Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 ...Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including int展开更多
目的研究阿托伐他汀对血压控制正常的高血压肾病患者蛋白尿的治疗作用及其与CRP和IL-6的关系.方法52例血压控制正常的高血压肾病患者随机分为他汀组(26例)或对照组(26例),分别给与阿托伐他汀(10 mg)或安慰剂治疗3月,观察血压(SBP/DBP)...目的研究阿托伐他汀对血压控制正常的高血压肾病患者蛋白尿的治疗作用及其与CRP和IL-6的关系.方法52例血压控制正常的高血压肾病患者随机分为他汀组(26例)或对照组(26例),分别给与阿托伐他汀(10 mg)或安慰剂治疗3月,观察血压(SBP/DBP)、血浆C-反应蛋白(CRP)、白介素-6(IL-6)、血脂(TG、TC、HDL-C、LDL-C)、肌酐(Cr)、肌酐清除率(Ccr)、24 h尿蛋白(U-pro)和尿酸(UA)的变化.结果治疗3月后,与对照组比较,他汀组的U-pro(510.3±320.7 vs 748.3±411.6)mg/d、CRP(2.6±1.0 vs 3.7±1.4)mg/L和IL-6(133.6±37.7 vs 165.5±50.5)ng/L均显著降低(P<0.05~0.01),并较治疗前的基线值分别下降27%、25%和18%(P<0.01),且尿蛋白的减少量(△U-pro)与CRP和IL-6的变化值[△CRP(P<0.001)和△IL-6(P<0.001)]及基线的HDL-C值(P=0.029)呈线性相关;而两组间的Cr、Ccr无显著改变(P>0.05).结论阿托伐他汀能减轻高血压肾病的蛋白尿,该作用可能通过降脂以外的降低炎症因子CRP、IL-6的抗炎作用实现.展开更多
文摘Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including int
文摘目的研究阿托伐他汀对血压控制正常的高血压肾病患者蛋白尿的治疗作用及其与CRP和IL-6的关系.方法52例血压控制正常的高血压肾病患者随机分为他汀组(26例)或对照组(26例),分别给与阿托伐他汀(10 mg)或安慰剂治疗3月,观察血压(SBP/DBP)、血浆C-反应蛋白(CRP)、白介素-6(IL-6)、血脂(TG、TC、HDL-C、LDL-C)、肌酐(Cr)、肌酐清除率(Ccr)、24 h尿蛋白(U-pro)和尿酸(UA)的变化.结果治疗3月后,与对照组比较,他汀组的U-pro(510.3±320.7 vs 748.3±411.6)mg/d、CRP(2.6±1.0 vs 3.7±1.4)mg/L和IL-6(133.6±37.7 vs 165.5±50.5)ng/L均显著降低(P<0.05~0.01),并较治疗前的基线值分别下降27%、25%和18%(P<0.01),且尿蛋白的减少量(△U-pro)与CRP和IL-6的变化值[△CRP(P<0.001)和△IL-6(P<0.001)]及基线的HDL-C值(P=0.029)呈线性相关;而两组间的Cr、Ccr无显著改变(P>0.05).结论阿托伐他汀能减轻高血压肾病的蛋白尿,该作用可能通过降脂以外的降低炎症因子CRP、IL-6的抗炎作用实现.