论著

来曲唑和氯米芬治疗极严重少精子症的疗效分析

Efficacy of letrozole and clomiphene in the treatment of extremely severe oligospermia

:105-108
 
目的 比较来曲唑和氯米芬治疗极严重少精子症的治疗效果。方法 选取2020—2021年在本生殖中心门诊50例极严重少精子症病例,分为2组,A组(来曲唑,研究组n=26)、B组(氯米芬,对照组n=24)。结果 来曲唑和氯米芬治疗后1月、3月,A组精子浓度明显提高,优于B组[(4.5±3.1) vs (2.0±1.3);(8.3±3.5) vs (2.0±1.8),P<0.05]。通过卵胞浆内单精子注射/体外受精胚胎移植治疗,A组妊娠16例(61.5%),B组妊娠11例(45%)。2组治疗后的血清卵泡刺激素、黄体生成素、睾酮升高[(5.9±3.8) vs (20.3±2.6);(3.6±2.8) vs (9.5±5.7);(13.6±10.5) vs (25.3±10.8),P<0.05],A组雌二醇水平降低[(36.8±20.6) vs (7.6±2.5),P<0.05]。结论 来曲唑治疗极严重少精子症有较理想的临床治疗效果,明显优于氯米芬。
Objective To explore and compare the therapeutic effects of letrozole and clomiphene in the treatment of extremely severe oligospermia. Methods A tatal of 50 cases of extremely severe oligosperospermia in the reproductive center from 2020 to 2021 were selected and divided into two groups, group A (letrozole, study group n=26) and B (clomiphene, control group n=24). Results After letrizole and clomiphene treated for 1 and 3 months, sperm concentration in group A was significantly better than group B[(4.5±3.1) vs (2.0±1.3);(8.3±3.5) vs (2.0±1.8),P<0.05]. With ICSI/IVF, 16 cases (61.5%) succeed in encyesis in group A, 11 cases (45%) in group B. Serum follicle stimulating hormone, luteinizing hormone and testosterone levels were significantly increased after treatment [(5.9±3.8) vs (20.3±2.6), (3.6±2.8) vs (9.5±5.7), (13.6±10.5) vs (25.3±10.8), P<0.05]. The level of estradiol in group A decreased [(36.8±20.6) vs (7.6±2.5), P<0.05]. Conclusions Letrozole has ideal clinical treatment effect, which is obviously superior to clommiphene.
论著

美多巴联合盐酸司来吉兰治疗帕金森患者的临床效果及影响

Clinical effect and influence of medopa combined with selegilan hydrochloride in the treatment of patients with Parkinson's disease

:97-100
 
目的 探讨美多巴联合盐酸司来吉兰治疗帕金森患者的临床效果及对不良反应情况的影响。方法 选取我院2018年1月—2020年12月收治的96例帕金森患者,通过单双号抽签法将96例患者分为2组,分别为对照组、观察组(每组48例)。对照组给予美多巴治疗,观察组在美多巴联合盐酸司来吉兰进行治疗。然后对比2组患者治疗前后的临床疗效,采用帕金森统一评分量表计算精神状态 、运动功能和日常活动评分并记录不良反应的发生率。结果 对比2组患者治疗前后临床疗效,观察组患者临床总有效率高于对照组(87.50% vs 66.66%),差异有统计学意义(χ2=5.897,P=0.015);治疗后2组患者精神状态 、运动功能和日常活动评分低于治疗前(P<0.05),且观察组患者各项评分低于对照组,差异有统计学意义(t=8.250,P<0.001;t=4.388,P=<0.001;t=3.207,P=0.002);对比2组患者不良反应发生率,对照组与观察组不良反应发生率比较无差异(10.41% vs 12.50%,χ2=0.103,P=0.749),2组患者治疗后的不良反应均为一过性,停药或休息后可自行缓解。结论 美多巴联合盐酸司来吉兰治疗帕金森患者的临床疗效良好,能让患者精神状态、运动功能和日常生活得到显著改善,且不良反应较少。
Objective To explore the clinical effect of medopa combined with selegiline hydrochloride in the treatment of patients with Parkinson's disease and its impact on adverse reactions. Methods A total of 96 Parkinson's disease patients from January 2018 to December 2020 were selected and divided into two groups by the odd and even number drawing method, 48 cases each. The control group was treated with medopa, and the observation group was treated with selegiline hydrochloride on the basis of the control group. Then the clinical efficacy of the two groups were compared, and the Unified Parkinson's Disease Rating Scale was used to access the mental state, motor function and daily activity scores of the patients, and the incidence of adverse reactions was recorded. Results The total effective rate of the observation group was higher than that of the control group (87.50% vs 66.66%), with statistical significance(χ2=5.897,P=0.015). After treatment, the scores of mental state, motor function and daily activities were lower (P<0.05), and the scores of the observation group were significantly lower than those of the control group (t=8.250, P<0.001; t=4.388, P=<0.001; t=3.207, P=0.002);the incidence of adverse reactions had no differences (10.41% vs 12.50%, χ2=0.103, P=0.749). The adverse reactions were transient, which could be alleviated by drug withdrawal or rest. Conclusions Madopa combined with selegiline hydrochloride had a good clinical effect in the treatment of patients with Parkinson's disease. It could significantly improve the mental state, motor function and daily life of patients, with less adverse reaction, which is worthy of promotion.
论著

