Journal Detail Information

1

Cite

Share

Clinical observation of anticoagulants and antithrombotic therapy in elderly patients with atrial fibrillation

Wenliang LU ; Zhaohui QIU ; Li DAI ; Xingui GUO

Chinese Journal of Geriatrics.2009;28(11):897-900. doi:10.3760/cma.j.issn.0254-9026.2009.11.006

Objective To observe the effectiveness and safety of oral anticoagulants and antithrombotic therapy in elderly patients with atrial fibrillation. Methods Patients were divided into anticoagulant group (warfarin) and antithrombotie group (aspirin or clopidogrel) based on the initial treatment. The prothrombin time (PT), activated clotting time (ACT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fihrinogen (FIB), thrombin time (TT), coagulation factor Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ, and Ⅹ,fibrin degradation product (FDP) and D-dimer were tested at baseline and after therapy in both groups. Results The average treatment period was 44.2±37.5 months in antithrombotic group and 39.0±61.5 months in anticoagulant group. There were six cases of isehemic stroke, one acute artery embolism in right lower limb and three gastrointestinal bleeding in antithrombotic group, while two gastrointestinal bleeding and two fatal hemorrhagic stroke in anticoagulant group. The results of PT, ACT, INR, APTT, FIB, TT, coagulation factor Ⅱ,Ⅴ ,Ⅶ, Ⅷ,Ⅸ,Ⅹ,FDP and D-dimer had no significant differences compared with the baseline in antithrombotic group. However, there were significant increase in PT and INR [(8.4±7.5)s and (0. 93±0. 83)s, both P<0. 05)], and significant decrease in ACT, coagulation factor Ⅱ,Ⅶ, Ⅸ and Ⅹ (all P<0. 05) in anticoagulant group. Conclusions Anticoagulant therapy may he effective in prevention of ischemic stroke in elderly patients with atrial fibrillation. However, it may slightly increase the hemorrhage incidence. The overall adverse events were not significantly reduced.

2

Cite

Share

Effect of slow-acting antirheumatic drugs on lipid profile in patients with rheumatoid arthritis

Hua XU ; Yingyuan CHEN

Chinese Journal of Geriatrics.2009;28(11):890-892. doi:10.3760/cma.j.issn.0254-9026.2009.11.004

Objective To investigate the effect of slow-acting antirheumatic drugs on lipid profile and disease activity index in patients with rheumatoid arthritis (RA). Methods Eighty-two patients with RA who met the American College of Rheumatology (ACR) criteria were treated with disease-modifying antirheumatic drugs including methopterin (MTX), salazosulfapyridine (SASP) and hydroxychloroquine sulfate, while seventy-nine healthy volunteers were used for control. All persons were followed up for 12 months. The observations included 28 joint indices score (DAS-28), lipid profile, c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Results Compared with the control group before treatment, RA patients exhibited higher serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides. Whereas, high-density lipoprotein cholesterol (HDL-C) was significantly lower. After 12 months treatment, the disease activity index[(6.7±0.6)vs. (2.1±0.9)], ESR [(62±18)mm/h vs. (13±9)mm/h] and CRP [(2.2±0.3 ) mg/L vs. (0. 3±0.2 ) mg/L, all P<0.01] were significantly decreased and HDL-C [1.0±0. 1)mmol/L vs. (1.5±0. 3)mmol/L, P<0. 01] was increased in RA patients. Conclusions RA patients are characterized by an atherogenic lipid profile, which are improved after therapy. Immuno-intervention to control disease activity may reduce the risks for the atherosclerotic process and cardiovascular events in RA patients.

