AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on phys...AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP ≥ 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period ofthe first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shoc展开更多
AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment s...AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment syndrome （ACS）.METHODS： Patients （η = 44） with AP recruited in this study were divided into two groups （ACS and non-ACS） according to intra-abdominal pressure （IAP） determined by indirect measurement using the transvesical route via Foley bladder catheter. On admission and at regular intervals, the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems： Glasgow-Imrie score, Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE-Ⅱ） score, and Multiorgan Dysfunction Score （MODS）. The diagnostic performance of scores predicting ACS development, cut-off values and specificity and sensitivity were established using receiver operating characteristic （ROC） curve analysis.RESULTS： The incidence of ACS in our study population was 19.35%. IAP at admission in the ACS group was 22.0 （18.5-25.0） mmHg and 9.25 （3.0-12.4） mmHg in the non-ACS group （P 〈 0.01）. Univariate statistical analysis revealed that patients in the ACS group had significantly higher multifactorial clinical scores （APACHE Ⅱ, Glasgow-Imrie and MODS） on admission and higher maximal scores during hospitalization （P 〈 0.01）. ROC curve analysis revealed that APACHE Ⅱ, Glasgow-Imrie, and MODS are valuable tools for early prediction of ACS with high sensitivity and specificity, and that cut-off values are similar to those used for stratification of patients with severe acute pancreatitis （SAP）.CONCLUSION： IAH and ACS are rare findings in patients with mild AR Based on the results of our study we recommend measuring the IAP in cases when patients present with SAP （APACHE Ⅱ 〉 7; MODS 〉 2 or Glasgow-Imrie score 〉 3）.展开更多
目的:系统评价口服硝苯地平与静脉注射拉贝洛尔分别治疗妊娠期高血压急症的有效性及安全性。方法:通过检索数据库,搜集口服硝苯地平与静脉注射拉贝洛尔分别治疗妊娠期高血压急症的相关随机对照试验,根据Cochrane系统评价方法对纳入的研...目的:系统评价口服硝苯地平与静脉注射拉贝洛尔分别治疗妊娠期高血压急症的有效性及安全性。方法:通过检索数据库,搜集口服硝苯地平与静脉注射拉贝洛尔分别治疗妊娠期高血压急症的相关随机对照试验,根据Cochrane系统评价方法对纳入的研究进行质量评价,采用Rev Man 5.3软件进行文献荟萃(Meta)分析。结果:纳入7个随机对照试验,共480例患者。Meta分析结果显示,与静脉注射拉贝洛尔组患者比较,口服硝苯地平组患者达到目标血压所需时间明显更短,差异有统计学意义(MD=-12.12,95%CI=-20.25^-3.99,P=0.003);2组患者达到目标血压所用治疗剂量与初始剂量比值的差异无统计学意义(MD=-0.51,95%CI=-1.08~0.05,P=0.07)。安全性方面,两组围产期妇女不良反应发生率(OR=0.98,95%CI=0.27~3.50,P=0.97)、5 min Apgar评分<7分的新生儿数(OR=0.42,95%CI=0.14~1.25,P=0.12)及重症监护住院新生儿数(OR=0.74,95%CI=0.43~1.29,P=0.29)比较,差异均无统计学意义。结论:口服硝苯地平与静脉注射拉贝洛尔都可以用于治疗妊娠期高血压急症,口服硝苯地平达到目标血压需要的时间更少,但仍需要更多设计严格的大样本随机对照研究为临床提供更可靠的证据。展开更多
目的探讨降压治疗对急性缺血性脑卒中预后的影响,比较早期降压与晚期降压的差异。方法纳入2018-10—2020-08包头医学院第一附属医院神经内科急性脑梗死合并血压升高的患者54例,随机分为早期降压组和晚期降压组,记录2组患者14 d、30 d NI...目的探讨降压治疗对急性缺血性脑卒中预后的影响,比较早期降压与晚期降压的差异。方法纳入2018-10—2020-08包头医学院第一附属医院神经内科急性脑梗死合并血压升高的患者54例,随机分为早期降压组和晚期降压组,记录2组患者14 d、30 d NIHSS评分和30 d、90 d mRS评分,比较2组预后。结果早期和晚期降压组患者在发病后14 d、30 d NIHSS评分比较差异均无统计学意义(P>0.05)。早期和晚期降压组患者在发病后30 d、90 d mRS评分比较差异均无统计学意义(P>0.05)。结论缺血性脑卒中急性期降压可能不获益,降压时间的早晚可能对预后无影响。展开更多