厄贝沙坦联合肾炎康复片治疗慢性肾炎的药学分析及对肾功能的影响

Pharmacological analysis of irbesartan and Shenyan Kangfu Tablet in the treatment of chronic nephritis and its effect on renal function

:90-92
 
目的 探讨在慢性肾炎中采用厄贝沙坦+肾炎康复片对肾功能的影响。方法 在我院肾内科2018年3月—2020年8月收治的慢性肾炎患者中随机选取80例,按照抽签法分为2组,对照组(40例)采用厄贝沙坦,研究组在其基础上加用肾炎康复片,对比2组肾功能指标、临床疗效及不良反应。结果 治疗后2组肾功能指标均好转,且研究组血肌酐、尿素氮、24 h尿蛋白量均低于对照组,肾小球滤过率高于对照组(P<0.05)。2组治疗总有效率对比差异显著(P<0.05),不良反应对比无差异。结论 在对慢性肾炎的治疗中联用厄贝沙坦及肾炎康复片可有效提高肾功能,疗效显著。
Objective To investigate the effect of irbesartan and Shenyan Kangfu Tablet on renal function in chronic nephritis. Methods A total of 80 patients of chronic nephritis admitted in our hospital from March 2018 to August 2020 were randomly selected and divided into two groups by drawing lots. The control group (40 cases) received irberartan, while the research group added Shenyan Kangfu Tablet on the basis of irberartan. The renal function indexes, clinical efficacy and adverse reactions of the two groups were compared. Results After treatment, renal function indexes in both groups were improved, and serum creatinine, urea nitrogen and 24 h urinary protein levels in the research group were lower than those in the control group, and glomerular filtration rate was higher than that in the control group (P<0.05). The total effective rate was significantly different between the two groups (P<0.05), but there was no difference in adverse reaction rate. Conclusions In the treatment of chronic nephritis, irbesartan combined with Shenyan Kangfu Tablets could effectively improve renal function, and the effect is significant.
论著

