1.Analysis of risk factors for occurring hyperglycemia in patients with acute myocardial infarction and cerebral infarction
Yalu DU ; Yungao WAN ; Jian WU ; Zhiyuan SUN ; Hong CHANG
Chinese Journal of Cerebrovascular Diseases 2014;(10):511-515,550
Objective To analyze the incidence of stress hyperglycemia and its influential factors in patients with acute myocardial infarction and cerebral infarction. Methods The case data of 1630 consecutive patients with incipient myocardial infarction without cerebrovascular disease admitted in the department of cardiology and 1338 patients with atherosclerotic acute cerebral infarction without cardiovascular disease admitted in the department of neurology,Xuanwu Hospital,Capital Medical University from January 2009 to December 2012 were analyzed retrospectively. A total of 2048 patients without diabetes mellitus were selected from them,among them 1165 patients were in an acute myocardial infarction group and 883 were in a cerebral infarction group. The fasting blood glucose >7. 8 mmol/L in the next morning after admission was defined as hyperglycemia. Single factor and multifactor logistic regression analyses were used to compare the incidence of stress hyperglycemia and its influential factors of both groups. Results ( 1 ) Of the 1165 patients with myocardial infarction,the incidence of stress hyperglycemia was 17. 2% (n=201);of the 883 patients with cerebral infarction,the incidence of stress hyperglycemia was 5.4% (n=48). There was significant difference between the 2 group (χ2= 65.677;P < 0. 01). (2) Comparing the general information of the patients with stress hyperglycemia (n=249) and those without stress hyperglycemia ( n=1799) of the cardio-cerebrovascular diseases showed that there were significant differences in hyperlipidemia, drinking history, family history of cardio-cerebrovascular diseases, age, heart rate, total cholesterol, low density lipoprotein cholesterol,leukocyte count,blood urea nitrogen,and triacylglycerols between the 2 groups (P<0. 05). (3) Multivariate Logistic analysis showed that heart rate ( OR,1. 013,95%CI 1.002-1.024),leukocyte count (OR,1.109,95%CI 1.508-1.163),and triacylglycerols(OR,1.174, 95%CI 1. 042-1. 322) were the independent risk factors for stress hyperglycemia in myocardial infarction. (4) Systolic blood pressure (OR,1. 019,95% CI 1. 006-1.033) and leukocyte count (OR,1. 132,95%CI 1. 009-1. 268) were the independent risk factors for stress hyperg lycemia in cerebral infarction. Conclusion The incidence of stress hyperglycemia in patients with myocardial infarction is higher than that in patients with cerebral infarction,and the increased leukocyte count is a common independent risk factor for both.
2.Primary Study on Noninvasive Detection of Vascular Function Based on Finger Temperature Change.
Qing DONG ; Xia LI ; Yungao WAN ; Gaoquan LU ; Xinxin WANG ; Kuan ZHANG
Journal of Biomedical Engineering 2016;33(1):144-148
By studying the relationship between fingertip temperature changes and arterial function during vascular reactivity test, we established a new non-invasive method for detecting vascular function, in order to provide an assistance for early diagnosis and prevention of cardiovascular diseases. We customized three modules respectively for blood occlusion, measurement of finger temperature and blood oxygen acquisition, and then we established the hardware of data acquisition system. And the software was programmed with Labview. Healthy subjects [group A, n = 24, (44.6 ± 9.0) years] and subjects with cardiovascular diseases [group B, n = 33, (57.2 ± 9.9) years)] were chosen for the study. Subject's finger temperature, blood oxygen and occlusion pressure of block side during and after unilateral arm brachial artery occlusion were recorded, as well as some other regular physiological indexes. By time-domain analysis, we extracted 12 parameters from fingertip temperature signal, including the initial temperature (Ti), temperature rebound (TR), the time of the temperature recovering to initial status (RIt) and other parameters from the finger temperature signal. We in the experiment also measured other regular physiological body mass index (BMI), systolic blood pressure (SBP), diastiolic blood pressure (DBP) and so on. Results showed that 8 parameters difference between the two group of data were significant. based on the statistical results. A discriminant function of vascular function status was established afterwards. We found in the study that the changes of finger temperature during unilateral arms brachial artery occlusion and open were closely related to vascular function. We hope that the method presented in this article could lay a foundation of early detection of vascular function.