BACKGROUND The incidence of hypertriglyceridemia(HTG)-induced acute pancreatitis(AP)is steadily increasing in China,becoming the second leading cause of AP.Clinical complications and outcomes associated with HTG-AP ar...BACKGROUND The incidence of hypertriglyceridemia(HTG)-induced acute pancreatitis(AP)is steadily increasing in China,becoming the second leading cause of AP.Clinical complications and outcomes associated with HTG-AP are generally more severe than those seen in AP caused by other etiologies.HTG-AP is closely linked to metabolic dysfunction and frequently coexists with metabolic syndrome or its components.However,the impact of metabolic syndrome components on HTGAP clinical outcomes remains unclear.AIM To investigate the impact of metabolic syndrome component burden on clinical outcomes in HTG-AP.METHODS In this retrospective study of 255 patients diagnosed with HTG-AP at the First Affiliated Hospital of Guangxi Medical University,we collected data on patient demographics,clinical scores,complications,and clinical outcomes.Subsequently,we analyzed the influence of the presence and number of individual metabolic syndrome components,including obesity,hyperglycemia,hypertension,and low high-density lipoprotein cholesterol(HDL-C),on the aforementioned parameters in HTG-AP patients.RESULTS This study found that metabolic syndrome components were associated with an increased risk of various complications in HTG-AP,with low HDL-C being the most significant risk factor for clinical outcomes.The risk of complications increased with the number of metabolic syndrome components.Adjusted for age and sex,patients with highcomponent metabolic syndrome had significantly higher risks of renal failure[odds ratio(OR)=3.02,95%CI:1.12-8.11)],SAP(OR=5.05,95%CI:2.04-12.49),and intensive care unit admission(OR=6.41,95%CI:2.42-16.97)compared to those without metabolic syndrome.CONCLUSION The coexistence of multiple metabolic syndrome components can synergistically worsen the clinical course of HTGAP,making it crucial to monitor these components for effective disease management.展开更多
文摘AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP ≥ 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period ofthe first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shoc
文摘AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment syndrome （ACS）.METHODS： Patients （η = 44） with AP recruited in this study were divided into two groups （ACS and non-ACS） according to intra-abdominal pressure （IAP） determined by indirect measurement using the transvesical route via Foley bladder catheter. On admission and at regular intervals, the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems： Glasgow-Imrie score, Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE-Ⅱ） score, and Multiorgan Dysfunction Score （MODS）. The diagnostic performance of scores predicting ACS development, cut-off values and specificity and sensitivity were established using receiver operating characteristic （ROC） curve analysis.RESULTS： The incidence of ACS in our study population was 19.35%. IAP at admission in the ACS group was 22.0 （18.5-25.0） mmHg and 9.25 （3.0-12.4） mmHg in the non-ACS group （P 〈 0.01）. Univariate statistical analysis revealed that patients in the ACS group had significantly higher multifactorial clinical scores （APACHE Ⅱ, Glasgow-Imrie and MODS） on admission and higher maximal scores during hospitalization （P 〈 0.01）. ROC curve analysis revealed that APACHE Ⅱ, Glasgow-Imrie, and MODS are valuable tools for early prediction of ACS with high sensitivity and specificity, and that cut-off values are similar to those used for stratification of patients with severe acute pancreatitis （SAP）.CONCLUSION： IAH and ACS are rare findings in patients with mild AR Based on the results of our study we recommend measuring the IAP in cases when patients present with SAP （APACHE Ⅱ 〉 7; MODS 〉 2 or Glasgow-Imrie score 〉 3）.