影响先天性甲状腺功能减低症不同转归的早期因素

The early factors influencing different outcomes of congenital hypothyroidism

:84-89
 
目的 探讨影响先天性甲状腺功能减低症患儿不同转归的早期因素。 方法 选取2013年12月—2017年3月期间在本中心筛查并确诊的先天性甲状腺功能减低症患儿共80例,经左旋甲状腺激素钠治疗2~3年后停药评估再随访1年以上者,根据疾病转归将患儿分为持续性甲低组(29例)与暂时性甲低组(51例)。对2组患儿的临床情况进行回顾性分析,寻求影响结局的早期因素。结果 持续性甲低与暂时性甲低患儿初筛促甲状腺激素值[ 63.89 (43.89, 114.25) vs 38.54 (27.27, 60.00) mIU/L]、促甲状腺激素恢复正常所需剂量[(4.29±1.46) vs (3.38±1.34) μg/(kg·d)]、早期甲状腺超声正常比例[58.6%(17/29)vs 90.2%(46/51)]差异有统计学意义(P<0.05)。其中初筛促甲状腺激素值(最佳临界值:37.825 mIU/L,AUC=0.745,灵敏度0.897,特异度0.490)和出生后第8个月左旋甲状腺激素钠给药剂量[最佳临界值3.38 μg/(kg·d),AUC=0.759,灵敏度 0.586,特异度 0.843]可早期区别持续性甲低与暂时性甲低患儿。结论 初筛促甲状腺激素值和出生后左旋甲状腺激素钠给药剂量对先天性甲状腺功能减低症患儿临床转归有早期预测作用。
Objective To investigate the early factors affecting different outcomes of children with congenital hypothyroidism (CH). Methods A total of 80 children with CH screened and diagnosed at Meizhou Maternal and Child Health Care and Family Planning Service Center between December 2013 and March 2017, who were treated with levothyroxine sodium for 2~3 years and then discontinued for assessment and followed up for over 1 year, were selected and divided into the permanent CH group (29 cases) and transient CH group (51 cases) according to disease outcomes. The clinical conditions of the children were retrospectively analysed to seek early factors affecting outcome. Results The initial screening thyroid hormone values [ 63.89 (43.89, 114.25) vs 38.54 (27.27, 60.00) mIU/L ], the required dose to restore normal thyroid hormone in permanent and transient CH group [(4.29±1.46) vs (3.38±1.34) μg/(kg·d)], and the proportion of early normal thyroid ultrasound [58.6% (17/29) vs 90.2% (46/51)] had significant differences(P<0.05). The initial screening thyroid hormone value (optimal threshold: 37.825 mIU/L, AUC=0.745, sensitivity 0.897 and specificity 0.490) and the levothyroxine sodium dosage at eighth month of age [optimal threshold 3.38 μg/(kg·d), AUC=0.759, sensitivity 0.586 and specificity 0.843] could early distinguish permanent and transient CH children. Conclusions Initial screening thyroid hormone values and postnatal levothyroxine sodium dosage had an early predictive effect on clinical outcome in children with CH.
论著

对比不同血管通路运用于血液透析中的透析充分性及并发症发生率分析

To compare the dialysis adequacy and complication rate of different vascular pathways in hemodialysis

:80-83
 
目的 对比不同血管通路运用于血液透析中的透析充分性及并发症发生率分析。方法 选取我院2018年5月—2020年10月收治的其中60例血液透析患者作为研究对象,根据患者不同血管通路分为3组,甲组30例,采取自体动静脉内瘘为通路方式,乙组15例,采取聚四氟乙烯移植血管内瘘为通路方式;丙组15例,采取带隧道和涤纶套的透析导管为通路方式。观察并记录3组患者透析后的血红蛋白、高密度脂蛋白、总胆固醇、C反应蛋白、血浆清蛋白、低密度脂蛋白、尿素清除指数、甘油三酯、尿素降低率水平,并对患者随访10个月,观察3组患者血管通路并发症(感染及血栓栓塞)的发生情况。结果 透析后3组患者血红蛋白、总胆固醇、高密度脂蛋白、甘油三酯、血浆清蛋白、C反应蛋白、低密度脂蛋白、尿素清除指数、尿素清除率比较,差异无统计学意义(P>0.05)。甲组的感染和血栓栓塞发生率低于乙组和丙组,而乙组的感染率又低于丙组,差异有统计学意义(P<0.05)。结论 自体动静脉内瘘可以做为血液透析治疗中血管通路的首选方式,若患者自体血管条件有限,可考虑建立移植血管内瘘来保证透析的充分性,降低并发症发生率,提高患者透析安全性及生活质量。
Objective To compare the dialysis adequacy and complication incidence of different vascular access in hemodialysis. Methods A total of 60 hemodialysis patients treated in our hospital from May 2018 to October 2020 were selected as the research objects. They were divided into three groups according to different vascular access. Thirty patients in group A took autologous arteriovenous fistula (AVF) as the access, and 15 patients in group B took polytetrafluoroethylene graft (arteriovenous grafts,AVG) as the access, 15 cases in group C were treated with dialysis catheter with tunnel and polyester sleeve (tunnel-cuffed catheter,TCC). The levels of hemoglobin, high density lipoprotein, total cholesterol, C-reactive protein, plasma albumin, low density lipoprotein, urea clearance index, triglyceride and urea reduction ratio (URR) were observed and recorded. The patients were followed up for 10 months to observe the incidence of vascular access complications (infection and thromboembolism) in the three groups. Results There was no significant difference in hemoglobin, total cholesterol, high density lipoprotein, triglyceride, plasma albumin, C-reactive protein, low density lipoprotein, urea clearance index and URR among the three groups after dialysis (P>0.05). The incidence of infection and thromboembolism in group A was lower than that in group B and group C, while the infection rate in group B was lower than that in group C, the differences were statistically significant (P<0.05). Conclusions AVF can be used as the preferred way of vascular access in hemodialysis treatment. If the patient's autologous vascular conditions are limited, it can be considered to establish transplanted vascular fistula (AVG) to ensure the adequacy of dialysis, reduce the incidence of complications and improve the dialysis safety and quality of life of patients.
论著

