTT及D-dimer检测结果为男性Hb 正常组[(29.1±3.4)s、(0.23±0.12)g/L]、贫血组[(28.1±2.9)s、(0.45±0.26)g/L]、正常对照组[(30.1±0.6)s、(0.26±0.09)g/L]。贫血组与Hb正常组( t =2.04, P <0.05;t =3.55, P <0.05)及对照组( t =2.23, P <0.05;t =3.29, P <0.05)比较,差异有统计学意义( P<0.05),Hb 正常组与对照组差异无统计学意义( P >0.05)。 APTT和D-dimer检测结果女性Hb正常组[(30.1± 3.4)s、(0.21±0.14)g/L]、贫血组[(29.1±2.8)s、(0.42±0.19)g/L]、对照组[(31.1±3.2)s、(0.22±0.15)g/L]。贫血组与Hb正常组( t =1.99, P <0.05;t =3.01, P <0.05)及对照组( t =2.03, P <0.05;t =2.83, P <0.05)比较,差异有统计学意义( P <0.05),Hb正常组与对照组比较差异无统计学意义( P >0.05)。结论上消化道出血量较大的患者机体明显处于高凝状态,临床上应考虑给予对症治疗。  相似文献   

2.
目的:分析青年冠心病患者的危险因素。方法对2006年7-12月在阜外心血管病医院进行冠状动脉造影的292例青年患者(≤40岁)的病例资料进行回顾性分析,对比分析冠心病组(217例)和非冠心病组(75例)临床特征及相关实验室检查数据,分析青年冠心病患者的危险因素。结果被调查的292例青年患者中体重指数>24 kg/m^2者占78.8%(230/292),吸烟者71.6%(209/292);饮食习惯中喜油腻饮食者55.5%(162/292)。冠心病组严重吸烟者(吸烟史超过10年,每天吸烟超过20支)的比例高[207.%(45/217)比9.2%(7/75),P=0.015]。与代谢和炎症相关的实验室检查数据分析表明,冠心病组血浆总胆固醇、低密度脂蛋白胆固醇、脂蛋白a、尿酸、红细胞沉降率以及大内皮素1水平明显高于非冠心病组[血浆总胆固醇:(4.6±1.5)mmol/L比(4.1±1.0)mmol/L,低密度脂蛋白胆固醇:(2.4±1.1)mmol/L比(2.1±0.6)mmol/L,脂蛋白a:(135±110)mg/L比(102±58)mg/L,尿酸:(360±100)μmol/L比(337±94)μmol/L,5(2,13)mm/1 h比2(36,)mm/1 h;0.450(0.290,2.510)pmol/L比0.320(0.208,04.75)pmol/L],差异均有统计学意义(P<0.05或P<0.01),高敏C 反应蛋白差异无统计学意义[1.750(0.738,3.755) mg/L比12.80(0.550,2.71)mg/L](P>0.05)。多因素Logistic回归分析表明,吸烟[比值比(OR)=1.89,95%置信区间(CI):17.4~2.05],高血压(O R=1.56,95% CI:1.48~1.65),2型糖尿病(O R=1.37,95%CI:1.25~15.0),高脂饮食(OR=1.35,95%CI:1.28~1.43)和体重指数>24 kg/m^2(OR=1.09,95% CI:1.03~1.17)和有饮酒史(OR=1.37,95% CI:1.30~1.46)的年轻人患冠心病的危险明显增加(均P<0.01)。结论在被调查的年龄≤40岁的青年患者  相似文献   