3

Cite

Share

Relationship between peripheral atherosclerosis and coronary heart disease in elderly people

Fang LIU ; Meilin LIU ; Yuchuan WANG ; Qingping TIAN

Chinese Journal of Geriatrics.2009;28(11):883-886. doi:10.3760/cma.j.issn.0254-9026.2009.11.002

Objective To investigate the relationship between peripheral atheroselerosis and coronary heart disease(CHD) in the elderly.MethodsCarotid and femoral intima-media thickness (IMT),total plaque area and carotid total plaque score were measured in 152 elderly inpatients by vascular ultrasound one week before coronary angiography,meanwhile carotid atherosclerosis was classified.The severity of CHD was estimated by the number of vessel lesions and Gensini score. ResultsCarotid and femoral IMT,plaque morbidity,total plaque area and total plaque score were much higher in the patients with CHD than in those without(all P<0.05).Carotid total plaque area,total plaque score,femoral total plaque area and femoral IMT were much higher in the patients with two-vessel lesions[(1.57±0.37)mm~2,(4.595±3.39),(0.51±0.21)mm~2 and (1.07±0.15)mm] or three-vessel lesions [(1.885±0.15) mm~2,(6.67±5.90),(0.59±0.23) mm~2 and (1.15±0.14) mm] than in those with single-vessel lesion [(0.58±0.11 )mm~2,(3.82±2.11),(0.24±0.26) mm~2 and (0.97±0.11)mm,all P<0.05)].There was positive correlation between the classification of carotid atherosclerosis(r= 0.282,P< 0.01),total plaque score (r= 0.307,P < 0.01),total plaque area ( r=0.494,P<0.01) and the number of vessel lesions.There was also positive correlation between carotid total plaque area and Gensini score(r=0.472,P<0.01),between femoral IMT(r=0.415,P<0.01),total plaque area and the number of vessel lesions(r=0.692,P<0.01),and between femoral IMT(r=0.404,P<0.01),total plaque area ( r=0.648,P<0.01 ) and Gensini score.Using multiple stepwise regression analysis,the following parameters were found to be independent predictors of coronary artery Gensini score: carotid total plaque area (OR=2.2; 95% CI:0.79 ～2.46),femoral total plaque area(OR= 1.6;95% CI:O.28～1.35) and femoral IMT (OR=1.6;95% CI:1.20～15.10).Conclusions The assessment of peripheral atherosclerosis by ultrasonography is significantly associated with the prevalence and severity of CHD.

4

Cite

Share

Clinic analysis of bone mineral density and its related factors in elderly men with type 2 diabetes

Yanhong GAO ; Jiangrong ZHANG ; Jing CHANG ; Weicheng LU ; Zhihong PAN

Chinese Journal of Geriatrics.2009;28(11):915-917. doi:10.3760/cma.j.issn.0254-9026.2009.11.011

Objective To explore the possible risk factors that influence bone mineral density (BMD) in elderly men with type 2 diabetes. Methods A total of 80 elderly men with type 2 diabetes were included in this study. The BMD of lumbar vertebrae and femur were measured by dual-energy X-ray absorptiometry (DXA). And fasting blood and urine samples were taken to check the biochemical levels of bone metabolism and blood glucose. The correlations between BMD and other related factors were analyzed. Results In this group, the prevalence rates of osteoporosis and osteopenia were 18. 6% and 53.8%, respectively. Body mass and body mass index (BMI) were positively correlated with BMD at all sites (r=0. 202～0. 298, P<0. 05 or P<0. 01). However, age and glycosylated hemoglobin (HbAlc) were negatively correlated with BMD of lumbar and femoral neck (r=-0. 172～-0. 211 ,all P<0. 05). Leptin was not only positively correlated with the BMD of femoral neck and Ward's triangle, but also with body mass, BMI, fasting blood glucose (FBG), total cholesterol and HbAlc (r=0. 219 ～ 0. 509, P<0.05 or P<0.01). Using stepwise regression analysis, body mass was the predictor of BMD at all sites assessed, while the HbAlc and leptin levels could respectively influence BMD at femoral neck and Ward's triangle (r~2= 0. 196 ～ 0. 276, all P< 0. 01). Conclusions It may suggest that differential factors predict the variance of BMD at different sites in elderly men with type 2 diabetes.

