Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventiona...Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventional M-mode(MM)offers high-resolution imaging but requires precise alignment,which can be diffi cult in ICU patients.[3-5]Anatomical M-mode(AMM)allows flexible line adjustment,enabling accurate DE measurements despite poor acoustic windows.[6]However,comparative data between MM and AMM are limited.This retrospective study evaluated the concordance between MM and AMM for assessing right DE.展开更多
Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAP...Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAPSE in patients with mitral valve replacement for rheumatic mitral stenosis patients is still under focused. Therefore, the objective of the study was to predict the outcome after MVR in rheumatic mitral stenosis patients in relation to preoperative TAPSE. This comparative cross-sectional study was conducted at the Department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute. A total of 72 patients of rheumatic mitral stenosis patients who underwent mitral valve replacement were included in the study. They were divided into two groups: Group A and B. Group A included 36 patients with TAPSE 0.05) except for the preoperative TAPSE. Mean TAPSE of Group A was 13.17 (±1.40) and Group B was 18.61 (±1.57), the difference was statistically significant (p 0.05). Among the postoperative complications, including postoperative atrial fibrillation was higher in Group A (30.56%) than Group B (11.11%), mean ventilation time was higher in Group A (27.78%) than Group B (5.56%), length of intensive care was higher in Group A (33.33%) than Group B (11.12%), and hospital stay was higher in Group A (25.0%) than Group B (5.56%), (p < 0.05). Higher preoperative TASPE could be used as a prognostic tool for MVR in rheumatic mitral stenosis patients in our settings.展开更多
目的探究甘油三酯-葡萄糖体质指数(triglyceride-glucose body mass index,TyG-BMI)、动脉粥样硬化指数(atherogenic index of plasma,AIP)联合餐后血糖波动(postprandial glucose excursions,PPGE)对2型糖尿病(type 2 diabetes mellitu...目的探究甘油三酯-葡萄糖体质指数(triglyceride-glucose body mass index,TyG-BMI)、动脉粥样硬化指数(atherogenic index of plasma,AIP)联合餐后血糖波动(postprandial glucose excursions,PPGE)对2型糖尿病(type 2 diabetes mellitus,T2DM)患者肌少症的预测价值。方法本研究为观察性横断面研究,选取2023年1月至2024年12月在重庆医科大学附属第一医院内分泌科住院治疗的T2DM患者590例,其中男性322例,女性268例。收集其一般人口学资料及关键代谢指标[空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(postprandial 2-hour plasma glucose,PPG)、甘油三酯(triglyceride,TG)等],计算TyG-BMI、AIP和PPGE。按照亚洲肌少症工作组(Asian Working Group for Sarcopenia,AWGS)2019年标准诊断肌少症,并据此将患者分为肌少症组(n=140)与非肌少症组(n=450)。对2组患者进行1∶1倾向性评分匹配(propensity score matching,PSM),匹配后纳入肌少症组与非肌少症组各102例。比较2组FPG、PPG、TyG-BMI、AIP和PPGE等代谢指标的差异,进行Spearman相关分析,并采用条件Logistic回归模型分析T2DM患者肌少症的影响因素,并绘制受试者工作特征(receptor operating characteristic,ROC)曲线评估预测效能。收集2023年1月至2024年12月在陆军军医大学第一附属医院江北院区内分泌科的192例外部数据进行模型验证。结果PSM后,2组的基线资料均衡。肌少症组的PPG、AIP和PPGE水平均值较非肌少症组更高,TyG-BMI指数则更低(P=0.001)。Spearman相关分析显示,TyG-BMI指数与T2DM患者肌少症呈显著负相关(r=-0.404,P=0.001),AIP和PPGE与T2DM患者肌少症均呈显著正相关(r=0.280,P=0.001;r=0.372,P=0.001)。条件Logistic回归分析显示,AIP(OR=14.367)和PPGE(OR=1.245)为T2DM患者肌少症的独立危险因素,TyG-BMI指数(OR=0.966)为T2DM患者肌少症的独立保护因素。ROC曲线显示,联合应用TyG-BMI指数、AIP和PPGE的预测模型曲线下面积(area under the curve,AUC)为0.918,外部验证中AUC为0.954,敏感度和特异性均优。结论TyG-BMI指数、AIP及PPGE是T2DM患者肌少症的重要代谢预测指标,三者联合应用具有良好的2型糖尿病患者肌少症筛查价值与外部适用性。展开更多
文摘Diaphragmatic function is central to respiration,and its evaluation is critical in intensive care unit(ICU)settings.Ultrasonography is a reliable bedside tool to assess diaphragmatic excursion(DE).[1,2]The conventional M-mode(MM)offers high-resolution imaging but requires precise alignment,which can be diffi cult in ICU patients.[3-5]Anatomical M-mode(AMM)allows flexible line adjustment,enabling accurate DE measurements despite poor acoustic windows.[6]However,comparative data between MM and AMM are limited.This retrospective study evaluated the concordance between MM and AMM for assessing right DE.
