目的 了解新疆疏附县人民医院心脑血管疾病发病趋势和分析高血压发病相关危险因素,为高血压及其相关的心脑血管疾病的综合防治提供依据。方法 回顾性分析2007—2011年疏附县人民医院住院患者资料,按年份统计慢性非传染性疾病(以下简称慢性病)住院人数情况,并采用Logistic回归分析法分析维吾尔族人群高血压发病的相关危险因素。结果 新疆疏附县人民医院心脑血管疾病住院人数逐年增长,5年增长了约2.7倍,其中因高血压住院人数增长了3.5倍。BMI、血钠水平升高、血脂异常、年龄是维吾尔族人群高血压的危险因素。结论 新疆疏附县人民医院住院患者中以高血压为主的心脑血管疾病逐年增长。当地高血压及其相关的心脑血管疾病的防治采取生活方式干预基础上给予降压、降脂治疗的综合策略是优选。

Objective To investigate the incidence trend of cardio-cerebrovascular disease and the related risk factors about hypertension in Shufu people's hospital of Xinjiang. Moreover, to provide evidence of making prevention and controlling strategies for hypertension and the related cardio-cerebrovascular diseases.Methods A retrospective review was did on case data of the inpatients in Shufu people's hospital during 2007-2011.We counted the number of inpatients of chronic non-communicable diseases(NCDs)by year and collected the information of hypertensive inpatients and non-hypertensive inpatients to analyze the risk factors of hypertension in Uygurs using Logistic regression.Results The number of inpatients with cardio-cerebrovascular disease in Shufu people's hospital was increased by 2.7 times in 5 years, while the number of hypertensive inpatients was increased by 3.5 times. BMI, elevated blood sodium, and dyslipidemia, age are risk factors for hypertension in Uygur population.Conclusion The inpatients with cardio-cerebrovascular disease especially those with hypertension in Shufu people's hospital were increasing in recent 5 years. The strategy of lifestyle intervention combined with antihypertensive as well as lipid-lowering therapy is better to the prevention and treatment of hypertension and the related cardio-cerebrovascular diseases.

目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并肺动脉高压(pulmonary hypertention,PH)的危险因素。方法 回顾2014年1月—2015年1月广州医科大学附属第一医院住院患者55例,经心脏彩色多普勒超声测量肺动脉收缩压(PASP),分为:轻度组(36≤PASP＜50 mmHg),中度组(51≤PASP＜70 mmHg)和重度组(PASP≥70 mmHg),分析比较三组临床特征,危险因素采用单因素及多因素Logistic回归分析。结果 年龄(75.3±11.6)岁,PASP为(52.6±15.1)mmHg。单因素分析中-重度PH与年龄、HCT、PaCO₂、PaO₂、D-二聚体有关;多因素Logistic回归分析确定3项危险因素:HCT[比值比(OR)=51.82,95% CI: 2.34～1149.02],RV(OR=4.53,95% CI: 2.83～7.27),及PaCO₂(OR=1.02,95% CI: 1.00～1.03)。结论 呼吸病相关PH多为轻-中度,高水平的HCT、RV直径及PaCO₂提示PH病情较重。

Objective To analyze the clinical risk factors of pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease(COPD). Methods A total of 55 hospitalized patients from 2014 to 2015 were enrolled in the study and were classified into three groups according to pulmonary artery systolic pressure (PASP) with echocardiography as follows: the mild group (36≤PASP＜50 mmHg), the moderate group (51≤PASP＜70 mmHg) and the severe group (PASP≥70 mmHg). Clinical data were recorded and retrospectively analyzed. Results The average age of all patients was (75.3±11.6)years. Echocardiography showed a mean PASP was 52.6±15.1 mmHg. Age, hematocrit (HCT), partial pressure of carbon dioxide (PaCO₂), the oxygen partial pressure (PaO₂), D-dimer and right ventricular (RV) diameter (>20 mm) were associated with moderate-to-severe PH on an univariate regression analysis, while RV (diameter >20 mm)[odds ratio (OR)=4.53, 95% CI: 2.83～7.27], HCT(OR=51.82, 95% CI: 2.34~1149.02) and PaCO₂ (OR=1.02, 95% CI: 1.00-1.03), to these patients, were independent risk factors using the multiple logistic regression analysis. Conclusion PH related to respiratory diseases is mostly mild-to-moderate. Haemoptysis,high levels of RV diameter, HCT and PaCO₂ suggest a serious condition of patients with PH related to chronic respiratory disease.

