目的 探讨血清乳酸脱氢酶（LDH）在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料，随访截止2025年8月，并记录随访结果，包括患者的疾病缓解情况和死亡情况，以及无疾病进展生存期（PFS）、总生存期（OS）。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线，并通过Log-rank检验比较生存曲线。同时，运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示，在50例肝癌患者中，基线LDH低于200 U/L的有15例，而高于200 U/L的有35例。与基线LDH＜200 U/L组相比，基线 LDH≥200 U/L患者PFS、OS更短，差异均有统计学意义（χ2分别为5.51、15.6，P值分别为0.019、0.017）。治疗8周后，与LDH降低患者相比，LDH升高患者OS更短，差异有统计学意义（χ2=13.2，P=0.04）。多因素Cox比例风险回归分析结果表明，基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素［P=0.035，HR（95%CI）=5.03（1.12，22.54）］。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。
Objective To evaluate the prognostic significance of serum lactate dehydrogenase（LDH）levels in patients with advanced hepatocellular carcinoma（HCC）undergoing targeted therapy combined immunotherapy．Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024，diagnosed with pathological and imaging examinations results．Patient baseline data were collected from the hospital’s electronic medical records，with follow-up extending until August 2025．We documented outcomes such as disease response and mortality，along with progression-free survival（PFS）and overall survival（OS）．Kaplan-Meier survival curves were constructed based on baseline LDH levels，and the Log-rank test was employed for comparison．Additionally，multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy．Results Among the 50 patients，15 had baseline LDH levels below 200 U/L，while 35 had levels above．Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH ＜200 U/L（χ2=5.51 and 15.6 for PFS and OS，respectively；P=0.019 and 0.017，respectively）．After 8 weeks of treatment，patients with increased LDH had significantly shorter OS compared with patients with decreased LDH（χ2=13.2，P=0.04）．Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy（P=0.035，HR 5.03［1.12，22.54］）．Conclusions Patients with lower baseline LDH levels demonstrated better OS，suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy．
目的 评估血清白蛋白/球蛋白比值（AGR）和全身炎症反应指数（SIRI）与胃癌患者生存预后的关系。方法 选取118例胃癌患者，收集患者的年龄、性别、病理类型及Ki-67、人类表皮生长因子受体2（Her-2）、TNM分期，入院时白蛋白（ALB）、球蛋白（GLB）、外周血中性粒细胞、单核细胞和淋巴细胞计数，计算出AGR和SIRI。通过受试者工作特征（ROC）曲线获取AGR、SIRI的最佳截断值，并将患者分为高、低AGR组和高、低SIRI组。分析不同AGR、SIRI分组与胃癌患者临床病理特征的关系，应用Kaplan-Meier法进行生存分析，通过多因素Cox回归模型分析影响胃癌患者预后的危险因素。结果 根据截断值，将患者分为高AGR组（AGR≥1.57，53例）和低AGR组（AGR＜1.57，65例），高SIRI组（SIRI≥1.57，27例）和低SIRI组（SIRI＜1.57，91例）。高AGR组和低AGR组，高SIRI组和低SIRI组在年龄、性别、Her-2表达、Ki-67表达方面比较差异无统计学意义，在TNM分期比较差异有统计学意义（P＜0.05）。生存分析显示，低AGR组的累积生存率低于高AGR组（18.9% vs. 41.3%，P＜0.01），低SIRI组的累积生存率高于高SIRI组（36.1%vs. 0，P＜0.01）。多因素Cox回归分析表明，分期Ⅲ/Ⅳ期、SIRI≥1.57是胃癌患者生存的独立危险因素。结论 AGR、SIRI可成为预测胃癌患者生存预后的重要指标。