Adult
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Aged
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Arteries
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physiopathology
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Blood Pressure
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Cardiovascular Diseases
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diagnosis
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Fingers
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Humans
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Middle Aged
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Skin Temperature
3.Impact of prior cerebral infarction on in-hospital mortality in patients with acute myocardial infarction
Yungao WAN ; Dong XU ; Huijuan WANG ; Qi HUA ; Shida HE ; Qiang KONG ; Zhenxing FAN ; Zhi LIU
Chinese Journal of Internal Medicine 2011;50(9):747-749
Objective To investigate the impact of prior cerebral infarction (PCI) on in-hospital mortality in patients with Acute Myocardial Infarction (AMI).MethodsA retrospective analysis of documents of a total of 3572 consecutive patients with AMI admitted to Xuanwu Hospital of Capital Medical University from 2002 Jan.1 to 2009 Dec.31 were performed.Results There were 564 patients ( 15.8% )with PCI.Compared with the group of without PC1,the group with PCI were substantially older[(69.4 ±9.9) vs (64.2 ± 12.9)years,P =0.000],and had a higher prevalence of hypertensive disease,diabetes mellitus,prior myocardial infarction (MI) and non-ST-segment elevation myocardial infarction(NSTEMI)( respectively,71.0% vs 57.3%; 41.0% vs 25.7%,12.9% vs 9.5%; 14.9% vs 10.7%,P < 0.01 ),and a higher in-hospital mortality ( 16.5% vs 10.0%,P= 0.000).Univariate analysis demonstrated that in-hospital mortality associated with age,gender,extensive anterior MI,anterior MI,diabetes mellitus,prior cerebral infarction,prior myocardial infarction,coronary angiography and percutaneous coronary intervention.Logistic regression analysis found that risk factors were age,extensive anterior MI,anterior MI,diabetes mellitus and prior cerebral infarction,and protective factors were coronary angiography and percutanous coronary intervention.PCI was independently associated with in-hospital mortality,OR 1.368,95% CI 1.047-1.787,P = 0.022.Conclusion In patients with acute myocardial infarction,the presence of PCI increases the risk of worse in-hospital outcome.
4.Homocysteine and risk factors in patients with atherosclerotic myocardial infarction and cerebral infarction:a comparative analysis
Jun LIU ; Yungao WAN ; Jing ZHAO ; Zhiyuan SUN ; Yalu DU ; Jian WU ; Hong CHANG
Chinese Journal of Cerebrovascular Diseases 2014;(7):354-358
Objectives To investigate the relationship between atherosclerotic acute myocardial infarction (AMI),acute cerebral infarction (ACI)and homocysteine (Hcy). Methods Three hundred and twenty consecutive patients with primary acute myocardial infarction (AMI)(group A)were admitted to the Department of Cardiology,310 patients with primary large artery atherosclerotic cerebral infarction (group B)were admitted to the Department of Neurology,and 327 healthy individuals without cardiovascular and cerebrovascular diseases (group C)at the Department of Physical Examination,Xuanwu Hospital, Capital Medical University were enrolled retrospectively from March 2010 to October 2011. The age and sex were matched in the 3 groups. All the clinical data of subjects were colleted in detail and then were compared and analyzed. Results (1)The Hcy levels (μmol/L)of group A,B,and C were 15. 10 (12. 43, 19.47),15. 80 (13. 10,20. 83),and 13. 20 (11. 00,16. 50;median [interquartile range]),respectively. There were significant differences among the 3 groups (P<0. 05). The incidences of hyperhomocysteinemia (HHcy)were 92. 8%(n=297),97. 1%(n=301),and 84. 7%(n=277)(P<0. 05). (2)Multivariate Logistic regression analysis showed that the independent risk factors for ACI were HHcy (OR 8. 97,95% CI 3. 01-26. 71),hypertension,diabetes,hyperlipidemia and blood ureanitrogen;the independent risk factors for AMI were HHcy (OR 4. 36,95% CI 1. 70-11. 21),hypertension,diabetes,hyperlipidemia,and total blood cholesterol. Conclusion HHcy is an independent factor for ACI and AMI,which have closer relationship with ACI. ACI and AMI have some common risk factors,but their degrees of action are different.