3.
目的探讨急性冠状动脉综合征(ACS)合并2型糖尿病患者抑郁情况及影响因素。方法连续入选2011年1月至2012年1月我院心内科住院ACS合并2型糖尿病患者121例,采用综合医院焦虑抑郁评分量表进行心理测评,评价焦虑抑郁的发生率,并对抑郁的影响因素进行分析。结果121例患者中,44例(36.4%)存在焦虑状态(焦虑组),45例(37.2%)存在抑郁状态(抑郁组),焦虑抑郁共病32例(26.4%)。抑郁组患者糖化血红蛋白、报销比例≤40%者、左心室射血分数〈50%患者比例明显高于非抑郁组『分别为(7.9±1.9)%比(7.1±1.8)%,45.5%(20/45)比20.8%(16/76),28.9%(13/45)比7.9%(6/76)],差异均有统计学意义(P〈0.05或P〈0.01)。Logistic逐步回归分析显示报销比例≤40%、左心室射血分数〈50%和糖化血红蛋白升高是抑郁的主要影响因素[分别为比值比(OR)4.596,95%置信区间(凹)1.806~11.698:OR6.319,95%CI1.831~21.810;OR1.352,95%CI1.064~1.719;P〈0.05或P〈0.011。结论ACS合并2型糖尿病患者抑郁状态发生率高,应尽早给予心理干预,改善预后。  相似文献   

4.
李小娟 《安徽医药》2015,(3):543-545
目的:观察不同类型冠心病患者血清脂蛋白(a)[Lp(a)]水平与血管内超声(IVUS)下冠状动脉斑块显像特征关系。方法选择急性冠状动脉综合征(ACS)患者109例,稳定型心绞痛(stable CAD 组)患者91例,同时以诊断阴性者100例作为对照组,测定三组患者血清 Lp(a)水平,应用 IVUS 评价 ACS 组和 stable CAD 组患者冠状动脉斑块的形态、特征及易损性。并进一步评价血清 Lp(a)与 IVUS 评价易损性斑块指标的相关性。结果ACS 组血清 Lp(a)浓度显著高于 stable CAD 组及对照组(P <0.05),ACS 组狭窄病变处主要为软斑块、偏心性斑块,ACS 组 IVUS 斑块面积(P <0.05)、偏心指数及重构指数(P <0.05)均大于 stable CAD 组,血浆 Lp(a)水平与软斑块面积百分比、偏心指数和血管重构指数(r =0.336,P <0.05;r =0.164,P=0.02和 r =0.314,P <0.05)呈正相关。结论ACS 组血清 Lp(a)水平明显高于 stable CAD 组和对照组,血清 Lp(a)水平与IVUS 评价斑块易损性指标相关,Lp(a)可作为冠状动脉易损斑块的评估因子。  相似文献   

5.
目的:探究ST段抬高心肌梗死患者远期死亡的相关因素。方法对收治的100例ST段抬高心肌梗死患者的临床资料进行回顾性分析,根据出院后的临床结局,分为存活组与死亡组,采用Logistic回归分析远期死亡的危险因素。结果存活组与死亡组患者的例数分别为80例(80.00%)与20例(20.00%);经单因素筛选及多元回归分析后,年龄( OR=2.010,95CI=1.100~3.673)、糖尿病史(OR=2.131,95CI=1.192~3.810)、急诊经皮冠状动脉介入(PCI)(OR=0.692,95CI=0.461~0.812)以及低T3综合征(OR=1.811,95CI=1.252~2.620)等是ST段抬高心肌梗死患者远期死亡率的独立影响因素(均P<0.05)。结论 ST段抬高心肌梗死患者的远期死亡率较高,与患者年龄、糖尿病史以及低T3综合征等多种因素有关,对于不存在禁忌证患者,应及时实施急诊PCI,以降低远期死亡率。  相似文献   

6.
目的探讨血清超敏C反应蛋白(hs-CRP)水平与冠状动脉慢血流现象(SCF)的相关性。方法选择冠状动脉造影检查提示SCF的患者31例为SCF组以及冠状动脉造影检查示冠状动脉无狭窄且血流正常者36例为对照组,比较两组的血清hs-CRP水平,并以统计学处理分析hs-CRP与SCF的关系。结果 SCF组的血清hs-CRP水平明显高于对照组(P〈0.05),且与平均TIMI血流帧数呈正相关(r=0.476,P〈0.01)。结论 hs-CRP与SCF的形成过程密切相关。  相似文献   