5

Cite

Share

The value of the Montreal Cognitive Assessment in diagnosing mild cognitive impairment

Jie XIANG ; Deqin GENG ; Zhaohui QIN

Chinese Journal of Geriatrics.2009;28(11):905-907. doi:10.3760/cma.j.issn.0254-9026.2009.11.008

Objective To explore the value of Montreal Cognitive Assessment (MoCA) in the diagnosis of mild cognitive impairment. Methods Mini-mental state examination (MMSE) was used in 532 elderly persons aged 60 years and over in Xuzhou city Gulou county. The 69 healthy people and patients with mild cognitive impairment were chosen to undergo MoCA. Then the sensitivity and specificity of MoCA were analyzed. Results According to MMSE, there were 19 patients with mild cognitive impairment (27. 5 %), 50 healthy persons (72.5 %). While according to MoCA, there were 58 patients with mild cognitive impairment (84.1%), 11 healthy persons (15.9 %). The consistency of the two scales was not good. And compared with MMSE, the sensitivity of MoCA was 94.7%, and the specificity was 20. 1%. Conclusions In the diagnosis of mild cognitive impairment, MoCA is more sensitive than MMSE.

6

Cite

Share

Association of lipoprotein-associated phospholipase A2 levels with coronary artery disease, extent of angiographic coronary artery lesions and risk factors in the elderly

Xiangyu ZHANG ; Xiaobing QU ; Xiaoli PENG

Chinese Journal of Geriatrics.2009;28(11):901-904. doi:10.3760/cma.j.issn.0254-9026.2009.11.007

Objective To observe the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2) levels and coronary artery disease (CAD), extent of angiographic coronary artery lesions and risk factors of CAD in the elderly. Methods Plasma levels of Lp-PLA2, triglyceride (TG), total cholesterol(TC), low density lipoprotein(LDL-C), high density lipoprotein cholesterol (HDL-C) and high sensitivity C-reactive protein(hs-CRP) were measured in 67 elderly patients with angiographic CAD meanwhile in 23 normal controls without angiographic coronary artery lesions. The extent of coronary artery lesions was evaluated according to the number of vessel lesions (divided into single, double and triple-vessel lesions) and Gensini scoring system. Then the relationship between Lp-PLA2 and CAD was assessed. Results The plasma levels of Lp-PLA2 were significantly higher in the CAD group than in the controls [(352.7 ± 129.0) vs. (204.0 ± 59. 7) μg/L, P < 0. 01]. Lp-PLA2 levels increased with the number of coronary artery lesions and Gensini score, then were positively correlated with age(r= 0. 25, P<0. 05) ,TC(r=0. 33, P<0. 01) ,LDL-C(r=0.27, P< 0. 05),apoB(r=0. 36, P<0. 01). The levels of LP-PLA2 and LP(a) were associated with CAD by using stepwise regression analysis. Conclusions In the eldly, the levels of LP-PLA2 are much higher in angiographic CAD, and these may reflect the severity of CAD. LP-PLA2 is a risk factor for CAD.

7

Cite

Share

Contrast-induced nephropathy in the elderly and the correlated clinical risk factors

Hong WANG ; Lijun MU ; Yifang CHEN ; Wei YU ; Dingkun GUI ; Jianguo CHEN ; Hanchao SHEN

Chinese Journal of Geriatrics.2009;28(11):893-896. doi:10.3760/cma.j.issn.0254-9026.2009.11.005

