目的 探讨24 h动态心电图联合血清BNP、MPO、IMA在诊断老年冠心病(Coronary Heart Disease, CHD)合并无症状心肌缺血(Silent Myocardial Ischemia, SMI)中的价值。方法 选择2023年1月—2024年1月本院收治的疑似CHD合并SMI的337例老年患...目的 探讨24 h动态心电图联合血清BNP、MPO、IMA在诊断老年冠心病(Coronary Heart Disease, CHD)合并无症状心肌缺血(Silent Myocardial Ischemia, SMI)中的价值。方法 选择2023年1月—2024年1月本院收治的疑似CHD合并SMI的337例老年患者作为研究对象,以冠状动脉造影(Coronary Angiography, CAG)检查结果为金标准,将其分为阳性组(n=215例)和阴性组(n=122例)两组,对所以患者行24 h动态心电图检测分析其相关参数[24 h QT间期变异性(24 h QTV)、24 h连续5 min正常R-R间期标准差(Standard Deviation of All Normal to Normal RR Intervals Averaged for All 5-Minute Segments of a 24-Hour Period,SDANN-index)以及24 h连续5 min正常R-R间期标准差均值(Standard Deviation of NN Intervals, SDNN)],并对其血清BNP、MPO、IMA水平进行检测,采用受试者工作特征曲线(ROC)分析24 h动态心电图相关参数联合血清BNP、MPO、IMA水平预测老年CHD合并SMI的诊断效能。结果 阳性组患者24 h动态心电图相关参数指标均明显低于阴性组(P<0.05);阳性组患者血清BNP、MPO以及IMA水平均明显高于阴性组(P<0.05);Logistic回归分析结果显示,BNP、MPO以及IMA为老年CHD并发SMI的危险因素,24 h QTV是其保护因素(均P<0.05);绘制ROC曲线结果显示,24 h QTV、BNP、IMA以及MPO水平诊断老年CHD并发SMI的AUC值分别为0.719、0.904、0.915以及0.895,而联合检查的AUC值为0.991;阳性组ST段压低共发生236阵次,阴性组ST段压低共发生749阵次,其发作时间主要集中在06︰01~12︰00,两组发作时间分布比较无差异(Z=5.958,P=0.114)。结论 24 h动态心电图联合BNP、MPO以及IMA指标对老年CHD合并SMI具有较高的诊断价值,能有效鉴别其性质,可作为CHD合并SMI的诊断指标,且联合检测不仅提高了诊断的准确性,还降低了误诊和漏诊率,从而避免了不必要的医疗资源浪费;此外,早期诊断和及时干预能够显著改善患者的生活质量,减少并发症的发生,进一步降低了长期医疗成本。因此,该诊断方法具有较高的经济效益和临床推广价值。展开更多
BACKGROUND Esophageal cancer is a common malignancy with high mortality.Radiotherapy is an important treatment.Sarcopenia affects patients'physical function and prog-nosis.However,the relationship between sarcopen...BACKGROUND Esophageal cancer is a common malignancy with high mortality.Radiotherapy is an important treatment.Sarcopenia affects patients'physical function and prog-nosis.However,the relationship between sarcopenia diagnosed by Chun-Hou Chen method for sarcopenia measurement and index(C3SMI)criteria and eso-phageal cancer prognosis after radiotherapy is unclear.AIM To explore the correlation between sarcopenia(SA)diagnosed based on C3SMI criteria and the prognosis of patients with esophageal cancer following radiothe-rapy.METHODS A retrospective analysis was conducted on the general clinical data of 131 eso-phageal cancer patients who received radiotherapy in the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from March 2021 to July 2024.Based on the presence of SA,the patients were assigned into two groups-the SA group and the non-SA group.Logistic regression analysis was used for investi-gating the risk factors influencing SA in esophageal cancer patients.Additionally,the patients were followed up,with their prognosis recorded.As per their prognostic outcomes,the patients were allocated into a good prognosis group and a poor prognosis group.The data of the two groups were compared.Using logistic regression analysis,the risk factors that may influence the prognosis of these patients were analyzed.SPSS 26.0 statistical software was introduced for analyzing the study data.Comparisons were made between groups using t-tests or χ_(2) tests based on the data type.RESULTS As revealed through logistic regression analysis,age[odds ratio(OR)=2.898,P=0.038],body mass index(OR=5.983,P=0.006),prealbumin(OR=6.253,P=0.003),and Karnofsky performance status score(OR=3.854,P=0.010)were independent risk factors impacting SA for esophageal cancer patients(P<0.05).Logistic regression analysis also found that age(OR=3.823,P=0.030),differentiation degree(OR=4.802,P=0.028),American Joint Committee on Cancer clinical staging(OR=3.732,P=0.013),alpha-fetoprotein level(OR=3.508,P=0.018),thrombospondin-1 level(OR=5.749,P=0.006),carcinoembryonic antigen level(OR=3.873,P=0.030),and SA(OR=3.593,P=0.017)were independent risk factors that may influence esophageal cancer patients'prognosis(P<0.05).CONCLUSION The presence of SA has a significant relation to the poor prognosis of esophageal cancer patients,which highlights the importance of assessing and intervening in SA in clinical management so as to improve patient prognosis.展开更多
