AIM: To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999. METHODS AND RESULTS: Data were retrospectively...AIM: To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999. METHODS AND RESULTS: Data were retrospectively analyzed by chart review. In 95 cases (72 males and 23 females) sufficient data were available for analysis. Twenty five (29%) of 85 patients were HBsAg or anti HBc positive, 21/85 (25%) were anti HCV positive, and 6/85 (7%) were positive for both HBV and HCV-markers. Age was significantly lower in HBV positive patients than in the other two groups. Thirty one (34%) of 90 patients had histories of alcohol abuse. In 79/94 (84%) patients, cirrhosis was diagnosed. Of these cirrhotic patients, 29/79 (37%) belonged to Child Pugh's group (CHILD) A, 32/79 (40%) to CHILD B, and 18/79 (23%) to CHILD C. AFP was elevated in 61/91 (67%) patients. A single tumor nodule was found in 38/94 (40%), more than one nodule in 31/94 (34%), and 25/94 (26%) had a diffusely infiltrating tumor, i.e. the tumor margins could not be seen on imaging procedures. Portal vein thrombosis was present in 19/94 (20%). Imaging data consistent with lymph node metastases were found in 10/92 (11%), while distant metastases were found in 8/93 (9%). According to Okuda 28/94 (30%) were grouped to stage I, 53/94 (56%) were grouped to stage II, and 13/94 (14%) were grouped to stage II. Survival data were available for 83 patients. The Kaplan-Meier estimate for median survival was 8 4 months. Factors influencing survival were the Okuda score, the presence of portal vein thrombosis, and the presence of ascites. The presence of non complicated liver cirrhosis by itself, distant metastases, or infection with hepatitis viruses did not influence survival. AFP positivity by itself did not influence survival, though patients with an AFP value greater than 100 microg/L did experience shortened survival. Treatment besides tamoxifen or supportive care was associated with prolonged survival. The influence of therapy on survival was most pronounced in Okuda展开更多
目的观察血浆同型半胱氨酸(homocysteine,Hcy)对老年急性脑梗死患者预后的影响。方法选择老年急性脑梗死患者377例。根据入院时血浆Hcy水平分为高Hcy血症组251例和对照组126例,观察2组患者的临床特征,神经功能及残疾评定采用美国国立卫...目的观察血浆同型半胱氨酸(homocysteine,Hcy)对老年急性脑梗死患者预后的影响。方法选择老年急性脑梗死患者377例。根据入院时血浆Hcy水平分为高Hcy血症组251例和对照组126例,观察2组患者的临床特征,神经功能及残疾评定采用美国国立卫生研究院脑卒中量表(the national institutes of health stroke scale,NIHSS)和改良Rankin量表评分,所有患者随访至90d,比较2组预后。结果与对照组比较,高Hcy血症组90d时NIHSS评分<4分、入院时及90d时改良Rankin量表评分0～2分的比例明显升高,颈动脉内膜中层厚度明显增厚,差异有统计学意义(P<0.05)。logistic回归分析显示,高Hcy血症是老年急性脑梗死预后不良的独立危险因素(OR=1.473,95%CI:0.878～3.246,P=0.039)。结论高Hcy的老年急性脑梗死患者神经功能缺损更重,预后不良。展开更多
目的 探讨脑梗死二级预防中阿司匹林抵抗（AR）发生率.随访期AR与脑梗死复发及其他血管事件发生的关系.方法 600例脑梗死患者,入院当Et开始服用阿司匹林,服用7～10 d后检测血小板聚集率,筛选出AR患者及敏感患者,并对患者进行6～24个月随...目的 探讨脑梗死二级预防中阿司匹林抵抗（AR）发生率.随访期AR与脑梗死复发及其他血管事件发生的关系.方法 600例脑梗死患者,入院当Et开始服用阿司匹林,服用7～10 d后检测血小板聚集率,筛选出AR患者及敏感患者,并对患者进行6～24个月随访,观察脑梗死复发及其他血管事件发生情况,采用Logistic回归分析AR及血管事件发生的危险因素和预后.结果 600例脑梗死患者中有AR者150例（25.0%）,敏感者450例（75.0%）;AR组女性、糖尿病患者比例及血低密度脂蛋白（LDL）胆固醇水平均高于阿司匹林敏感组;糖尿病（OR=2.58,95% CI 1.37～4.85,P=0.003）、高LDL血症（OR=1.89,95% CI 1.21～2.93,P=0.005）为AR发生的独立危险因素;AR组随访期脑梗死复发率、心肌梗死发生率以及全因死亡率均高于阿司匹林敏感组;糖尿病（OR=2.47,95% CI 1.36～4.65,P=0.003）、动脉粥样硬化血栓型脑梗死（OR=2.13,95% CI 1.24～3.95,P=0.023）及AR（OR=3.86,95% CI 1.79～5.87,P=0.002）是随访期血管事件发生的独立危险因素,有AR者血管事件发生的风险增加3.86倍.结论 脑梗死二级预防中AR发生率高,AR与脑梗死复发及其他血管事件的发生密切相关.展开更多