7.
目的评价右冠状动脉病变患者在不同狭窄程度时的临床特点。方法选取1998年1月至2004年4月住院期间经冠状动脉造影检查确诊为右冠状动脉单支病变且资料完整的病例76例,进行回顾性分析。根据临床特点分为心肌梗死组36例和心绞痛组40例,分别比较两组在不同狭窄程度时的临床特点。结果①同心绞痛组比较,心肌梗死组患者的收缩压和舒张压低,糖尿病所占比例高,FBG和CK峰值高,重度狭窄和完全闭塞患者所占比例高(P〈0.05)。心肌梗死组低血压和心律失常的发生率高于心绞痛组(P〈0.05),房室传导阻滞在心肌梗死组中发生率高于心绞痛组(P〈0.05)。②心肌梗死组:完全闭塞组较轻中度狭窄组易形成侧支循环(P〈0.05)。完全闭塞组较狭窄组再灌注心律失常发生率高(P〈0.05)。③心绞痛组:轻度狭窄组较非轻度狭窄组男性和有吸烟史患者所占比例低(P〈0.05)。完全闭塞组较狭窄组易形成侧支循环(P〈0.05)。重度狭窄组较轻中度狭窄组易发生心力衰竭(P〈0.05)。结论①右冠状动脉病变患者在不同狭窄程度时的临床特点存在差别。②右冠状动脉病变完全闭塞患者更易形成侧支循环。  相似文献   

8.
目的:探讨不同透析方案下尿毒症患者的血红蛋白状况。方法选取2011年2月至2014年8月进行维持性透析的尿毒症患者140例,根据患者透析的类型将患者分为腹膜透析组( n=70)和血液透析组( n=70)。对比两组患者的基线资料和透析前、透析后3个月、透析后半年、透析后9个月的每周红细胞生成素( EPO)剂量、血红蛋白( Hb)水平;对比两组患者透析前后血清C-反应蛋白(CRP)水平。结果与透析前相比,腹膜透析组患者透析后3个月Hb升高、每周EPO用量增加(P<0.05);与腹膜透析组相比,血液透析组患者透析前、透析后3个月、透析后半年、透析后9个月每周EPO用量较高(P<0.05);与血液透析组相比,腹膜透析组患者透析前后CRP水平较低(P<0.001);与透析前相比,血液透析组患者透析后CRP水平明显升高;每周EPO用量波动(OR=1.110,95%CI=1.034~1.191)、血液透析(OR=3.080,95%CI=1.620~5.858)是血红蛋白变异的危险因素。结论血液透析较腹膜透析患者每周EPO用量多,CRP水平明显高于腹膜透析的患者,每周EPO剂量波动和血液透析为血红蛋白变异的危险因素。  相似文献   

9.
目的探讨血清骨钙素水平与老年骨质疏松及冠状动脉病变的相关性。方法选取183例年龄在60-85岁的患者,根据骨密度测定结果分为2组:非骨质疏松组86例,骨质疏松组97例;根据冠状动脉螺旋CT检查结果分为3组:轻度钙化组(积分〈200)68例;中度钙化组(200≤积分〈300)43例;重度钙化组(积分I〉300)72例。比较各组患者的冠状动脉狭窄病变和钙化程度。应用酶联免疫吸附试验者测定各组患者血清骨钙素水平。结果骨质疏松组患者合并肥胖、高血压、高血脂和糖尿病的比例分别为56.7%(55/97)、80.4%(78/97)、78.4%(76/97)、71.1%(69/97),高于非骨质疏松组的37.2%(32/86)、54.7%(47/86)、44.2%(38/86)、31.4%(27/86)(P〈0.05);骨质疏松组患者血清骨钙素水平明显低于非骨质疏松组患者[(14.4±3)ng/L比(424±6)ng/L(P〈0.05)];骨质疏松组患者任意冠状动脉分支的钙化程度均高于非骨质疏松组,2组比较差异有统计学意义(P〈0.05)。骨质疏松组冠状动脉单支病变超过50%狭窄者比例明显高于非骨质疏松组,冠状动脉2支以上病变者占比更高[20.6%(20/97)比3.5%(3/86)],差异均有统计学意义(均P〈0.05)。冠状动脉血清骨钙素水平分别为(45.6±8.3)、(26.2±4.8)、(15.5±10.2)ng/L,任意两两比较差异均有统计学意义(均P〈0.01)。结论骨钙流失与钙质在冠状动脉的沉积存在共同的发病机制。该机制与血清骨钙素水平有关,血清骨钙素对老年男性骨质疏松与冠状动脉钙化有保护作用。  相似文献   