Objective To investigate the incidence of contrast-induced nephropathy (CIN) in the elderly undergoing coronary angiography and the correlated clinical risk factors.Methods 0.90% sodium chloride (1 ml · kg~-1 · h~-1 ) was administered 6 hours before and 12 hours after contrast media administration for 195 elderly patients,and the dose of sodium chloride was half when the patients were suffering from severe congestive heart failure.The levels of serum creatinine (Scr) and cystatin C were measured 3 days before and on the 2nd,5th day after the administration of contrast,respectively .Results(1) The incidence of CIN was 8.7% (17/195).The renal function of 11 cases recovered to baseline level 3 months after the use of contrast,2 cases had transformation to chronic renal failure but without undergoing maintenance hemodialysis,and 3 cases were dependent on maintenance hemodialysis,while 1 case developed multiple organ dysfunction until death.(2) There was no significant difference between pre-and post-contrast administration in the level of cystatin C (t=O.137,P= 0.891). But the concentration of Scr was reduced significantly on the 2nd day compared with the baseline (t=4.776,P = 0.000).Both the cystatin C and Scr recovered to the baseline on the 5th day.(3) There were no significant differences between the CIN and non-CIN group in gender,the dose of contrast,the baseline Scr,and the proportion of coronary heart disease.But there were significant differences in age,the baseline serum cystatin C,the proportions of diabetes mellitus,hypertension and congestive heart failure.(4) The clinical risk factors of CIN were the baseline Scr (OR = 1.039),the baseline serum cystatin C (OR=6.654),diabetes mellitus (OR=8.104) and congestive heart failure (OR=9.597) according to the analysis of logistic regression.ConclusionsWith the hydration and the use of low-osmolar nonionic contrast,it is safe to receive contrast examination for the elderly patients.The baseline serum levels of Scrand cystatin C,diabetes mellitus and congestive heart failure are the clinical risk factors of CIN.Compared with Scr,serum cystatin C is the more powerful predictor for the development of CIN.

8

Cite

Share

The role of nerve growth factor in the pathogenesis of diabetic neuropathy

Chongjuan WEI ; Yan CHENG ; Xiaodong KONG ; Hao LIANG ; Ying CHEN

Chinese Journal of Geriatrics.2009;28(11):887-889. doi:10.3760/cma.j.issn.0254-9026.2009.11.003

Objective To investigate the role of nerve growth factor (NGF) in the pathogenesis of diabetic neuropathy (DNP) and the correlation of NGF level with,sensory nerve conduction velocity (SNCV) and duration of DNP.MethodsThe 41 patients with DNP,35 diabetics without DNP and 33 healthy controls were enrolled.And the serum level of NGF was measured with ELISA,the SNCV of left medial nerve,ulnar nerve,peroneal nerve and tibial nerve were measured too. Then the correlation analysis was completed. ResultsThe serum level of NGF was significantly lower in DNP patients [(665.18±188.32) ng/L] than in healthy controls [(976.44±159.07)ng/L] and in diabetics without DNP [(943.32±167.33) ng/L,F=9.316,P<0.001].The NGF level of DNP patients was positively correlated with SNCV of left medial nerve (r=0.810,P<0.001 ),left peroneal nerve (r=0.760,P<0.001) and duration of DNP (r=0.542,P<0.001).Conclusions The serum level of NGF is lower in DNP patients than in healthy controls.The decrease of the production of NGF may play a role in the pathogenesis of DNP.

9

Cite

Share

Experimental study of histomorphology and oxidative damage in the liver in senescence accelerated mouse (SAMPS)

Ming YANG ; Yanqing SHI ; Xiaoyun SHI ; Xiaochun CHEN

Chinese Journal of Geriatrics.2009;28(11):955-958. doi:10.3760/cma.j.issn.0254-9026.2009.11.025