目的 探讨宫腔积血对于中晚期妊娠结局的影响以及影响的因素。方法 结合477例中晚期宫腔积血孕妇的临床资料分析,根据妊娠结局分为正常妊娠结局组(NP)及不良妊娠结局组(AP)。结果 AP的平均孕周(23.22±6.87周)明显大于NP(16.11±4.76周),两组有明显差异性(P<0.001)。两组首次B超宫腔积血平均体积分别为8.01(2.22~28.67)(NP),13.05(3.54~26.34)mL(AP)(P=0.001),但相邻第二次测量结果两组相差不大(P=0.230)。AP组中胎盘下血肿的比率(53.4%)明显大于NP组(24.2%),而绒毛膜下血肿比率(44.0%)明显小于NP(73.8%),两组有明显差异性(P<0.001)。宫缩也是影响因素之一,在AP组可扪及宫缩的病例(88例55.3%)明显高于NP(38例11.9%),两组有明显差异性(P<0.001)。但在阴道流血率方面两组没有明显差异(P=0.407)。结论 妊娠中晚期宫腔积血可能会导致不良妊娠结局,而首次出现的孕周,急性大量宫腔出血、宫腔积血位置以及是否伴有宫缩都是影响妊娠结局的重要因素。

Objective To study the poor pregnancy outcomes of patients with intrauterine hematoma in the second and third trimesters, and discuss the risk factors. Methods We analyzed the clinical data of 477 patients who underwent routine examination in our hospital from January 2010 to June 2016 and classified them into normal pregnancy (NP) group and adverse pregnancy (AP) group according to their pregnancy outcomes. Results Gestational age at first detection of hematoma of AP group(23.22±6.87 weeks) was more than NP group (16.11±4.76 weeks)(P<0.001). The volumes of hematoma during the first detection were significantly different between the two groups (P=0.001).The average hematoma volume were 8.01(2.22-28.67)(NP),13.05(3.54-26.34)mL(AP)respectively. However, the hematoma volumes recorded in the second B-ultrasound examination were not significantly different between the two groups (P=0.230). In the AP group, the incidence of retroplacental hematoma (53.4%) was significantly higher than in the NP group (24.2%), while the incidence of subchorionic hematoma (44.0%) was significantly lower than in the NP group (73.8%)(P<0.001). The incidence of palpable contractions in the AP group (62.8%) was significantly higher than in the NP group (12.1%), P<0.001. However, the incidence of vaginal bleeding was similar (P=0.407). Conclusion Intrauterine hematoma in the second and third trimester may lead to adverse pregnancy outcomes. Risk factors for poor pregnancy outcomes are included gestational age at first diagnosis, acute and large intrauterine bleeding, location of hematoma and accompanying contraction.

目的 探讨影响本区肺结核发病的危险因素,为肺结核的防控提供参考依据。方法 采用频数匹配病例对照的研究方法,选自2012—2015年间,在本区居住的肺结核患者为病例组,按1∶1病例对照,在本区选择与病例组同性别、年龄相差<2 a的健康居民为对照组,用单因素Logistic分析及对多因素非条件Logistic 回归分析进行统计学分析。结果 肺结核发病的保护因素有文化程度的高低(OR=0.237,P<0.037),居住环境采光(OR=0.393,P<0.013),蔬菜水果类摄入(OR=0.748,P<0.021),蛋奶类摄入(OR=0.704,P<0.027)。肺结核的危险因素有工作环境是否接触粉尘(OR=2.984,P<0.001)是否吸烟(OR=1.537,P<0.020),是否饮酒(OR=1.110,P<0.041),结核病人接触史(OR=11.052,P<0.001),居住环境潮湿(OR=1.117,P<0.001)。最终被选入回归方程的因素为,文化程度、工作环境是否接触粉尘、结核病人接触史、居住环境潮湿、蔬菜水果类摄入,其OR值分别为0.471、8.945、17.652、14.268、0.234。结论 文化程度及蔬菜水果类的摄入为肺结核保护因素,工作环境接触粉尘、接触过结核病人及居住环境潮湿是肺结核的危险因素。

目的 探讨断指再植术后血管危象发生情况及危险因素。方法 收集2015年8月—2016年12月我院行断指再植术患者66例临床资料行回顾性分析,根据患者术后是否发生血管危象分为A组(发生血管危象)和B组(未发生血管危象),收集两组患者一般临床资料,采用单因素和多因素Logistic 回归分析影响断指再植术患者术后血管危象发生的危险因素。结果 单因素分析得出,性别、年龄、吸烟史、指别、外伤原因、末端断离及缺血时间在A、B两组间比较有统计学意义(P＜0.05)。多因素分析得出,性别、年龄、吸烟史、指别、外伤类型、末端断离、缺血时间均为影响断指再植术术后血管危象发生危险因素。结论 血管危象为断指再植术常见并发症,影响发生血管危象危险因素较多,临床中应针对性进行预防和干预,以降低断指再植术患者术后血管危象发生率,提高断指存活率。