10.
周冉  段文 《安徽医药》2015,19(12):2397-2400
目的:评价七叶皂苷钠治疗胫腓骨骨折所致肢体肿胀的疗效及安全性。方法计算机检索CNKI 、CBM、万方、维普从建库到2015年3月31日前七叶皂苷钠治疗胫腓骨骨折所致肢体肿胀所有临床研究文献,采用RevMan5.3软件进行Meta分析。结果共纳入4项研究,共398例患者。七叶皂苷钠组较甘露醇组治疗胫腓骨骨折所致肿胀有效率更高,差异具有统计学意义[OR=2.68,95%CI(1.41,5.10),Z=3.01,P=0.003];七叶皂苷钠组与甘露醇组治疗胫腓骨骨折所致肿胀疗程上差异无统计学意义[MD=-1.08,95%CI(-3.17,1.01),Z=1.01,P=0.31];联合用药组较甘露醇组治疗胫腓骨骨折所致肿胀有效率更高,差异具有统计学意义[OR=4.37,95%CI(1.37,13.96),Z=2.49,P=0.01];联合用药组较甘露醇组治疗胫腓骨骨折所致肿胀疗程更短,差异具有统计学意义[MD=-1.58,95%CI(-1.98,1.17),Z=7.65,P<0.000001]。结论七叶皂苷钠单独使用可以增加治疗胫腓骨骨折所致肿胀有效率,但不能缩短疗程;联合用药不仅能增加治疗肿胀有效率,同时能缩短疗程。  相似文献   

11.
左冠状动脉主干狭窄的临床分析   总被引:3,自引:0,他引:3  
目的探讨左主干狭窄的临床特点和治疗方法.方法分析左主干病变(狭窄≥50%)者和非左主干病变者临床资料.结果1 275例确诊的冠心病患者中,左主干狭窄74例(5.8%),非左主干病变180例(14.1%).左主干合并3支病变占66.2%,左主干病变组心绞痛发生率较非左主干病变组高.57例(77.0%)胸痛发作时心电图ST段下移≥0.2 mV.左主干并3支组与单纯左主干组比较心肌梗死发生率高(P<0.05),左室射血分数低(P<0.01).23例行CABG 1年内心绞痛症状消失或明显减轻,3例行无保护左主干直接支架术,术后半年心绞痛明显减轻.结论左主干狭窄者多合并其它冠脉病变,心绞痛严重.冠状动脉旁路移植术是最佳治疗手段.  相似文献   

12.
目的 评价宝石能谱CT冠状动脉成像(CTA)在冠心病诊断中应用价值.方法 63例疑似冠心病分别接受CTA和冠状动脉造影检查,以冠状动脉造影结果为“金标准”对照,评估冠状动脉CTA检查的准确度.结果 冠状动脉CTA可以清晰显示冠状动脉狭窄病变,与冠状动脉造影相比,两者的符合率达96.0%.结论 CTA安全、简便和无创伤,对冠状动脉疾病具有较大的诊断价值.  相似文献   

13.
经皮冠状动脉介入治疗79例临床分析   总被引:1,自引:1,他引:0  
目的探讨经皮冠状动脉介入治疗的可行性、安全性和成功率。方法选择该院2005年1月~2009年7月经皮股动脉穿刺冠状动脉腔内成形术(PTCA)及支架术79例患者为研究对象。结果A型病变支架术成功率100%(36/36),B型病变成功率98.9%(88/89),C型病变成功率95.3%(41/43)。1例分叉、弯曲、偏心性病变和2例慢性闭塞性病变(CTO)因指引导丝不能通过病变致手术失败,总成功率为98.2%。结论经皮冠状动脉介入治疗创伤小,恢复快,安全且成功率高。  相似文献   

