1.Change of thyroid hormone level with aging in elderly patients
Chinese Journal of Geriatrics 2012;31(5):410-412
Objective To explore the change rule of serum thyroid hormone level in senile patients. Methods Totally 2433 elderly patients in our hospital during January to August 2011 were divided into three groups by age:adult group aged(46.0± 10.8)years(n=1030),elderly group aged (69.5±6.3)years (n=848) and advanced age group aged (83.9±3.8)years (n=555).The levels of serum free triodothyronine (FT3),free thyroxine (FT4),thyroid-stimulating hormone (TSH) were determined by chemistry luminescence technique. Results The levels of serum FT3 [(4.33 ± 1.22)pmol/L,(3.96 ± 0.89) pmol/L vs.(5.08 ± 2.99) pmol/L,t=7.075,8.799,both P=0.000] and FT4 [(18.32±5.81)pmol/L,(18.58±6.71)pmol/L vs.(19.87±10.97) pmol/L,t=3.732,2.709,both P=0.000] were lower in the elderly and advanced age than in adult.The levels of serum TSH were higher in the elderly than in adult (P=0.002),while no difference was found between advanced age and adult (P=0.134)[(5.51± 17.39) mU/L in the elderly,(3.33±5.65) mU/L in adults vs.(4.53±14.37)mU/L in advanced age].There were no significant differences in the levels of serum FT3,FT4 and TSH between advanced age and the elderly (all P>0.05).The detection rate of the decreased FT3,FT4 and TSH in elderly and advanced age were (13.3% vs.25.8%),(2.9%vs.1.8%),(6.8%vs.12.3%),while the detection rate of increment were (3.1 %vs.0.1%),(8.6%vs.9.9%),(18.0%vs.15.7%),respectively.The rates of declined FT3 and TSH were obviously higher in the advanced age than in the elderly (x2=39.96,15.83,all P =0.000),but the rates of declined FT4 and increased FT3 were lower in the advanced age than in the elderly (x2 =27.84,16.32,all P=0.000). Conclusions The abnormal detection rates of thyroid hormones are high in the elderly,thus due attention should be paid to thyroid function test for early diagnosis and treatment of senile thyroid disease.
2.Mid and long-term outcomes of catheter ablation of recurrent atrial tachycardias post Mini-Maze surgery
Sulin ZHENG ; Xianzhang ZHAN ; Yumei XUE ; Xianhong FANG ; Hongtao LIAO ; Hai DENG ; Wei WEI ; Zili LIAO ; Fangzhou LIU ; Yang LIU ; Yuanhong LIANG ; Shulin WU
Chinese Journal of Interventional Cardiology 2017;25(7):372-378
Objective To analyze the clinical characteristics and follow-up data of catheter ablation of recurrent atrial tachycardias (ATs) after Mini-Maze surgery,and to explore prognostic factors for recurrence.Methods 59 patients in Guangdong General Hospital with ATs post Mini-Maze and concomitant open-heart surgery from April.2010 to June.2015 were included.According to high density precise mapping,activation mapping,voltage mapping and entrainment mapping,they underwent electrophysiological study and ablation which was guided by three-dimensional mapping system.All patients were followed up regularly.We explored the prognostic factors for recurrence by the Cox regression analysis.Results There were 88 types of ATs being mappedwith mean (1.49 ± 0.75) types of ATs identified per case.Most ATs were macro-reentry ATs(67/88,76.1%)and focal ATs (20/88,22.7%),respectively.56 patients (94.9%) achieved immediate ablation success.In a mean follow-up of (30.8 ± 17.7) months,recurrences were observed in 12 patients after the first time catheter ablation.Recurrent time was 3.5 (1.3,12.0) months and the overall ablation success rate was 74.6% (44/59).6 patients received second ablation and the achievement of freedom from arrhythmias reached 79.7% (47/59).Multivariate analysis showed that the LA diameter was the independent predictor for recurrence (HR 1.108,95% CI 1.002 to 1.226,P =0.045).Conclusion Catheter ablation of ATs post Mini-Maze with concomitant surgery is save and feasible.LA diameter is the independent predictor for recurrence.