文摘目的 探讨24 h动态心电图联合血清BNP、MPO、IMA在诊断老年冠心病(Coronary Heart Disease, CHD)合并无症状心肌缺血(Silent Myocardial Ischemia, SMI)中的价值。方法 选择2023年1月—2024年1月本院收治的疑似CHD合并SMI的337例老年患者作为研究对象,以冠状动脉造影(Coronary Angiography, CAG)检查结果为金标准,将其分为阳性组(n=215例)和阴性组(n=122例)两组,对所以患者行24 h动态心电图检测分析其相关参数[24 h QT间期变异性(24 h QTV)、24 h连续5 min正常R-R间期标准差(Standard Deviation of All Normal to Normal RR Intervals Averaged for All 5-Minute Segments of a 24-Hour Period,SDANN-index)以及24 h连续5 min正常R-R间期标准差均值(Standard Deviation of NN Intervals, SDNN)],并对其血清BNP、MPO、IMA水平进行检测,采用受试者工作特征曲线(ROC)分析24 h动态心电图相关参数联合血清BNP、MPO、IMA水平预测老年CHD合并SMI的诊断效能。结果 阳性组患者24 h动态心电图相关参数指标均明显低于阴性组(P<0.05);阳性组患者血清BNP、MPO以及IMA水平均明显高于阴性组(P<0.05);Logistic回归分析结果显示,BNP、MPO以及IMA为老年CHD并发SMI的危险因素,24 h QTV是其保护因素(均P<0.05);绘制ROC曲线结果显示,24 h QTV、BNP、IMA以及MPO水平诊断老年CHD并发SMI的AUC值分别为0.719、0.904、0.915以及0.895,而联合检查的AUC值为0.991;阳性组ST段压低共发生236阵次,阴性组ST段压低共发生749阵次,其发作时间主要集中在06︰01~12︰00,两组发作时间分布比较无差异(Z=5.958,P=0.114)。结论 24 h动态心电图联合BNP、MPO以及IMA指标对老年CHD合并SMI具有较高的诊断价值,能有效鉴别其性质,可作为CHD合并SMI的诊断指标,且联合检测不仅提高了诊断的准确性,还降低了误诊和漏诊率,从而避免了不必要的医疗资源浪费;此外,早期诊断和及时干预能够显著改善患者的生活质量,减少并发症的发生,进一步降低了长期医疗成本。因此,该诊断方法具有较高的经济效益和临床推广价值。
文摘BACKGROUND Esophageal cancer is a common malignancy with high mortality.Radiotherapy is an important treatment.Sarcopenia affects patients'physical function and prog-nosis.However,the relationship between sarcopenia diagnosed by Chun-Hou Chen method for sarcopenia measurement and index(C3SMI)criteria and eso-phageal cancer prognosis after radiotherapy is unclear.AIM To explore the correlation between sarcopenia(SA)diagnosed based on C3SMI criteria and the prognosis of patients with esophageal cancer following radiothe-rapy.METHODS A retrospective analysis was conducted on the general clinical data of 131 eso-phageal cancer patients who received radiotherapy in the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from March 2021 to July 2024.Based on the presence of SA,the patients were assigned into two groups-the SA group and the non-SA group.Logistic regression analysis was used for investi-gating the risk factors influencing SA in esophageal cancer patients.Additionally,the patients were followed up,with their prognosis recorded.As per their prognostic outcomes,the patients were allocated into a good prognosis group and a poor prognosis group.The data of the two groups were compared.Using logistic regression analysis,the risk factors that may influence the prognosis of these patients were analyzed.SPSS 26.0 statistical software was introduced for analyzing the study data.Comparisons were made between groups using t-tests or χ_(2) tests based on the data type.RESULTS As revealed through logistic regression analysis,age[odds ratio(OR)=2.898,P=0.038],body mass index(OR=5.983,P=0.006),prealbumin(OR=6.253,P=0.003),and Karnofsky performance status score(OR=3.854,P=0.010)were independent risk factors impacting SA for esophageal cancer patients(P<0.05).Logistic regression analysis also found that age(OR=3.823,P=0.030),differentiation degree(OR=4.802,P=0.028),American Joint Committee on Cancer clinical staging(OR=3.732,P=0.013),alpha-fetoprotein level(OR=3.508,P=0.018),thrombospondin-1 level(OR=5.749,P=0.006),carcinoembryonic antigen level(OR=3.873,P=0.030),and SA(OR=3.593,P=0.017)were independent risk factors that may influence esophageal cancer patients'prognosis(P<0.05).CONCLUSION The presence of SA has a significant relation to the poor prognosis of esophageal cancer patients,which highlights the importance of assessing and intervening in SA in clinical management so as to improve patient prognosis.
