目的研究人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者接受长期抗逆转录病毒治疗(antiretroviral therapy,ART)后骨密度(bone mineral density,BMD)及骨小梁分数(trabecular bone score,TBS)的变化。方法回顾性收集在北...目的研究人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者接受长期抗逆转录病毒治疗(antiretroviral therapy,ART)后骨密度(bone mineral density,BMD)及骨小梁分数(trabecular bone score,TBS)的变化。方法回顾性收集在北京协和医院感染内科随诊的HIV感染者中,有基线BMD及TBS数据、ART治疗时间在1年及以上的HIV感染者数据,分析入组患者基线及第1~5年的BMD与TBS。结果本研究共纳入459例HIV感染者,平均年龄(36.1±11.3)岁,男性占91.7%。在68例年龄≥50岁的患者中,BMD正常但TBS减低者占19.1%。与基线相比,第1~4年腰椎BMD均低于基线BMD,第5年腰椎BMD与基线BMD无明显差异[(1.183±0.144)vs.(1.168±0.161)g/cm 2,P=0.118]。腰椎BMD第1、2年分别下降3.0%及2.4%(P=0.196),第3年以后腰椎BMD变化百分比维持稳定。股骨颈BMD第1年下降3.5%,第2年下降4.6%,随后股骨颈BMD变化百分比保持稳定。全髋BMD与股骨颈BMD变化趋势相似。TBS第1年下降1.6%,随后维持稳定。结论在接受ART治疗前,仅凭BMD评价骨质量将忽略近20%存在骨微结构损伤的HIV感染者。长期ART治疗后各部位BMD及TBS均可维持稳定。展开更多
Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to inv...Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to investigate the relation of ECG abnormalities to outcome in the patients with ABI. Methods We performed a retrospective, observational study on the ABI patients admitted to the Department of Neurosurgery of the Beijing Tiantan Hospital between December 2005 and December 2007. All the patients accepted 12-lead electrocardiographic examination within 24 hours after injury, then divided into three groups according to the Glasgow coma score （GCS）. In-hospital mortality and one-month outcome assessed by the Glasgow outcome score （GOS） were investigated. Results Of 335 ABI patients （mean ages 32.4 years）, 246 patients （73.4%） had abnormal ECGs. The most common abnormality was ST-T changes （41.5%）, followed by sinus tachycardia （23.6%）. ECG changes had a significant association with the severity and outcome. Logistic regression analysis showed the presence of ST-T changes （OR 2.587, 95%C/1.009 to 6.629, P=0.048） and QT dispersion prolongation （OR 4.656, 95%C/1.956 to 11.082, P=0.001） significantly associated with short outcomes. Conclusions ABI can lead to myocardial damage and ECG changes had a significant association with the severity. ST-T changes and QT dispersion prolongation were the independent prognosis factors for the negative outcome of ABI patients.展开更多
文摘目的研究人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者接受长期抗逆转录病毒治疗(antiretroviral therapy,ART)后骨密度(bone mineral density,BMD)及骨小梁分数(trabecular bone score,TBS)的变化。方法回顾性收集在北京协和医院感染内科随诊的HIV感染者中,有基线BMD及TBS数据、ART治疗时间在1年及以上的HIV感染者数据,分析入组患者基线及第1~5年的BMD与TBS。结果本研究共纳入459例HIV感染者,平均年龄(36.1±11.3)岁,男性占91.7%。在68例年龄≥50岁的患者中,BMD正常但TBS减低者占19.1%。与基线相比,第1~4年腰椎BMD均低于基线BMD,第5年腰椎BMD与基线BMD无明显差异[(1.183±0.144)vs.(1.168±0.161)g/cm 2,P=0.118]。腰椎BMD第1、2年分别下降3.0%及2.4%(P=0.196),第3年以后腰椎BMD变化百分比维持稳定。股骨颈BMD第1年下降3.5%,第2年下降4.6%,随后股骨颈BMD变化百分比保持稳定。全髋BMD与股骨颈BMD变化趋势相似。TBS第1年下降1.6%,随后维持稳定。结论在接受ART治疗前,仅凭BMD评价骨质量将忽略近20%存在骨微结构损伤的HIV感染者。长期ART治疗后各部位BMD及TBS均可维持稳定。
基金This study was supported by the National Natural Science Foundation of China （No. C03030201）
文摘Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to investigate the relation of ECG abnormalities to outcome in the patients with ABI. Methods We performed a retrospective, observational study on the ABI patients admitted to the Department of Neurosurgery of the Beijing Tiantan Hospital between December 2005 and December 2007. All the patients accepted 12-lead electrocardiographic examination within 24 hours after injury, then divided into three groups according to the Glasgow coma score （GCS）. In-hospital mortality and one-month outcome assessed by the Glasgow outcome score （GOS） were investigated. Results Of 335 ABI patients （mean ages 32.4 years）, 246 patients （73.4%） had abnormal ECGs. The most common abnormality was ST-T changes （41.5%）, followed by sinus tachycardia （23.6%）. ECG changes had a significant association with the severity and outcome. Logistic regression analysis showed the presence of ST-T changes （OR 2.587, 95%C/1.009 to 6.629, P=0.048） and QT dispersion prolongation （OR 4.656, 95%C/1.956 to 11.082, P=0.001） significantly associated with short outcomes. Conclusions ABI can lead to myocardial damage and ECG changes had a significant association with the severity. ST-T changes and QT dispersion prolongation were the independent prognosis factors for the negative outcome of ABI patients.