目的 评估血清白蛋白/球蛋白比值（AGR）和全身炎症反应指数（SIRI）与胃癌患者生存预后的关系。方法 选取118例胃癌患者，收集患者的年龄、性别、病理类型及Ki-67、人类表皮生长因子受体2（Her-2）、TNM分期，入院时白蛋白（ALB）、球蛋白（GLB）、外周血中性粒细胞、单核细胞和淋巴细胞计数，计算出AGR和SIRI。通过受试者工作特征（ROC）曲线获取AGR、SIRI的最佳截断值，并将患者分为高、低AGR组和高、低SIRI组。分析不同AGR、SIRI分组与胃癌患者临床病理特征的关系，应用Kaplan-Meier法进行生存分析，通过多因素Cox回归模型分析影响胃癌患者预后的危险因素。结果 根据截断值，将患者分为高AGR组（AGR≥1.57，53例）和低AGR组（AGR＜1.57，65例），高SIRI组（SIRI≥1.57，27例）和低SIRI组（SIRI＜1.57，91例）。高AGR组和低AGR组，高SIRI组和低SIRI组在年龄、性别、Her-2表达、Ki-67表达方面比较差异无统计学意义，在TNM分期比较差异有统计学意义（P＜0.05）。生存分析显示，低AGR组的累积生存率低于高AGR组（18.9% vs. 41.3%，P＜0.01），低SIRI组的累积生存率高于高SIRI组（36.1%vs. 0，P＜0.01）。多因素Cox回归分析表明，分期Ⅲ/Ⅳ期、SIRI≥1.57是胃癌患者生存的独立危险因素。结论 AGR、SIRI可成为预测胃癌患者生存预后的重要指标。
目的 探讨入院时血清淀粉样蛋白A（SAA）、载脂蛋白A1（ApoA1）、C反应蛋白（CRP）水平联合检测对老年急性脑梗死（ACI）患者规范治疗后3个月内发生预后不良的早期预测效能。方法 前瞻性选取2023年1月～2025年1月于焦作市第五人民医院就诊的108例老年ACI患者作为ACI组，另选取同期健康志愿者108例作为对照组。比较两组血清SAA、ApoA1、CRP水平。老年ACI患者予以规范治疗，根据治疗后3个月内预后情况将其分为预后不良（46例）和预后良好（62例）亚组，比较不同预后ACI患者患者临床资料及入院时血清SAA、ApoA1、CRP水平；Logistic回归分析入院时血清SAA、ApoA1、CRP水平是否为老年ACI患者规范治疗后3个月内发生预后不良的独立影响因素；ROC曲线分析入院时血清SAA、ApoA1、CRP水平联合检测对ACI患者预后不良的预测效能。结果 ACI组入院时血清SAA、CRP水平高于对照组，血清ApoA1水平低于对照组（P＜0.05）；预后不良亚组高血压占比、入院NIHSS评分、梗死体积、入院时血清SAA、CRP水平高于预后良好亚组，血清ApoA1水平低于预后良好亚组（P＜0.05）；剔除存在多重共线性指标高血压、入院NIHSS评分、梗死体积后，入院时血清SAA、ApoA1、CRP水平仍是老年ACI患者规范治疗后3个月内发生预后不良的独立影响因素（P＜0.05）；入院时血清SAA、ApoA1、CRP水平联合预测ACI患者预后不良的AUC值为0.873，显高于各指标单独预测值0.738、0.768、0.749（P＜0.05）。结论 入院时血清SAA、ApoA1、CRP水平是老年ACI患者预后不良的独立影响因素，联合检测对预后不良具有较高的预测效能，可将其作为ACI患者血清敏感指标，协助临床医师早期制定针对性干预措施，减少ACI患者预后不良的发生。
目的：分析冠状动脉CT血管成像（CTA）联合动态心电图（DCG）与冠心病患者冠脉狭窄程度及预后情况的关联。方法：研究对象选择我院2024年1月~2025年3月收治的210例冠心病患者及同期接受检查的210例非冠心病患者，分别列为病例组和对照组，比较两组CTA参数、DCG参数间差异。依据入院测得（Gensini）评分不同，将入组患者分别列为轻度组（60例，Gensini评分≤30分）、中度组（75例，Gensini评分＞30分、≤60分）和重度组（75例，Gensini评分＞60分），比较三组CTA参数、DCG参数间差异，分析CTA参数、DCG参数与Gensini评分的相关性。统计入组患者不良预后发生情况，比较不同预后患者CTA参数、DCG参数间差异，归纳冠心病患者预后影响因素，检验CTA参数、DCG参数对患者不良预后的预测效能。结果：病例组的最小管腔直径（MLD）、最小管腔面积（MLA）、血流储备分数（FFR）、正常窦性间期的标准差（SDNN）、每5min平均RR间期的标准差（SDANN）、相邻RR间期差值的均方根（RMSSD）均低于对照组，斑块总体积（TPV）、低频/高频比值（LF/HF）均高于对照组（t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389；P＜0.05）。重度组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于中度组，轻度组，TPV、LF-HF均高于中度组，轻度组（F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983；P＜0.05）。MLD、MLA、FFR、SDNN、SDANN、RMSSD均与Gensini评分负相关，TPV、LF-HF均与Gensini评分正相关（r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355；P＜0.05）。经统计，210例冠心病患者的不良预后发生率为38.10%（80/210）。预后不良组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于预后良好组，TPV、LF-HF均高于预后良好组（t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465；P＜0.05）。MLA、FFR、SDNN升高为冠心病不良预后的保护因素，LF/HF升高为冠心病不良预后的危险因素。FFR、SDNN联合检测预测不良预后的 AUC 值优于两项指标单独检测（Delong检验，P＜0.05）。结论：CTA、DCG能客观评估冠心病患者冠脉狭窄程度，联合检测FFR、SDNN可作为预测冠心病不良预后的重要辅助手段。