基金This research Was supported by a grant from Bonfor(O-107.0022)to C. Rabe
文摘AIM: To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999. METHODS AND RESULTS: Data were retrospectively analyzed by chart review. In 95 cases (72 males and 23 females) sufficient data were available for analysis. Twenty five (29%) of 85 patients were HBsAg or anti HBc positive, 21/85 (25%) were anti HCV positive, and 6/85 (7%) were positive for both HBV and HCV-markers. Age was significantly lower in HBV positive patients than in the other two groups. Thirty one (34%) of 90 patients had histories of alcohol abuse. In 79/94 (84%) patients, cirrhosis was diagnosed. Of these cirrhotic patients, 29/79 (37%) belonged to Child Pugh's group (CHILD) A, 32/79 (40%) to CHILD B, and 18/79 (23%) to CHILD C. AFP was elevated in 61/91 (67%) patients. A single tumor nodule was found in 38/94 (40%), more than one nodule in 31/94 (34%), and 25/94 (26%) had a diffusely infiltrating tumor, i.e. the tumor margins could not be seen on imaging procedures. Portal vein thrombosis was present in 19/94 (20%). Imaging data consistent with lymph node metastases were found in 10/92 (11%), while distant metastases were found in 8/93 (9%). According to Okuda 28/94 (30%) were grouped to stage I, 53/94 (56%) were grouped to stage II, and 13/94 (14%) were grouped to stage II. Survival data were available for 83 patients. The Kaplan-Meier estimate for median survival was 8 4 months. Factors influencing survival were the Okuda score, the presence of portal vein thrombosis, and the presence of ascites. The presence of non complicated liver cirrhosis by itself, distant metastases, or infection with hepatitis viruses did not influence survival. AFP positivity by itself did not influence survival, though patients with an AFP value greater than 100 microg/L did experience shortened survival. Treatment besides tamoxifen or supportive care was associated with prolonged survival. The influence of therapy on survival was most pronounced in Okuda
文摘目的观察血浆同型半胱氨酸(homocysteine,Hcy)对老年急性脑梗死患者预后的影响。方法选择老年急性脑梗死患者377例。根据入院时血浆Hcy水平分为高Hcy血症组251例和对照组126例,观察2组患者的临床特征,神经功能及残疾评定采用美国国立卫生研究院脑卒中量表(the national institutes of health stroke scale,NIHSS)和改良Rankin量表评分,所有患者随访至90d,比较2组预后。结果与对照组比较,高Hcy血症组90d时NIHSS评分<4分、入院时及90d时改良Rankin量表评分0～2分的比例明显升高,颈动脉内膜中层厚度明显增厚,差异有统计学意义(P<0.05)。logistic回归分析显示,高Hcy血症是老年急性脑梗死预后不良的独立危险因素(OR=1.473,95%CI:0.878～3.246,P=0.039)。结论高Hcy的老年急性脑梗死患者神经功能缺损更重,预后不良。
文摘目的 探讨脑梗死二级预防中阿司匹林抵抗（AR）发生率.随访期AR与脑梗死复发及其他血管事件发生的关系.方法 600例脑梗死患者,入院当Et开始服用阿司匹林,服用7～10 d后检测血小板聚集率,筛选出AR患者及敏感患者,并对患者进行6～24个月随访,观察脑梗死复发及其他血管事件发生情况,采用Logistic回归分析AR及血管事件发生的危险因素和预后.结果 600例脑梗死患者中有AR者150例（25.0%）,敏感者450例（75.0%）;AR组女性、糖尿病患者比例及血低密度脂蛋白（LDL）胆固醇水平均高于阿司匹林敏感组;糖尿病（OR=2.58,95% CI 1.37～4.85,P=0.003）、高LDL血症（OR=1.89,95% CI 1.21～2.93,P=0.005）为AR发生的独立危险因素;AR组随访期脑梗死复发率、心肌梗死发生率以及全因死亡率均高于阿司匹林敏感组;糖尿病（OR=2.47,95% CI 1.36～4.65,P=0.003）、动脉粥样硬化血栓型脑梗死（OR=2.13,95% CI 1.24～3.95,P=0.023）及AR（OR=3.86,95% CI 1.79～5.87,P=0.002）是随访期血管事件发生的独立危险因素,有AR者血管事件发生的风险增加3.86倍.结论 脑梗死二级预防中AR发生率高,AR与脑梗死复发及其他血管事件的发生密切相关.