文摘Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAPSE in patients with mitral valve replacement for rheumatic mitral stenosis patients is still under focused. Therefore, the objective of the study was to predict the outcome after MVR in rheumatic mitral stenosis patients in relation to preoperative TAPSE. This comparative cross-sectional study was conducted at the Department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute. A total of 72 patients of rheumatic mitral stenosis patients who underwent mitral valve replacement were included in the study. They were divided into two groups: Group A and B. Group A included 36 patients with TAPSE 0.05) except for the preoperative TAPSE. Mean TAPSE of Group A was 13.17 (±1.40) and Group B was 18.61 (±1.57), the difference was statistically significant (p 0.05). Among the postoperative complications, including postoperative atrial fibrillation was higher in Group A (30.56%) than Group B (11.11%), mean ventilation time was higher in Group A (27.78%) than Group B (5.56%), length of intensive care was higher in Group A (33.33%) than Group B (11.12%), and hospital stay was higher in Group A (25.0%) than Group B (5.56%), (p < 0.05). Higher preoperative TASPE could be used as a prognostic tool for MVR in rheumatic mitral stenosis patients in our settings.
文摘目的探究甘油三酯-葡萄糖体质指数(triglyceride-glucose body mass index,TyG-BMI)、动脉粥样硬化指数(atherogenic index of plasma,AIP)联合餐后血糖波动(postprandial glucose excursions,PPGE)对2型糖尿病(type 2 diabetes mellitus,T2DM)患者肌少症的预测价值。方法本研究为观察性横断面研究,选取2023年1月至2024年12月在重庆医科大学附属第一医院内分泌科住院治疗的T2DM患者590例,其中男性322例,女性268例。收集其一般人口学资料及关键代谢指标[空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(postprandial 2-hour plasma glucose,PPG)、甘油三酯(triglyceride,TG)等],计算TyG-BMI、AIP和PPGE。按照亚洲肌少症工作组(Asian Working Group for Sarcopenia,AWGS)2019年标准诊断肌少症,并据此将患者分为肌少症组(n=140)与非肌少症组(n=450)。对2组患者进行1∶1倾向性评分匹配(propensity score matching,PSM),匹配后纳入肌少症组与非肌少症组各102例。比较2组FPG、PPG、TyG-BMI、AIP和PPGE等代谢指标的差异,进行Spearman相关分析,并采用条件Logistic回归模型分析T2DM患者肌少症的影响因素,并绘制受试者工作特征(receptor operating characteristic,ROC)曲线评估预测效能。收集2023年1月至2024年12月在陆军军医大学第一附属医院江北院区内分泌科的192例外部数据进行模型验证。结果PSM后,2组的基线资料均衡。肌少症组的PPG、AIP和PPGE水平均值较非肌少症组更高,TyG-BMI指数则更低(P=0.001)。Spearman相关分析显示,TyG-BMI指数与T2DM患者肌少症呈显著负相关(r=-0.404,P=0.001),AIP和PPGE与T2DM患者肌少症均呈显著正相关(r=0.280,P=0.001;r=0.372,P=0.001)。条件Logistic回归分析显示,AIP(OR=14.367)和PPGE(OR=1.245)为T2DM患者肌少症的独立危险因素,TyG-BMI指数(OR=0.966)为T2DM患者肌少症的独立保护因素。ROC曲线显示,联合应用TyG-BMI指数、AIP和PPGE的预测模型曲线下面积(area under the curve,AUC)为0.918,外部验证中AUC为0.954,敏感度和特异性均优。结论TyG-BMI指数、AIP及PPGE是T2DM患者肌少症的重要代谢预测指标,三者联合应用具有良好的2型糖尿病患者肌少症筛查价值与外部适用性。