Objective:To analyze the correlation between CTA combined with DCG and the degree of coronary stenosis and prognosis in patients with coronary heart disease.Methods:The research subjects selected were 210 patients with coronary heart disease admitted to our hospital from January 2024 to March 2025, as well as 210 non coronary heart disease patients who underwent examinations during the same period. They were divided into a case group and a control group. The differences in CTA parameters and DCG parameters between the two groups were compared. According to the different Gensini scores obtained upon admission, the enrolled patients were divided into mild group (60 cases, Gensini score ≤ 30 points), moderate group (75 cases, Gensini score>30 points, ≤ 60 points), and severe group (75 cases, Gensini score>60 points). The differences in CTA parameters and DCG parameters among the three groups were compared, and the correlation between CTA parameters, DCG parameters, and Gensini score was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in CTA and DCG parameters among patients with different prognoses, summarize the factors affecting the prognosis of coronary heart disease patients, and test the predictive power of CTA and DCG parameters for poor prognosis in patients.Results:The MLD, MLA, FFR, SDNN, SDANN, and RMSSD in the case group were all lower than the control group, while the TPV and LF/HF were higher than the control group (t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389; P<0.05). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the severe group were lower than the moderate group, mild group, while the TPV and LF-HF of the mild group were higher than the moderate group, mild group (F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983; P<0.05). MLD, MLA, FFR, SDNN, SDANN, and RMSSD are all negatively correlated with Gensini score, while TPV and LF-HF are positively correlated with Gensini score (r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355; P<0.05). According to statistics, the incidence of poor prognosis in 210 patients with coronary heart disease was 38.10% (80/210). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the poor prognosis group were lower than the good prognosis group, while TPV and LF-HF were higher than the good prognosis group (t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465; P<0.05). High MLA, FFR, and SDNN are protective factors for poor prognosis of coronary heart disease, while higher values than LF/HF are risk factors for poor prognosis of coronary heart disease. The combined detection of FFR and SDNN has a better AUC value for predicting poor prognosis of coronary heart disease than the detection of FFR and SDNN alone (Delong test, P<0.05）.Conclusion:CTA and DCG can objectively evaluate the degree of coronary stenosis in patients with coronary heart disease, and combined detection of FFR and SDNN can be an important auxiliary tool for predicting poor prognosis of coronary heart disease.