重组人干扰素α 2b喷雾剂治疗儿童流行性感冒的疗效及安全性评价

Efficacy and safety evaluation of recombinant human interferon α2b spray in the treatment of influenza in children

:76-79
 
目的 探讨重组人干扰素α2b喷雾剂治疗儿童流行性感冒的疗效及安全性。方法 选取我院2017年1月—2020年2月所收治的80例儿童流行性感冒患者,按1:1随机分为实验组及对照组,每组患儿40例,对照组患者给予奥司他韦治疗,实验组患者在对照组治疗基础上联合重组人干扰素α2b喷雾剂治疗,对比2组患者的疗效及安全性。结果 实验组患儿咽痛症状消失时间(2.01±0.23)d、体温恢复正常时间(2.18±0.30)d、咳嗽症状消失时间(1.68±0.52)d、治疗时间(5.41±0.36)d均短于对照组(t=26.001、9.766、19.277、28.089,P<0.05);实验组患儿治疗有效率95.0%高于对照组治疗有效率(χ2=4.114,P<0.05);实验组患儿的不良反应发生率低于对照组(χ2=4.021,P<0.05)。结论 重组人干扰素α2b喷雾剂治疗儿童流行性感冒的方案可获取较为理想的治疗效果,保证患儿用药安全性,尽快缓解患儿的临床症状,促使患儿病情康复,促进患儿健康生长,该治疗方案可在临床中推广应用。
Objective To explore the efficacy and safety of recombinant human interferon α2b spray in the treatment of influenza in children. Methods Eighty children with influenza who were admitted to our hospital from January 2017 to February 2020 were randomly divided into experimental group and control group evenly, with 40 children in each group. Oseltamivir treatment was given to the control group, the experimental group was treated with recombinant human interferon α2b spray on the basis of oseltamivir, and the efficacy and safety of the two groups were compared. Results In the experimental group, the time for the disappearance of sore throat was (2.01±0.23) d, the time for the body temperature returned to normal was (2.18±0.30) d, the time for the cough to disappear was (1.68±0.52) d, and the treatment time was (5.41±0.36) d, which were all shorter than the control group (t=26.001, 9.766, 19.277, 28.089, P<0.05). The treatment effective rate of children in the experimental group was 95.0%, which was significantly higher than that in the control group (χ2=4.114, P<0.05); the incidence of adverse reactions in experimental group was significantly lower than that in the control group (χ2= 4.021, P<0.05). Conclusions The recombinant human interferon α2b spray for the treatment of influenza in children could obtain a more ideal therapeutic effect, ensure the safety of the children's medication, relieve the clinical symptoms as soon as possible, promote the improvement of the children's condition, and promote the healthy growth of the children. The treatment plan can be promoted and applied in clinical practice.
论著