Objective To evaluate the feasibility of liver senescence model with senescence accelerated mouse prone 8 (SAMP8), and to explore the possible mechanism of oxidative stress in the process of liver aging in SAMP8. Methods Male SAMP8 mice at the age of 9 months were chosen as research objects, and senescence accelerated mouse resistance 1 (SAMR1) mice were used for normal control. Histopathological changes in the liver of SAMR1 and SAMP8 mice were observed by hematoxylin-eosin (HE), Sudan Ⅳ and Masson staining. Senescence associated β-galactosidase activity was measured by histoehemical staining method, and the activities of superoxide dismutase (SOD), eatalase (CAT), glutathione peroxidase (GSH-Px) and the level of malondialdehyde (MDA) in liver homogenate were examined by chemical colorimetry. Results Compared with SAMR1 group, the liver degenerative changes of SAMP8 mice were observed by microscopy, such as extensive fatty degeneration, focal necrosis of hepatocytes and inflammatory cells infiltration. Meanwhile, senescence associated β-galactosidase-positive cells were significantly increased in SAMP8 group [(78.1±11.0) vs.( 23.9±8.8),t=10.887, P<0.01]. In addition, the activities of SOD, CAT and GSH-Px in liver homogenate were decreased [SOD: (214.8 ± 34.8) vs. ( 295.3 ± 29.7), t = 4.975,P<0.01;CAT: (23.0±4.0) vs. ( 36.3±8.3),t=4.084,P<0.01;GSH-Px: (524.0±74.2) vs. (648. 4±102.8) ,t=2. 776, P<0. 05]and the level of MDA was markedly increased ((2.3±0.2) vs. (1.8±0. 1),t = 6. 329, P<0. 01]. Conclusions SAMP8 mice is a feasible animal model for the study of liver senescence, and oxidative stress may play an important role in the process of liver aging in SAMP8.

10

Cite

Share

Effects of lamotrigine on cognitive function and the quality of life in patients with partial epilepsy

Guirong XIAO ; Xinfang SUN ; Yanxing ZHANG

Chinese Journal of Geriatrics.2009;28(11):924-927. doi:10.3760/cma.j.issn.0254-9026.2009.11.014

Objective To explore the effects of lamotrigine (LTG) on cognitive function and the quality of life (QOL) in patients with partial epilepsy. Methods Twenty six patients with newly diagnosed partial epilepsy were randomly divided into 2 different groups using oral administration of LTG and carbamazepine (CBZ) respectively. By neuropsychological test scores and the Quality of Life in Epilepsy Inventory (QOLIE-31) The cognitive function and QOL were assessed before and 16 weeks after the treatment. A battery of neuropsychological tests comprised WAIS digital span test (WDST), verbal fluency test (VFT), trail making test (TMT, parts A and B), stroop color word test (SCWT), Wisconsin card sorting test (WCST), delayed logical memory test, delayed optical memory test, arithmetic ability and digital symbol conversion test. Results The repeated assessments for the patients taking LTG were associated with significant improvements in many domains. When comparing the results at the end of 16 weeks with the baseline results, the verbal fluency were improved, the time of trail making test parts A and B were shortened, the WCST correct number and classification were improved, and the persistent error number and operation time of WCST were declined as well, digital symbol conversion was increased, delayed logic memory and optical memory were improved (t=3. 043, -3. 287,-2. 543,3. 167,3. 028,-2. 191, -3. 216,3. 061,3. 036, 3. 021 ,all P<0. 01 or P<0. 05). When comparing the efficacy of LTG with the CBZ group, the time of stroop color word test was shortened, digital symbol conversion was increased and arithmetic ability was improved (t= 3. 167,2. 142,2. 101, P<0.01 or P<0. 05). Compared with the baseline, both LTG group and CBZ group showed that the overall QOL, overall health, cognitive function and social function scores were improved (LTG group: t= 3. 321,2. 462,3. 294,3. 512;CBZ group: t=3. 314, 3. 149,3. 294,3. 202,all P<0.05). When comparing LTG group with CBZ group after therapy, cognitive function and social function scores were obviously improved (t = 2. 257,2. 140, both P< 0. 05), and the worry about seizure declined (t=2. 147,P<0. 05). Conclusions LTG may improve the cognitive function and QOL in patients with newly diagnosed partial epilepsy.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share