文摘目的:系统评价口服硝苯地平与静脉注射拉贝洛尔分别治疗妊娠期高血压急症的有效性及安全性。方法:通过检索数据库,搜集口服硝苯地平与静脉注射拉贝洛尔分别治疗妊娠期高血压急症的相关随机对照试验,根据Cochrane系统评价方法对纳入的研究进行质量评价,采用Rev Man 5.3软件进行文献荟萃(Meta)分析。结果:纳入7个随机对照试验,共480例患者。Meta分析结果显示,与静脉注射拉贝洛尔组患者比较,口服硝苯地平组患者达到目标血压所需时间明显更短,差异有统计学意义(MD=-12.12,95%CI=-20.25^-3.99,P=0.003);2组患者达到目标血压所用治疗剂量与初始剂量比值的差异无统计学意义(MD=-0.51,95%CI=-1.08~0.05,P=0.07)。安全性方面,两组围产期妇女不良反应发生率(OR=0.98,95%CI=0.27~3.50,P=0.97)、5 min Apgar评分<7分的新生儿数(OR=0.42,95%CI=0.14~1.25,P=0.12)及重症监护住院新生儿数(OR=0.74,95%CI=0.43~1.29,P=0.29)比较,差异均无统计学意义。结论:口服硝苯地平与静脉注射拉贝洛尔都可以用于治疗妊娠期高血压急症,口服硝苯地平达到目标血压需要的时间更少,但仍需要更多设计严格的大样本随机对照研究为临床提供更可靠的证据。
文摘目的探讨降压治疗对急性缺血性脑卒中预后的影响,比较早期降压与晚期降压的差异。方法纳入2018-10—2020-08包头医学院第一附属医院神经内科急性脑梗死合并血压升高的患者54例,随机分为早期降压组和晚期降压组,记录2组患者14 d、30 d NIHSS评分和30 d、90 d mRS评分,比较2组预后。结果早期和晚期降压组患者在发病后14 d、30 d NIHSS评分比较差异均无统计学意义(P>0.05)。早期和晚期降压组患者在发病后30 d、90 d mRS评分比较差异均无统计学意义(P>0.05)。结论缺血性脑卒中急性期降压可能不获益,降压时间的早晚可能对预后无影响。
基金Supported by the National Natural Science Foundation of China,No.82260539Guangxi Natural Science Foundation,No.2024GXNSFAA010072。
文摘BACKGROUND The incidence of hypertriglyceridemia(HTG)-induced acute pancreatitis(AP)is steadily increasing in China,becoming the second leading cause of AP.Clinical complications and outcomes associated with HTG-AP are generally more severe than those seen in AP caused by other etiologies.HTG-AP is closely linked to metabolic dysfunction and frequently coexists with metabolic syndrome or its components.However,the impact of metabolic syndrome components on HTGAP clinical outcomes remains unclear.AIM To investigate the impact of metabolic syndrome component burden on clinical outcomes in HTG-AP.METHODS In this retrospective study of 255 patients diagnosed with HTG-AP at the First Affiliated Hospital of Guangxi Medical University,we collected data on patient demographics,clinical scores,complications,and clinical outcomes.Subsequently,we analyzed the influence of the presence and number of individual metabolic syndrome components,including obesity,hyperglycemia,hypertension,and low high-density lipoprotein cholesterol(HDL-C),on the aforementioned parameters in HTG-AP patients.RESULTS This study found that metabolic syndrome components were associated with an increased risk of various complications in HTG-AP,with low HDL-C being the most significant risk factor for clinical outcomes.The risk of complications increased with the number of metabolic syndrome components.Adjusted for age and sex,patients with highcomponent metabolic syndrome had significantly higher risks of renal failure[odds ratio(OR)=3.02,95%CI:1.12-8.11)],SAP(OR=5.05,95%CI:2.04-12.49),and intensive care unit admission(OR=6.41,95%CI:2.42-16.97)compared to those without metabolic syndrome.CONCLUSION The coexistence of multiple metabolic syndrome components can synergistically worsen the clinical course of HTGAP,making it crucial to monitor these components for effective disease management.