14.
目的探讨室壁瘤形成与冠状动脉粥样硬化的关系,以及室壁瘤对心室功能的影响。方法采用冠状动脉造影方法对168例临床疑诊冠心病患者进行检查。结果发现室壁瘤26例,其中冠状动脉单支病变11例,双支7例,三支7例,冠状动脉正常1例,受累血管狭窄程度均在III级以上。室壁瘤累及心室壁一段、二段、三段及四段的左室射血分数分别平均为(50±31)%、(32±16)%、(29±21)%及(18±14)%(r=-0.65,P  相似文献   

15.
目的:探讨声学密度定量(AD)技术评价正常、狭窄及闭塞血管支配区域心肌的组织特征。方法:对疑诊冠心病的64例患者,根据冠状动脉造影结果将192支冠状动脉分组:正常组(A组)、狭窄组(B组)、闭塞组(C组),检测其相应血管支配区域心肌的背向散射积分参数。结果:与A组相比,B组心肌的背向散射积分的标化值(IBS%)增高;而背向散射积分周期变化幅度(CVIB)减小;C组心肌的IBS%增高更明显;CVIB减小也更明显。且14支闭塞血管支配区域心肌的CVIB曲线与正常节段呈反向,N-delay在B组及C组明显延长,同一参数组间比较差异均有显著性(P<0.01),结论:AD技术能客观反映正常,狭窄及闭塞冠状动脉脉供血区域心域心肌的不同组织特性变化,对鉴别冠心病不同病变心肌的灌流特征具有一定的诊断意义。  相似文献   

16.
Objective To explore the impact of different dose atorvastatin on the adhesion molecules level in the acute coronary syndrome (ACS) patients who had received percutaneous coronary intervention (PCI). Methods Eighty-eight ACS patients were divided into three groups, group A (normal treatment group), group B (normal treatment plus atorvastatin 10mg per day) and group C (normal treatment plus atorvastatin 80mg per day). The patients in group B received atorvastatin 10 mg per day orally before PCI and after PCI subsequently, and the patients in group C received atorvastatin 80 mg per day orally before PCI and after PCI subsequently for three days, then the dose of atorvastatin was decrease to 10 mg per day. The concentrations of soluble intercellular adhesionmolecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were detected before PCI and at the 3rd, 7th 14th day after PCI. Results At the 7th day, the concentrations of sICAM-1 and sVCAM-1 in group C were significantly lower than those in group B, which showed sICAM-1 (68.35±23.80) μg/L vs (131.45±29.12) μg/L and sVCAM-1 (251. 65±36.61)μg/L vs (334.87±32.98) μg/L, respectively. Compared to group A, the adhesion molecule level in group B and group C were significantly decreased (P<0.05) and had no obviously affect on blood fat level. Conclusion The treatment of atorvastatin could significantly decrease the adhesion molecules' level after PCI, which may play an important role in lowing inflammation and coronary artery restenosis after PCI.  相似文献   

17.
目的探讨影响冠心病患者对冠状动脉介入诊疗的依从性的主要因素。方法回顾性分析2008年10月至2009年7月间我科住院的临床诊断为冠心病的505名患者,观察资费来源、冠心病亚型及年龄阶段三个不同因素对住院期间冠状动脉介入诊疗依从性的影响。结果随着年龄的增长,对冠状动脉介入的依从性逐步减低;军队医保组与自费组较社会医保组依从性较高;疾病类型对介入依从性影响则相对较小。结论在当前医疗保障体制下,心脏冠状动脉介入诊疗的依从性明显受到包括医疗资源保障程度、年龄阶段等多种因素的影响。  相似文献   