甲状腺乳头状癌碘治疗前短期严重甲减对血脂的影响

Effect of short-term severe hypothyroidism on blood lipids in patients with papillary thyroid carcinoma before iodine therapy

:47-52
 
目的 探讨甲状腺乳头状癌患者在严重短期甲减的状态下甲状腺功能及相关因素对血脂水平的影响。方法 纳入61例通过病理确诊为甲状腺乳头状癌的患者,采集所有患者在手术前与碘治疗前的甲状腺功能水平与血脂水平等资料,比较患者不同性别、年龄、术式、淋巴结转移情况等相关因素对血脂的影响。结果 碘治疗前的全部血脂指标均高于手术前的基线水平;在促甲状腺激素 (TSH)>60 mIU/L组中的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(APO-A1)、载脂蛋白B(APO-B)、脂蛋白(LP)水平明显高于TSH≤60 mIU/L组;女性患者的甘油三酯(TG)、动脉硬化指数(AI)水平明显低于男性患者,男性组的HDL-C、APO-A1水平低于女性组,年龄>45岁的患者TC水平高于年龄≤45岁的患者,差异均有统计学意义(P均<0.05);不同术式及淋巴结转移分组间的血脂水平未见明显差异(P>0.05);TC水平与游离三碘甲状原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺素(T4)水平呈负相关(r分别为-0.342、-0.370、-0.340),HDL-C、LDL-C及APO-B水平与T4水平呈负相关(r分别为-0.294、-0.354、-0.324),APO-A1水平与FT4、三碘甲状腺原氨酸(T3)、T4水平呈负相关(r分别为-0.306、-0.262、-0.263),LPa水平与T3、T4水平呈负相关(r分别为-0.268、-0.313)。结论 甲状腺乳头状癌碘治疗前短期甲减可以导致全套血脂指标升高,在此甲减状态下程度越严重的甲减可产生越高的血脂水平,同时男性患者与中老年患者也可伴随更高的血脂水平。
Objectives To investigate the influence of thyroid function and related factors on blood lipid levels in patients with papillary thyroid cancer under short-term severe hypothyroidism. Methods Sixty-one patients with papillary thyroid carcinoma diagnosed by pathology were included. The data of thyroid function and blood lipid levels of all patients before operation and iodine treatment were collected. The effects of gender, age, operation mode, lymph node metastasis and other related factors on blood lipid were compared. Results Before iodine treatment, all blood lipid indexes were higher than the baseline level before operation. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (APO-A1), apolipoprotein B (APO-B), lipoproteins (LP) in the thyroid stimulating hormone (TSH)>60 mIU/L group were significantly higher than those in the TSH≤60 mIU/L group.Triglyceride (TG) and arteriosclerosis index (AI) levels were significantly lower in female patients compared with male patients, HDL-C and APO-A1 levels were lower in male patients compared with female patients, and TC levels were higher in patients aged>45 compared with those aged≤45, with significant differences (all P<0.05). No significant differences were observed in lipid levels among the different surgical procedures and lymph node metastasis subgroups (P>0.05). TC levels were negatively correlated with free triiodothyronines (FT3), free thyroxine (FT4), thyroxine (T4) levels (r=-0.342,-0.370,-0.340,respectively). HDL-C, LDL-C, and APO-B levels were negatively correlated with T4 levels (r=-0.294, -0.354, -0.324,respectively), APO-A1 levels were negatively correlated with FT4, triiodothyronine (T3), T4 levels (r=-0.306,-0.262,-0.263,respectively), and LP levels were negatively correlated with T3 and T4 levels (r=-0.268,-0.313, respectively). Conclusions Short term hypothyroidism before iodine treatment for papillary thyroid cancer could lead to the increase of full set of blood lipid indexes, male patients and middle-aged and elderly patients could also be accompanied by higher blood lipid levels.
论著