目的：描述发病48 h内急性缺血性卒中（acute ischemic stroke，AIS）患者依达拉奉右莰醇真实世界用药特征，探讨48 h内不同启动时间与住院期间神经功能改善及短期预后的关系。方法：回顾性连续筛选2023年12月1日至2026年4月30日本院诊断为AIS并使用依达拉奉右莰醇的住院患者，药学部基于药学信息系统、住院医嘱及病历记录提取资料。初筛147例，排除35例，纳入112例发病至首次用药时间（onset-to-treatment time，OTT）≤48 h者；按预设24 h界值分为24 h内用药组（n=67）和24～48 h用药组（n=45）。主要结局为住院期间美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）变化值（ΔNIHSS=入院NIHSS评分－出院前NIHSS评分）；次要结局包括出院前NIHSS评分、出院改良Rankin量表（modified Rankin Scale，mRS）评分、显著神经功能改善、住院时间、出院去向及安全性事件。采用多因素线性回归分析24 h内用药与ΔNIHSS的相关性，并行简化模型、排除再灌注治疗患者、完整疗程人群、进一步调整大血管闭塞及OTT连续变量模型等敏感性分析。结果：总体OTT为19.65（14.97，34.68）h，疗程12.00（11.00，13.00）d，完成相对完整疗程比例89.3%。两组入院NIHSS评分差异无统计学意义［8.00（6.00，9.00）分 vs 8.00（6.00，10.00）分，P=0.447］；24 h内用药组出院前NIHSS评分更低［5.00（4.00，6.50）分 vs 6.00（5.00，8.00）分，P=0.025］，ΔNIHSS更高［3.00（2.00，3.00）分 vs 2.00（1.00，2.00）分，P＜0.001］，显著神经功能改善率更高（77.6% vs 60.0%，P=0.045）。多因素校正后，24 h内用药仍与更大的ΔNIHSS相关（β=0.768，95%CI：0.377～1.159，P＜0.001）；Logistic探索性分析显示其与显著神经功能改善发生可能性较高相关（OR=2.475，95%CI：1.047～5.853，P=0.039）。两组出血转化、症状性颅内出血、药物相关不良反应及院内死亡差异均无统计学意义。结论：本单中心真实世界队列中，发病48 h内依达拉奉右莰醇治疗疗程完成比例较高、短期安全性事件发生率低；24 h内启动治疗与住院期间NIHSS改善幅度较大及显著神经功能改善率较高相关。由于为回顾性观察性研究，结果应解释为关联性证据，需前瞻性、多中心研究及长期功能结局验证。
Objective: To describe real-world treatment characteristics of edaravone dexborneol in acute ischemic stroke (AIS) patients treated within 48 hours of onset and to explore the association between initiation time and short-term in-hospital outcomes. Methods: This single-center retrospective real-world study screened hospitalized AIS patients with edaravone dexborneol records from December 1, 2023 to April 30, 2026. Medication data were extracted from the pharmacy information system, inpatient orders, and medical records. After 35 exclusions, 112 of 147 patients with onset-to-treatment time (OTT) ≤48 h were included and classified by a prespecified 24-hour cutoff into a within-24-hour group (n=67) and a 24-48-hour group (n=45). The primary outcome was in-hospital National Institutes of Health Stroke Scale (NIHSS) change (ΔNIHSS=admission NIHSS minus pre-discharge NIHSS); secondary outcomes included pre-discharge NIHSS, discharge modified Rankin Scale (mRS), marked neurological improvement, length of stay, discharge destination, and safety events. Multivariable linear regression assessed the association between within-24-hour treatment and ΔNIHSS, with sensitivity analyses using simplified adjustment, exclusion of reperfusion-treated patients, the complete-course population, additional adjustment for large-vessel occlusion, and continuous OTT modeling. Results: Median OTT was 19.65 (14.97, 34.68) h, treatment duration was 12.00 (11.00, 13.00) days, and 89.3% completed a relatively complete course. Baseline NIHSS was comparable [8.00 (6.00, 9.00) vs 8.00 (6.00, 10.00), P=0.447]. The within-24-hour group had lower pre-discharge NIHSS [5.00 (4.00, 6.50) vs 6.00 (5.00, 8.00), P=0.025], greater ΔNIHSS [3.00 (2.00, 3.00) vs 2.00 (1.00, 2.00), P<0.001], and a higher marked improvement rate (77.6% vs 60.0%, P=0.045). After adjustment for age, admission NIHSS, reperfusion therapy, and atrial fibrillation, within-24-hour treatment remained associated with greater ΔNIHSS (β=0.768, 95% CI: 0.377-1.159, P<0.001). Exploratory logistic regression showed a higher likelihood of marked improvement (OR=2.475, 95% CI: 1.047-5.853, P=0.039). Hemorrhagic transformation, symptomatic intracranial hemorrhage, drug-related adverse reactions, and in-hospital death did not differ significantly. Conclusion: In this real-world cohort, edaravone dexborneol within 48 h of AIS onset showed a high complete-course proportion and low short-term safety event incidence. Initiation within 24 h was associated with greater in-hospital NIHSS improvement and a higher marked improvement rate than initiation at 24-48 h. These findings are associative and need prospective multicenter validation with long-term functional outcomes.
