1.Analysis of correlation factors of MR diffusion-weighted imaging in patients with acute cerebral infarction
Clinical Medicine of China 2017;33(5):428-432
Objective To explore the correlation factors of cranial magnetic resonance diffusion weighted imaging(DWI) in patients with acute cerebral infarction.Methods A total of 350 patients with acute cerebral infarction who underwent MR imaging were divided into DWI positive group and negative group according to whether the first diffusion weighted imaging was abnormal or not.The clinical and radiological data of the two groups were retrospectively collected and analyzed.patients with negative DWI on initial MRI were re-examined 1 week later.Result Thirty-four(9.7%) patients were DWI-negative in 350 patients with acute cerebral infarction on initial MRI,and 5 patients in DWI-negative group had positive lesions on the re-examine MRI.Multivariate logistic regression analysis indicated the patients with first blood pressure of admission≥ 140/90 mmHg(P=0.033),first blood glucose of admission≥ 7.0 mmol/L(P=0.028) and the time from the onset to initial MRI>24 h were more likely showed DWI-positive on initial MRI(P=0.013).Patients with posterior circulation infarcts were more likely to have negative DWI findings than patients with anterior circulation infarction(P=0.001).Conclusion Some patients with acute cerebral infarction may show DWI negative results on initial MRI,which is related with the time from onset to initial MRI and the site of cerebral infarction.Patients with posterior circulation infarcts are more likely to have first negative MR findings than patients with anterior circulation infarction.Patients with elevation of the admission blood pressure or blood glucose are more likely to have DWI positive lesions.Patients with acute cerebral infarction within the time window should received be thrombolytic therapy after carefully assessment to avoid delay in treatment even if the DWI negative results.
2.The association of target organ damage with abnormal ankle brachial index in hypertensive patients
Yong MAO ; Jinming YU ; Fen ZHANG ; Yiqiang ZHAN ; Dayi HU ; Qingwu JIANG
Chinese Journal of Internal Medicine 2012;51(2):127-130
ObjectiveTo investigate the association of hypertensive target organ damage with abnormal ankle brachial index (ABI) in high-risk hypertensive patients.MethodsDuring December 2008 to May 2009,a cross-sectional study was conducted to investigated the prevalence of abnormal ABI (ABI < 0.90) in 2674 community-dwelling,hypertensive patients,who aged > 40 years,without coronary heart disease,stroke/transient ischemic attack or known arteriosclerosis,from 18 centers in China. Data were acquired through history,physical examination,laboratory and other diagnostic tests.ResultsThere were 2615 subjects eligible for the full analysis set. The high-risk hypertensive patients with arterial wall thickening,arterial wall thickening and slightly elevated serum creatinine had a higher prevalence of abnormal ABI than their counterparts respectively ( P < 0.05 ). Compared with the normal group,the abnormal ABI group had a higher serum creatinine level on average (P < 0.01 ).After adjustment for certain factors including investigation center,demographic factors,cardiovascular disease (CVD) risk and CVD risk factors using an unconditional logistic regression model,arterial wall thickening ( OR 2.416,95% CI 1.395-4.183,P =0.0016 ) and slightly elevated serum creatinine ( OR 3.377,95% CI 1.267-8.997,P =0.0149) were positively associated with abnormal ABI. However,arterial wall thickening (OR 0.988,95% CI 0.576-1.695,P=0.9664) and microalbuminuria (OR 1.389,95% CI0.685-2.817,P=0.3621)were irrelevant to abnormal ABI.Conclusions So far as a high-risk hypertensive patient is concerned,there are significant statistical correlations between arterial wall thickening and/or slightly elevated serum creatinine and an abnormal ABI,but no significant statistical correlations between arterial wall thickening or microalbuminuria and an abnormal ABI is observed.
3.The effect of pitavastatin on blood glucose and its efficacy in diabetic patients with hypercholesterolemia
Yong MAO ; Jinming YU ; Fen ZHANG ; Dayi HU ; Rongjing DING ; Yiqiang ZHAN ; Shechang LI ; Qunyu KONG ; Fanli LIN ; Gongxian JIA
Chinese Journal of Internal Medicine 2012;51(7):508-512
Objective To evaluate the effect of pitavastatin on blood glucose in patients with hypercholesterolemia,and to investigate the efficacy of pitavastatin in diabetic patients combined with hypercholesterolemia.Method This study was a 12-week,multi-center,open-label,without parallel-group comparison,phase Ⅳ clinical trail.Results Contrasting to baseline,the prevalences at week 4 and 12 post-treatment of abnormal fasting plasma glucose (FPG) and glycosylated hemoglobin Alc (HbA1c)( FPG:14.2% vs 14.1% and 11.0% ; HbA1c:14.3% vs 15.1% and 16.1% ) in the safety set subjects without diabetes mellitus (DM),as well as in those with DM but not taking glucose-lowering drugs (FPG:7/7 vs 4/7 and 5/7; HbAlc:5/5 vs 4/4 and 5/5) had no significant changes (all P vaules >0.05).Contrasting to baseline,the levels of TC [ (6.51±0.94) mmol/L vs (5.12 ±0.93) mmol/L and (4.54 ±1.00) mmol/L],LDL-C [(4.11 ±0.79)mmol/L vs (3.02 ±0.81) mmol/L and (2.51 ±0.70)mmol/L] and TG [2.10(1.53,2.54) mmol/L vs 1.62(1.26,2.00) mmol/L and 1.35(1.10,1.86)mmol/L]at week 4 and 12 post-treatment in the per protocol set 55 subjects with DM were significantly reduced (all P values < 0.05 ) ; 33.3% of subjects at high risk and 10.0% of subjects at very high risk had achieved a TC target value; 55.6% of subjects at high risk and 40.0% of subjects at very high risk had achieved a LDL-C target value.Conclusion Pitavastatin has a safe effect on blood glucose and it could be used to treat diabetic patients combined with hypercholesterolemia in China.