青藤碱对肾癌细胞786-O细胞增殖、细胞周期及凋亡的影响

Effects of sinomenine on cell cycle and apoptosis of 786-O renal carcinoma cells

:38-42
 
目的 探讨不同浓度的青藤碱对肾癌细胞增殖、细胞周期及凋亡的影响。方法 以不同浓度的青藤碱处理肾癌细胞786-O,采用四氮唑蓝盐法检测细胞增殖能力,流式细胞术检测细胞周期分布,Annexin-v FITC/PI双染流式细胞分析仪检测细胞凋亡率;采用实时荧光定量PCR及蛋白免疫印迹(WB)检测c-myc、Bax、Caspase-3等细胞周期、凋亡相关基因表达情况。结果 青藤碱显著抑制786-O细胞的增殖能力,诱导细胞周期G1/S期阻滞及细胞凋亡;且随着青藤碱浓度的增加,其抑制率也逐渐增加;青藤碱显著下调c-myc蛋白表达,而诱导凋亡蛋白Bax、Caspase-3表达上调。结论 青藤碱可以显著抑制786-O细胞中c-myc表达,使其增殖能力减弱,诱导细胞周期阻滞及凋亡。青藤碱可能具有潜在的抑制肾癌生长作用。
Objective To investigate the effects of different concentrations of sinomenine on proliferation, cell cycle and apoptosis of renal carcinoma cells. Methods The renal carcinoma cells were treated with different concentrations of sinomenine. MTS was used to analyze the effects of sinomenine on proliferation in 786-O renal carcinoma cells, the cell cycle changes were determined using flow cytometry, while the changes of apoptosis were detected by Annexin V-FITC / PI double staining. The expression of apoptosis-related proteins such as c-myc, Bax and Caspase-3 were detected by Western blot. Results Sinomenine significantly inhibited the proliferation of 786-O cells and induced cell cycle arrest and apoptosis in G1/S phase. With the increase of sinomenine concentration, the inhibition rate increased gradually. Sinomenine significantly down-regulated the expression of c-myc protein, while the expressions of the apoptotic protein Bax, Caspase-3 were up-regulated. Conclusions Sinomenine can significantly inhibit the expression of c-myc in 786-O cells, reduce proliferation ability, and induce cell cycle arrest and apoptosis. Sinomenine may have a potential therapeutic effect on renal cancer.
专题论著: 新型冠状病毒肺炎

新冠疫情影响下儿童输血时机对输血疗效的影响

The influence of blood transfusion timing in children on the efficacy of blood transfusion under COVID-19 pandemic

:22-28
 
目的 探讨在COVID-19流行期间血库资源紧张状态下输血时机对儿童输血效果及临床预后的影响。方法 本回顾性队列研究纳入2020年1月—2020年12月在广州市妇女儿童医疗中心儿科急诊就诊并申请输血的患儿的临床预后。结果 共566例发起红细胞和血小板的非手术输血申请的患儿纳入研究,包括 260 例的红细胞申请和306例血小板申请。260份红细胞申请中:209 例及时输血,40 例延时输血,11 例未输血;及时组和延时组的输血有效率分别为37.8%和35.0%(P=0.737);1名不良预后的死亡病例出现在及时组中,余病例临床预后均良好,3组的临床结局无统计学差异(组间P=0.886)。306份血小板申请中:195 例及时输血,108 例延时输血,3例未输血;1名不良预后的死亡病例出现在及时组中(0.51%),3名不良预后的死亡病例出现在延时组中(2.78%),余病例临床预后均良好,3组的临床结局无统计学差异(组间P=0.131)。结论 符合红细胞与血小板输血指征的非急诊手术用血的急诊患儿中,及时组、延时组和未输血组之间的临床结局没有差异。输血时机进一步需要大样本的循证研究加以确定。
Objective To investigate the influence of blood transfusion timing on blood transfusion efficacy and clinical prognosis in children under the strain of blood bank resources during COVID-19 pandemic. Methods This retrospective cohort study included clinical outcomes of pediatric emergency patients who applied for blood transfusion in Guangzhou Women and Children's Hospital from January 2020 to December 2020. Results A total of 566 children applicated blood transfusion for red blood cells and platelets for non-emergency surgical use were enrolled, including 260 red blood cells cases and 306 platelets cases. Among the 260 applications for red blood cells, 209 cases received timely transfusion, 40 cases received delayed transfusion, and 11 cases did not receive transfusion.The effective rate of transfusion for red blood cells was 37.8% in the timely group and 35.0% in the delayed group (P=0.737). One death case with poor prognosis was found in the timely transfusion group, and the clinical prognosis of the rest cases was good. There was no statistical difference in the clinical outcomes among the three groups (P=0.886). Among 306 applications for platelet, 195 cases had timely transfusion, 108 cases had delayed transfusion, and 13 cases did not had transfusion.One case with poor prognosis died in the timely transfusion group (0.51%), and three with poor prognosis died in the delayed transfusion group (2.78%). The rest of the cases had good clinical prognosis, and there was no statistical difference in clinical outcomes among the three groups (P=0.131). Conclusions There were no significant differences in clinical outcomes among the timely transfusion group, the delayed transfusion group, and the non-transfusion group for red blood cell and platelet transfusion respectively. The timing of transfusion may need to be determined by evidence-based studies with large samples.
专题论著: 新型冠状病毒肺炎