目的 探讨急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）术后6个月内预后不良的影响因素及术前血清髓过氧化物酶（MPO）、淀粉样蛋白A（SAA）、肌酸激酶同工酶（CK-MB）水平联合检测对预后不良的预测效能。方法 前瞻性选取2023年1月～2025年1月许昌市人民医院诊治的204例AMI患者作为AMI组，另选取同期102例健康志愿者作为对照组。比较两组血清MPO、SAA、CK-MB水平。AMI组患者予以PCI术治疗，依据PCI术后6个月内（失访8例）预后情况将分为预后不良亚组（42例）和预后良好亚组（154例），比较不同预后AMI患者临床资料及术前血清MPO、SAA、CK-MB水平。分析AMI患者PCI术后6个月内预后不良的影响因素；分析术前血清MPO、SAA、CK-MB水平联合检测对预后不良的预测效能。结果 AMI组血清MPO、SAA、CK-MB水平高于对照组（P＜0.05）；预后不良亚组多支病变占比、Killip分级Ⅲ级占比、支架置入数、术前血清MPO、SAA、CK-MB水平高于预后良好亚组（P＜0.05）；校正病变支数、Killip分级、支架置入数后，术前血清MPO、SAA、CK-MB水平是AMI患者PCI术后6个月内预后不良的独立影响因素（P＜0.05）；术前血清MPO、SAA、CK-MB联合预测预后不良的AUC值明显高于各血清指标单度指标预测（P＜0.05）。结论 AMI患者血清MPO、SAA、CK-MB水平明显升高，且是AMI患者PCI术后预后不良的独立影响因素，联合检测其水平对预后不良具有较高的预测效能。
【摘要】 目的 探讨基于峰值呼气流速（peak expiratory flow rate，PEFR）的呼吸性肌肉力量减低对I-IIIA期非小细胞肺癌（non-small cell lung cancer，NSCLC）患者术后预后的影响。方法 回顾性分析我院2020年1月-2025年11月接受根治性手术切除的I-IIIA期NSCLC患者临床及影像资料，包括基于肺功能的PEFR（呼吸性肌肉力量指标）及胸部CT的胸肌质量指数（pectoralis muscle index, PMI）。分别采用Jonckheere-Terpstra检验、Spearman’s相关分析比较PEFR与PMI随年龄的变化规律及二者的相关性。低PEFR定义为小于PEFR的性别特异性下四分位数，进一步采用单、多因素Cox回归分析探讨PEFR及PMI对NSCLC患者术后结局的影响。结果 共纳入102例患者，中位年龄62岁（53-67岁），男性65例（63.7%），低低PEFR组24例（23.5%）。低PEFR组在年龄、FEVI、DLCO、FEV1/FVC、FVC、血清白蛋白及随访时间等方面均与正常组间存在显著差异（P＜0.05）。在男、女性患者中，PEFR均表现为随年龄增长逐渐下降的趋势；且与PMI具有较好的相关性（r=0.25，P=0.001）。单因素及多因素Cox回归分析显示，低PEFR是影响NSCLC患者术后无进展生存期（progression free survival, PFS）的独立危险因素（HR=1.57，95%CI：1.03-2.39；P=0.036）结论 呼吸性肌肉力量减低是NSCLC患者术后PFS的独立危险因素，有望成为NSCLC术后复发的早期生物学标志物。
【Abstract】 Objective To investigate the impact of reduced respiratory muscle strength, assessed by peak expiratory flow rate (PEFR), on postoperative outcomes in patients with stage I-IIIA non-small cell lung cancer (NSCLC). Methods Clinical and imaging data of patients with stage I-IIIA NSCLC who underwent radical resection at our hospital from January 2020 to November 2025 were retrospectively analyzed, including PEFR (an indicator of respiratory muscle strength) based on pulmonary function tests and the pectoralis muscle index (PMI) derived from chest CT. The Jonckheere-Terpstra test and Spearman’s correlation analysis were used to evaluate age-related changes in PEFR and PMI and their correlation, respectively. Low PEFR was defined as values below the sex-specific lower quartile of PEFR. Univariate and multivariate Cox regression analyses were performed to assess the impact of PEFR and PMI on postoperative prognosis in NSCLC patients.Results A total of 102 patients were enrolled, with a median age of 62 years (range 53-67 years); 65 patients (63.7%) were male, and 24 (23.5%) were classified into the low PEFR group. The low PEFR group showed significant differences from the normal PEFR group in age, FEV1, DLCO, FEV1/FVC, FVC, serum albumin, and follow-up duration (all P < 0.05). In both male and female patients, PEFR progressively decreased with age and was positively correlated with PMI (r = 0.25, P = 0.001). Univariate and multivariate Cox regression analyses identified low PEFR as an independent risk factor for postoperative progression-free survival (PFS) in NSCLC patients (HR = 1.57, 95% CI: 1.03–2.39; P = 0.036).Conclusion Reduced respiratory muscle strength is an independent risk factor for postoperative PFS in NSCLC patients and may serve as an early biomarker for postoperative recurrence.
