| 罗显洪,夏 豪,唐东梁,等.溶血磷脂酸对于评估不稳定心绞痛患者不良预后的临床意义[J].安徽医药,2015,19(9):1704-1708. |
| 溶血磷脂酸对于评估不稳定心绞痛患者不良预后的临床意义 |
| The clinical significance of the poor prognosis of lysophosphatidic acid on the assessment of patients with unstable angina |
| 投稿时间：2014-10-19 |
| DOI： |
| 中文关键词: 溶血磷脂酸 非ST段抬高型急性冠状动脉综合征 不稳定心绞痛 非ST段抬高型急性心肌梗死 |
| 英文关键词: cerebrovascular accident blood pressure prognosis |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨溶血磷脂酸(LPA)对于不稳定心绞痛(UA)患者不良预后的临床意义。方法 纳入该院心血管内科于2012年7月1日至2013年7月1日期间收治尚处于UA阶段的非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者,收集相关危险因素的临床资料,并进行随访以确认预后转归。分析不同预后各项指标的差异性,并评判敏感指标的预后相关性。结果 与未转归至NSTEMI(UA组)相比,NSTEMI组患者的LPA等12项危险因素存在显著差异,经多因素Logistic回归分析得出年龄(Age)、心肌梗死溶栓试验危险评分(TIMI)、低密度脂蛋白胆固醇(LDL-C)、脂联素(APN)、LPA这5项指标是UA预后转归为NSTEMI的独立、敏感影响因素。其中LPA用于判定UA不良预后的AUC为0.731,联合其余4项指标判定UA不良预后的AUC为0.831,加入LPA后AUC增加至0.854。结论 LPA水平可作为评判UA预后的独立敏感因素,其含量变化对于UA进展至NSTEMI息息相关,将LPA纳入UA的诊疗体系以用于干预高危风险患者具有重要临床意义。 |
| 英文摘要: |
| Objective To investigate blood pressure(BP) variation and influential factors and the relationship between BP and prognosis in patients with acute stroke. Methods 226 consecutive patients within the first 24 hours after the onset of stroke were collected and analyzed using prospective study.Basic information was collected and the BP was monitored during the first 10 hospital days.Death,disability and recurrence were followed up at 1 and 6 months after the ictus of stroke.Results81.9% of the patients showed elevated BP values on admission,which gradually stabilized until 6 days.The multiple linear regression showed that stroke type had greatest impact on admission BP independently.Independent factors related to admission SBP were history of hypertension and smoking history and related to admission DBP were age and latency between onset of symptoms.A U-shaped relationship was found between BP and prognosis.Patients with a BP of 150/90 mmHg on admission,140/90 mmHg on day 1～6 would had a better prognosis.Multivariable analysis with logistic regression showed that the independent BP-related predictor of death at 1 month was 24th hour SBP below 120 mmHg after admission and death/disability at 6 month were the decrease of DBP within 24 hours after admission and 42nd DBP after admission.Subgroup analysis showed that the independent BP factors that influenced death at 1 month was 24th hour SBP<120mmHg after admission and death/disability at 6 month were SBP<140 mmHg on admission,SBP<120 mmHg and DBP <90 mmHg of 24 th hour after admission in cerebral infarction.In cerebral hemorrhage,independent BP factors affecting death at 1 month was the 4th day average SBP after admission and death/disability at 6 month were DBP reduction within 24 hours and the 5 th day average SBP after admission.ConclusionElevated BP is common and has tendency towards spontaneous decline usually in acute stroke.BP in acute stage influences the prognosis in patients with acute stroke independently. |
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