高基础水平血尿酸与动脉硬化的相关性及其预测作用

目的探讨血尿酸与动脉硬化的相关性及高基础水平血尿酸对动脉硬化的预测作用。方法选取2012年2月至2019年3月在首都医科大学附属北京友谊医院行健康体检的人群207例次,同一人至少行2次体检,两次体检间隔4~5年,第一次体检定义为基础数据组(207例),第二次体检定义为随访数据组(207例),采集两组人群既往病史、血尿酸、糖化血红蛋白、血脂、肱踝脉搏波传导速度(baPWV)等信息。采用t检验及χ^2检验分析动脉硬化组(baPWV≥14 m/s)和非动脉硬化组(baPWV<14 m/s)的血尿酸水平差异,多元线性回归分析基础数据的血尿酸对随访数据组动脉硬化的预测作用。结果基础数据组中,动脉硬化组血尿酸水平(356.29±81.14μmol/L)和非动脉硬化组的血尿酸水平(329.78±74.04μmol/L)比较,差异具有统计学意义(t=-2.425,P=0.016)。随访数据组中,动脉硬化组血尿酸水平(371.29±91.33μmol/L)和非动脉硬化组血尿酸水平(340.30±79.03μmol/L)比较,差异也具有统计学意义(t=-2.597,P=0.010);在调整了年龄、性别、高血压及糖尿病病史、高密度脂蛋白胆固醇等多种因素后,基础数据组血尿酸水平是随访数据组动脉硬化的独立危险因素(β=0.427,P=0.048)。结论血尿酸水平是动脉硬化的重要影响因素,高基础水平的血尿酸是动脉硬化的独立预测因子。     

Data analysis of 36 cases with intraductal papillary mucinous neoplasm of the pancreas for their clinicopathological features, diagnosis, and treatment

Background Intraductal papillary mucinous neoplasm （IPMN） is a rare pancreatic cystic neoplasm,accounting for 1％ of all exocrine pancreatic neoplasms.This study aimed to summarize the clinicopathological and biological behaviors,as well as the experience in diagnosis and treatment of IPMN.Methods Clinicopathological data were collected from 36 cases with IPMN who were treated in Department of General Surgery,Peking University Third Hospital from May 2001 to July 2011.Results The 36 cases of IPMN patients included 27 males and 9 females （M∶F=3∶1）.The age of patients ranged from 52 to 78 years,with an average of 67.3 years.Regarding tumor location,20 tumors were located in pancreatic head,3 in pancreatic neck,10 in pancreatic body and tail,and 3 in the whole pancreas.All the 36 cases underwent surgical treatment,with 13 cases of pancreaticoduodenectomy,3 cases of middle pancreatectomy,7 cases of tumor resection plus pancreaticojejunostomy,3 cases of distal pancreatectomy,7 cases of distal pancreatectomy plus spleen resection,and 3 cases of total pancreaticoduodenectomy.Of the 36 patients,9 patients underwent the operations under laparoscopy.The 36 cases included main duct type （14 cases,38.9％）,branch duct type （10 cases,27.7％）,and mixed duct type （12 cases,33.3％）.Pathologically,of the 36 cases,there were 7 IPMN adenomas,11 borderline IPMNs,6 IPMN with carcinomas in situ,and 12 IPMNs with invasive carcinomas.All the 36 cases were followed up.During an average of 42 months follow-up period （26-129 months）,no recurrence occurred.Conclusions IPMN,which primarily occurs in male,is a low-grade malignancy which may involve any part of the pancreas,with specific clinicopathological features.IPMN is a different malignancy type from pancreatic ductal carcinoma.Imaging and laboratory examination are helpful for the diagnosis and differential diagnosis.The prediction of invasive IPMN is still difficult.Surgical resection is recommended as the first choice of treatment.Aggressive and proper o