18.
Objective To explore the impact of different dose atorvastatin on the adhesion molecules level in the acute coronary syndrome (ACS) patients who had received percutaneous coronary intervention (PCI). Methods Eighty-eight ACS patients were divided into three groups, group A (normal treatment group), group B (normal treatment plus atorvastatin 10mg per day) and group C (normal treatment plus atorvastatin 80mg per day). The patients in group B received atorvastatin 10 mg per day orally before PCI and after PCI subsequently, and the patients in group C received atorvastatin 80 mg per day orally before PCI and after PCI subsequently for three days, then the dose of atorvastatin was decrease to 10 mg per day. The concentrations of soluble intercellular adhesionmolecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were detected before PCI and at the 3rd, 7th 14th day after PCI. Results At the 7th day, the concentrations of sICAM-1 and sVCAM-1 in group C were significantly lower than those in group B, which showed sICAM-1 (68.35±23.80) μg/L vs (131.45±29.12) μg/L and sVCAM-1 (251. 65±36.61)μg/L vs (334.87±32.98) μg/L, respectively. Compared to group A, the adhesion molecule level in group B and group C were significantly decreased (P<0.05) and had no obviously affect on blood fat level. Conclusion The treatment of atorvastatin could significantly decrease the adhesion molecules' level after PCI, which may play an important role in lowing inflammation and coronary artery restenosis after PCI.  相似文献   

19.
Objective To explore the impact of different dose atorvastatin on the adhesion molecules level in the acute coronary syndrome (ACS) patients who had received percutaneous coronary intervention (PCI). Methods Eighty-eight ACS patients were divided into three groups, group A (normal treatment group), group B (normal treatment plus atorvastatin 10mg per day) and group C (normal treatment plus atorvastatin 80mg per day). The patients in group B received atorvastatin 10 mg per day orally before PCI and after PCI subsequently, and the patients in group C received atorvastatin 80 mg per day orally before PCI and after PCI subsequently for three days, then the dose of atorvastatin was decrease to 10 mg per day. The concentrations of soluble intercellular adhesionmolecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were detected before PCI and at the 3rd, 7th 14th day after PCI. Results At the 7th day, the concentrations of sICAM-1 and sVCAM-1 in group C were significantly lower than those in group B, which showed sICAM-1 (68.35±23.80) μg/L vs (131.45±29.12) μg/L and sVCAM-1 (251. 65±36.61)μg/L vs (334.87±32.98) μg/L, respectively. Compared to group A, the adhesion molecule level in group B and group C were significantly decreased (P<0.05) and had no obviously affect on blood fat level. Conclusion The treatment of atorvastatin could significantly decrease the adhesion molecules' level after PCI, which may play an important role in lowing inflammation and coronary artery restenosis after PCI.  相似文献   

20.
Objective To explore the impact of different dose atorvastatin on the adhesion molecules level in the acute coronary syndrome (ACS) patients who had received percutaneous coronary intervention (PCI). Methods Eighty-eight ACS patients were divided into three groups, group A (normal treatment group), group B (normal treatment plus atorvastatin 10mg per day) and group C (normal treatment plus atorvastatin 80mg per day). The patients in group B received atorvastatin 10 mg per day orally before PCI and after PCI subsequently, and the patients in group C received atorvastatin 80 mg per day orally before PCI and after PCI subsequently for three days, then the dose of atorvastatin was decrease to 10 mg per day. The concentrations of soluble intercellular adhesionmolecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were detected before PCI and at the 3rd, 7th 14th day after PCI. Results At the 7th day, the concentrations of sICAM-1 and sVCAM-1 in group C were significantly lower than those in group B, which showed sICAM-1 (68.35±23.80) μg/L vs (131.45±29.12) μg/L and sVCAM-1 (251. 65±36.61)μg/L vs (334.87±32.98) μg/L, respectively. Compared to group A, the adhesion molecule level in group B and group C were significantly decreased (P<0.05) and had no obviously affect on blood fat level. Conclusion The treatment of atorvastatin could significantly decrease the adhesion molecules' level after PCI, which may play an important role in lowing inflammation and coronary artery restenosis after PCI.  相似文献   

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