目的：分析急性有机磷农药中毒（AOPP）引发缺血缺氧性脑病预后相关因素，建立相关的预后预测模型。方法：回顾性分析90例（33例预后不良、57例预后良好）AOPP致HIE患者（2022年3月～2025年8月）的临床资料、中毒指标和血清学指标，独立危险因素用Logistic回顾分析筛选，并构建预后不良预测模型，采用ROC工具对模型效能进行验证。结果：Logistic 回归分析显示，年龄≥60岁、重度中毒、中毒至就诊时间、LAC水平、CHE水平、CRP水平及NSE水平均为患者预后不良的独立危险因素（P＜0.05）；AUC、灵敏度、特异度为0.943、90.91%、87.72%。结论：高龄、中毒程度高及中毒至就诊时间长等因素可导致AOPP致HIE患者出现不良结局，据此构建风险预测模型可有效预测预后不良的发生风险。
To determine the key impacting factors for hypoxic ischemic encephalopathy (HIE) caused by acute organophosphorus pesticide poisoning (AOPP) and build a prediction model. Methods: The clinical data, poisoning indicators and serological indicators of 90 patients (33 cases with poor prognosis and 57 cases with good prognosis) with HIE caused by AOPP (from March 2022 to Aug 2025) were analyzed. Independent risk factors were screened using logistic retrospective analysis, and a poor prognosis prediction model was constructed. The model efficiency was verified by the receiver operating curve (ROC). Results: Logistic regression analysis showed that age ≥ 60 years, severe poisoning, time from poisoning to treatment, LAC level, CHE level, CRP level, and NSE level were all risk factors for the prognosis in patients (P < 0.05). The AUC, sensitivity, and specificity were 0.943, 90.91%, and 87.72%.Conclusion: Factors such as advanced age, high degree of poisoning, and long time from poisoning to treatment can lead to adverse outcomes in patients with HIE caused by AOPP. Based on this, building a risk prediction model can effectively predict the risk of poor prognosis.
虽然高效抗逆转录病毒治疗已经把艾滋病变成了能够长期管理的慢性传染病，可是患者预后的个体差异比较明显。近些年不良环境暴露被发现是影响艾滋病生存质量、免疫重建、疾病进展的重要外源性因素。环境污染物作为广泛存在而且有可预防的外部风险因素，有着低剂量、长时程、多途径暴露的特点，能够通过免疫毒性、氧化应激、慢性炎症激活、代谢紊乱等多种通路，干扰艾滋病患者的免疫重建进程和病毒抑制效果，进而影响其疾病进展、远期生存结局。本文系统综述了大气污染物、重金属、黄曲霉素、多环芳烃等典型环境污染物与艾滋病患者发病进展及预后转归的关联，深入分析人群易感性差异和当前研究存在的局限，可为优化HIV/AIDS患者的健康管理策略、降低环境相关健康风险、改善患者远期预后给予理论参考和实践依据。
Although highly active antiretroviral therapy has turned AIDS into a chronic infectious disease that can be managed for a long time, the individual differences in the prognosis of patients are obvious. In recent years, adverse environmental exposure has been found to be an important exogenous factor affecting the quality of life, immune reconstruction and disease progression of AIDS. As an external risk factor that exists and has potential intervention, environmental pollutants have the characteristics of low-dose, long-term and multi-channel exposure. They can interfere with the immune reconstruction process and virus inhibition effect of AIDS patients through various pathways such as immunotoxicity, oxidative stress, chronic inflammation activation, and metabolic disorders, thereby affecting their disease progression and long-term survival outcomes. This article systematically reviews the association between typical environmental pollutants such as air pollutants, heavy metals, aflatoxins, and polycyclic aromatic hydrocarbons and the progression and prognosis of AIDS patients. In-depth analysis of the differences in population susceptibility and the limitations of current research can provide theoretical reference and practical basis for optimizing the health management strategies of HIV / AIDS patients, reducing environmental-related health risks, and improving the long-term prognosis of patients.