目的 探讨难治性肠易激综合征(RIBS)患者的生活质量及影响因素。方法 采用症状严重程度量表(IBS-SSS)、汉密尔顿焦虑/抑郁量表(HAMA/HAMD)和生活质量量表(IBS-QOL)对601例消化专科门诊连续IBS患者和同期匹配的100例健康体检者进行测评,并通过多重线性回归分析探讨RIBS患者生活质量的影响因素。结果 RIBS组IBS-QOL总评分及IBS-QOL8个维度评分低于非RIBS组和健康对照组(P<0.05)。RIBS不同亚型间的IBS-QOL总评分无统计学意义(P>0.05),但在冲突行为、健康忧虑、社会反映3个维度方面有统计学意义(P<0.05)。IBS-SSS症状评分和焦虑症状评分为RIBS患者生活质量的影响因素。结论 难治性IBS患者的生活质量差,临床症状和焦虑情绪为其重要影响因素。

Objective To explore quality of life and its risk factors in patients with refractory irritable bowel syndrome(RIBS). Methods 601 IBS patients in gastroenterology clinic and 100 healthy volunteers were invited to complete irritable bowel syndrome- symptom severity scale (IBS-SSS), the Hamilton Rating Scale of Anxiety/ Depression (HAMA/HAMD), Irritable bowel syndrome-quality of life(IBS-QOL). And multiple linear regression analysis was used to explore the determinants of quality of life in patients with RIBS. Results The overall score and subscale scores of IBS-QOL in RIBS group were lower than those in the non-RIBS and healthy group (P<0.05). There were no significant differences in the overall scores of IBS-QOL among different subtypes of RIBS. However, the interference with activities, health anxious, social reaction scores were different among the subtypes (P<0.05). Multiple linear regression analysis demonstrated that quality of life in RIBS was independently associated with the scores in IBS-SSS and HAMA. Conclusion Quality of life in RIBS is obviously decreased. Quality of life in RIBS is closely related to clinical symptoms and anxiety condition.

目的 探讨清洁手术在围手术期间所出现的抗菌药物不合理现象的危险因素,提出应对措施。方法 选用我院普外科收治的四种清洁手术(骨折内固定取出手术、乳腺手术、甲状腺手术和疝气手术)患者460例,对所有患者在围手术期间抗菌药物的应用情况进行研究,并对其不合理使用危险因素进行多因素logistic回归分析。结果 患者在清洁手术中抗菌药物的应用率为100%,其中头孢菌素类药物的使用率最高,喹诺酮类药物次之,四种清洁手术的术后用药时间均>7天。对患者资料进行多因素logistic回归分析结果显示,围手术期抗菌药物的不合理使用危险因素主要包括无指征预防使用抗菌药物、给药时间不当、术后用药时间过长、药物选用不合理等七种危险因素(P<0.05)。结论 当前清洁手术的围手术期中,存在着抗菌药物不合理使用的情况,临床诊治过程中应强化科学应用意识和合理化使用观念,确保医药资源的充分利用。

目的 探讨规范二级预防下老老年人轻型卒中复发的危险因素。方法 收集我院80岁及以上、既往有轻型卒中病史、并进行规范二级预防半年以上的老老年患者的临床资料:一般资料、既往病史及用药情况、入院时血压及基础生化指标、影像学资料、缺血性卒中复发情况。根据有无复发缺血性卒中将患者分为复发组和无复发组两组,分析以上因素在两组间的差异。结果 80例患者中复发缺血性脑卒中共26例,复发率32.5%。统计结果显示,轻型卒中复发组与合并高血压病、入院时收缩压、D二聚体水平呈正相关,其相关系数分别为0.265(P=0.018)、0.232(P=0.038)和0.222(P=0.048)。复发组收缩压升高比例高于无复发组(χ²=6.919,P=0.031)。非条件Logistic多因素分析显示:合并高血压病[OR 95%CI=(1.162,10.230)]、收缩压升高[OR 95%CI=(0.997,68.840)]与轻型缺血性卒中复发相关。结论 合并高血压病、收缩压升高是老老年人轻型卒中规范二级预防下复发独立危险因素。

Objective To analyze the recurrence risk factors of aged patients with minor ischemic stroke under standardized secondary prevention. Methods Patients over 80 years old and with minor ischemic stroke history were enrolled, and the following data were collected: demographic characteristics, medical history, current medicine, blood test, imaging findings and recurrence of ischemic strokes. Patients were divided into two groups: the recurrence group and the non-recurrence group. Chi-square test,logistic regression models were performed to assess correlations between baseline variables and recurrence of minor stroke events. Results In our study, 26 patients had recurrent minor ischemic stroke(32.5%). The prevalence of recurrence of minor stroke was positively correlated with hypertension(CI 0.265, P 0.018), SBP(CI 0.232,P 0.038), d-2-dimer(CI 0.232,P 0.048). Patients in recurrence group are more likely to presented with SBP elevation compared to non-recurrence group(χ²=6.919, P=0.031). Unconditional logistic regression analysis showed that hypertension, especially high SBP significantly related to minor ischemic stroke recurrence. Conclusion Hypertension,especially elevated SBP, were considered as an independent risk factors for aged old patients with minor ischemic stroke who received standardized secondary prevention.