天津市三级综合医院疫情期间医护人员代谢综合征与高同型半胱氨酸血症的关系及靶器官损害的研究

Study on the relationship of metabolic syndrome and hyperhomocysteinemia and target organ damage among medical staff in a Tianjin third-class general hospital during the pandemic period

:11-16
 
目的 了解疫情期间医护人员代谢综合征(MS)、高同型半胱氨酸血症(HHcy)的患病率、二者关系及靶器官损害。方法 选取2020年1月—2021年11月在天津市某三级综合医院的1 544名医护人员作为研究对象。测量人体指标,测定血液生化、免疫等指标。分析MS及其组分的患病率、HHcy的患病率及靶器官损害。采用χ2检验,比较MS组、HHcy组与对照组靶器官损害的差异。采用Logistic回归模型分析MS与HHcy的关系。结果 三级综合医院医护人员疫情期间MS患病率为23.7%,MS组分:中心性肥胖、高血压/高血压病、高甘油三酯、低高密度脂蛋白和高空腹葡萄糖/糖尿病的患病率分别为49.4%、19.3%、24.3%、0.5%和37%。HHcy的患病率为29.7%。MS组、HHcy组与对照组靶器官损害程度差异有统计学意义(P<0.001)。HHcy与MS无直接相关性。结论 疫情期间医护人员MS和HHcy患病率较高,与对照组相比有明显的靶器官损害,HHcy不是MS的独立危险因素。
Objective To explore the prevalence of metabolic syndrome (MS) and hyperhomocysteinemia (HHcy), their relationship and target organ damage among medical staff during the pandemic. Methods A total of 1 544 medical staff in a third-class general hospital in Tianjin from January 2020 to November 2021 were selected as the object of study. The indexes of human body were measured, and the indexes of blood biochemistry and immunity were detected. The prevalence of MS and its components, the prevalence of HHcy and target organ damage were analyzed. χ2 test was used to analyze the difference of target organ damage among MS group, HHcy group and control group. The relationship between HHcy and MS was analyzed by Logistic regression model. Results The prevalence of MS among medical staff in the third-class general hospital during the pandemic was 23.7%. The prevalence of central obesity, hypertension / hypertension disease, high triglyceride, low high density lipoprotein cholesterol and high fasting plasma glucose/diabetes were 49.4%, 19.3%, 24.3%, 0.5% and 37%, respectively. The prevalence of HHcy was 29.7%. There was significant difference in target organ damage among MS group, HHcy group and control group (P<0.001). There was no direct correlation between HHcy and MS. Conclusions During the pandemic period, the prevalence of MS and HHcy in medical staff were high, and there was obvious target organ damage in those staff compared with the control staff. HHcy is not an independent risk factor of MS.
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