1.Application of fingertip photoplethysmogram assessment of endothelial function in screening coronary heart disease patients
Yunfei WANG ; Daoyuan SI ; Ping YANG
Journal of Jilin University(Medicine Edition) 2016;42(5):1014-1018
Objective:To investigate the application of photoplethysmogram in analyzing the fingertip pulse amplitude volume (PAV)to evaluate the endothelial function in diagnosing coronary heart disease,and to clarify its relationship with the risk factors of cardiovascular diseases.Methods:Total 409 patients with chest pain accepted coronary angiography (CAG)were selected and diveded into positive group (CAG+)(n=288)and negative group (CAG-) (n = 121)according to angiographic results.Fingertip photoplethysmogram was used to analyze the fingertip PAV by the way of applying endothelial function diagnostic after reactive ischemia,and the relationship between the PAV value and the risk factors of coronary heart diseases was analyzed,and the critical reference value of prediction index of coronary heart disease was determined.The risk factors such as age,gender,serum total cholesterol (TC ), low density lipoprotein (LDL ), high density lipoprotein (HDL ), non-HDL, serum triglyceride (TG),hypertension,diabetes,smoking,family history of coronary heart disease,body mass index (BMI)of the subjects in various groups were analyzed,and the relationship between the risk factors of coronary heart disease and PAV was analyzed by Logistic regression analysis.Results:The PAV of patients in CAG+group was significantly lower than that in CAG-group (P <0.01).The peak point of PAV was<1.37,if PAV<1.37 was used to predict the coronary heart disease,the predictive sensitivity,the specificity,the positive prediction and the negative prediction were 74.65%,44.63%, 76.24%, and 42.52%.The Logistic regression analysis showed that PAV was negatively associated with hypertension,smoking history,TG (OR= 1.476,OR=2.002, OR = 1.844;P < 0.01 ). Conclusion: PAV is associated with coronary heart disease and its risk factors (hypertension,smoking history,TG),and PAV=1.37 can be used as the peak point to predict the coronary heart disease.
2.Analysis of recurrence rate of great saphanous vein incompetence after endovenous laser therapy base on propensity score matching method
Guoqiang TAO ; Bin ZHANG ; Minghua CAO ; Yunfei SI ; Jiakuan WANG ; Qi HAN ; Jinxiu WU
Clinical Medicine of China 2017;33(1):7-10
Objective To compare the difference in recurrence rates between the endovenous laser therapy(EVLT) combined with percutaneous continuous circumsature (PCCS) and simplex EVLT following the treatment of great saphanous vein incompetence through the introduction of propensity score matching (PSM).Methods T the baseline data of 170 patients diagnosed with great saphanous vein incompetence who were treated in Punan Hospital in Pudong New District of Shanghai from 2009 to 2014 were retrospectively analyzed,of which underwent EVLT were 87 cases as EVLT group and EVLT combined with PCCS were 83 cases as EVLT +PCCS group.The groups covariate were balanced based on the PSM function of SPSS software using 1 ∶ 1 nearest neighbor matching method.The recurrence rates of the two groups were estimated by Kaplan-Meier method and the differences between the two groups were evaluated by Log-rank test.Results Sixty-seven pairs of patients were successfully matched.No significant difference between the two matched groups in the basic clinical features.Before PSM,the 1,2,and 3 year cummulative recurrence rates were 3.5%,5.4% and 7.3% in the EVLT group,and 0.9%,4.7% and 4.7% in the EVLT+PCCS group,respectively,there were no statistically significant differences between the two groups by Log-rank test (P =0.491).After PSM,the 1,2,and 3 year cummulative recurrence rates were 5.2%,5.2% and 7.1% in the EVLT group,and 0%,1.0% and 1.0% in the EVLT+PCCS group,there were statistically significant differences between the two groups (P =0.031).Conclusion The PSM methods can effectively balanced the covariates of groups in non-randomised study.EVLT combined with PCCS can effectively reduce the recurrence rate after the treatment of great saphanous vein incompetence.