目的 分析影响广州青少年自杀行为的因素。方法 选取100例自杀行为青少年为观察组,选100例健康青少年为对照组,对比两组青少年家庭结构、家庭教育方式、自身人格特征等指标。多因素Logistic回归分析其自杀行为危险因素。结果 观察组青少年抑郁量表、焦虑量表、攻击性人格及冲动性人格量表分值均高于对照组高;单亲家庭或父母常年在外、家庭教育方式不当、学校无健康心理教育课、抑郁或焦虑、冲动或攻击性人格、负面事件、消极应对是青少年自杀行为独立危险因素,P均＜0.05。结论 家长及学校应正确引导青少年处事方式,积极面对生活,打消自杀意念。

Objective To analyze the factors influencing the suicide behavior of adolescents in Guangzhou. Methods The 100 cases of adolescent suicide behavior were selected as the observation group, 100 healthy adolescents were selected as control group, compared with two groups of adolescent family structure, family education, personality traits and other indicators. Multivariate logistic regression analysis of risk factors was taken for suicidal behavior. Results In the observation group adolescent depression scale, anxiety scale, attack impulse personality and personality amount scores were higher than those in the control group, single parent family or parents staying outside, improper family education, school health psychological education, depression or anxiety, impulsivity, or aggressive personality, negative events, negative coping were independent risk factors for adolescent suicide, P<0.05. Conclusion Parents and schools should have guide to adolescents, toface life positively, and give up thought of suicide.

目的 了解化脓性脑膜炎患儿常见后遗症的种类及发生率,探讨可能导致化脓性脑膜炎患儿预后不良的高危因素。方法 选取129例化脑性脑膜炎患儿,患儿分为预后不良组及预后良好组,统计各种后遗症的发生率,并寻找预后不良的危险因素。结果 随访的80例患儿中,有较轻后遗症者12例,有严重后遗症者13例,包括智力低下11例,运动障碍8例,双侧听力障碍4例,继发性癫痫4例,10例患儿合并有两种或以上严重后遗症,最常见为智力低下合并运动障碍。行为问题共检查48例患儿,有行为问题患儿17例。预后不良组和预后良好组在发热总时间>7天、入院后反复抽搐≥3次、昏迷(Glasgow昏迷评分<8分)、感染性休克、瞳孔异常、肢体活动障碍为出现预后不良的危险因素,两组比较差异有统计学意义(P＜ 0.05)。结论 本研究发现,化脓性脑膜炎患儿的后遗症表现多种多样,提示患儿应该进行系统的随访;同时,本研究还发现昏迷、感染性休克等临床症状是导致预后不良的危险因素。早期识别这些症状,并给予早期干预,将对患儿的预后有着重要意义。

Objective To investigate the types and incidence of common sequelae in children with bacterial meningitis.To investigate the risk factors for adverse outcome of childhood bacterial meningitis. Methods Selected 129 children with bacterial meningitis all cases were divided into adverse outcome group and favorable outcome group.According to the incidences of different kinds of sequelae,The risk factor effecting bad prognosis were studied. Results A total of 80 children were successfully followed.Of them,12 might only have mild sequelae and 13 had serious sequelaes.Among these children who had serious sequelae,11 of them had mental retardation,8 of them had motor deficit,4 of them had bilateral hearing loss and 4 of them had secondary epilepsy.10 children had multiple serious sequelae,thes most common multiple impairment combinations were mental retardation plus motor deficit.48 parents of the children completed the Child Behaviour Checklist and found out 17(35.42%)of their children had behavioral disorders.Adverse outcome group and favorable outcome group,the length of fever(>7 days),repeated convulsions after admission(≥3 times),coma(Glasgow coma scale score <8 points),septic shock,abnormal pupils,limb movement disorder.There were significantly difference between the two groups(P＜ 0.05). Conclusions This study showed that there are different kinds of sequelaes of children with bacterial meningitis,it indicated that these children should be follow-up to track the effect.On the other hand,this study found out that the high risk factors with adverse outcome might be coma,septic shock and so on.It indicated that if we could identify the high risk factors in the early stage and then interpose them immediately,it might beneficial to improve the quality of life of the children.