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Objective:To explore the occurrence time and risk factors of deep vein thrombosis (DVT) in patients with acute cerebral infarction, so as to guide clinical prevention and treatment.Methods:1 129 patients with acute cerebral infarction treated in Beijing Tiantan Hospital from May 2014 to May 2016 were selected as the research objects. According to whether DVT occurred, the patients were divided into DVT group ( n=22) and non DVT group ( n=1 107); The information was analyzed retrospectively and the occurrence time of DVT was counted. The independent risk factors of acute cerebral infarction complicated with DVT were analyzed by univariate and multivariate logistic regression. Results:The time of DVT in patients with acute cerebral infarction was 10.5 (4-14) days. Univariate analysis showed that there were significant differences in age, gender, atrial fibrillation, smoking, drinking, chronic obstructive pulmonary disease, peripheral artery disease, renal failure, anticoagulants, BMI, white blood cell, blood glucose at admission and length of stay between the DVT group and the non DVT group ( P<0.05). Multiple factors further confirmed that renal failure [odds ratio ( OR)=57.421; 95% confidence interval ( CI), 5.792-569.314)] and length of hospital stay ( OR=1.148; 95% CI: 1.071-1.232) were independent risk factors for DVT. Conclusions:The median time of DVT in patients with acute cerebral infarction was 10.5 days. Renal failure and hospital stay were independent influencing factors of DVT in patients with acute cerebral infarction. This is helpful to determine the best prevention and treatment duration of DVT in patients with acute cerebral infarction, make rational use of medical resources and formulate personalized prevention and treatment strategies.
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Objective:To investigate the predictive value of pressure ulcer score and fall score and NIHSS scale for discharge outcome in patients with acute ischemic stroke (AIS).Methods:From January 2014 and November 2018, 4 468 patients with AIS who were treated in Hebei Province Renqiu Kangjixintu Hospital were selected as the research object. According to the modified Rankin scale (mRS) score standard discharge, mRS score in 0 to 2 scores was defined as good discharge outcome, and mRS score ≥3 scores defined as bad discharge outcome. Predictive value of pressure ulcer score, fall score and NIHSS score for the discharge outcome of AIS was analyzed.Results:The score of pressure ulcer in the group with bad discharge outcome was significantly lower than that in the group with good discharge outcome: (16.96 ± 2.89) scores vs. (19.91 ± 1.71) scores, the score of fall and NIHSS in the group with bad discharge outcome were higher than that in the group with good discharge outcome, with statistical significance: (6.66 ± 1.77) scores vs. (5.21 ± 1.64) scores, (7.34 ± 5.08) scores vs. (3.15 ± 2.21) scores ( P<0.01). The cutoff values of pressure sore score, fall score and NIHSS score for predicting adverse discharge outcome were 18.5, 5.5 and 3.5 scores, respectively. The area under the curve (AUC) was 0.809, 0.731 and 0.863, respectively. The sensitivity was 86.00%, 76.200% and 78.30%, and the specificity was 64.00%, 59.50% and 80.60%. The pressure ulcer score, fall score and NIHSS score had statistical difference in predicting the adverse outcome of discharge ( P<0.01). Conclusions:The pressure ulcer score, fall score and NIHSS score have good predictive value for the discharge outcome of AIS. The lower the pressure ulcer score and the higher fall score and NIHSS score are, the higher the risk of poor discharge outcome of AIS is. Actively controlling the occurrence of pressure ulcers and falls can effectively reduce the risk of poor discharge outcome of AIS.
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Objective To investigate the potential relationship between neck circumference and obesity related indexes and metabolic disorders associated with insulin resistance.Methods A random cluster sampling method was used to identify study population among the 4 412 60 -70 years old permanent residents in Renqiu region.Face to face health questionnaire,physical examination,laboratory tests were used.According to the gender group,the correlation between neck circumference and obesity related indexes and metabolic disorders associated with insulin resistance were analyzed.Results Comparing neck circumference and waist circumference,waist height ratio, and body mass index(BMI) of man and woman respondents,the differences were statistically significant.Neck circum-ference and waist circumference,waist height ratio,and BMI had positive correlation(male:r =0.752,0.695 and 0.761.W:r =0.707,0.655,0.721,all P <0.01).Increased trends of neck circumference,waist circumference,waist height ratio and BMI coincided with increased trend of thypertension,diabetes,hyperlipidemia and hyperinsulinemia and hyperlipidemia,and no gender differences.With the increase of the neck circumference,the incidence of above mentioned diseases also increased accordingly.Conclusion Neck circumference was associated with obesity related indexes and metabolic disorders associated with insulin resistance.Neck circumference measurement can be used as an effective indicator of central obesity,and had great significance for early prediction and prevention of metabolic disorders associated with clinical insulin resistance.
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Objective To investigate the potential relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei.Methods A random cluster sampling method was used to identify study population among 60 -70 years old residence in Renqiu region, Hebei.In the face of health questionnaire survey,neck vascular ultrasound examination,a total of 4 413 cases,inclu-ding 1 876 males and 2 537 females,the occurrence of carotid artery plaque and stenosis were detected by ultrasound. Carotid ultrasound was used to identify the characteristic of atherosclerotic plaque of bilateral carotid arteries,which were categorized as with and without plaque,single and multiple plaque,homogenous and heterogeneous plaque,and with and without stenosis.Cardiovascular events were defined as composite events of myocardial infarction,cardiovas-cular death,fatal or non -fatal stroke during the subsequent 2 years follow -up after initial evaluation.Multiple Logis-tic regression was performed to identify the association between the characteristics of bilateral carotid arteries and cardiovascular events.Results A total of 4 413 case enrolled in the study.With carotid ultrasound,2 438 cases (55.2%)were found to be with atherosclerotic plaque formation and 235(5.3%)were with carotid artery stenosis. The proportion of single,multiple,homogeneous and heterogeneous plaques were 1 024cases(23.2%),1 114cases (32.0%),1 106cases(25.1%)and 1 333cases(30.2%),respectively.Among them,the single plaque and new cardiovascular and cerebrovascular events occured in 83 cases(P =0.168),the multiple plaques and new cardiovascular and cerebrovascular events occured in 161 cases(P <0.001 ),the homogeneous patch and new cerebral vascular events occured in 98 cases(P =0.032),the non -homogeneous patch and new cerebral vascular events occured in 146 cases(P <0.001),the stenosis and cerebral vascular events occured in 42 cases(P <0.001).Taken the new onset cardiovascular and cerebrovascular events as dependent variable,the single factor analysis showed that the carotid plaques(χ2 =14.969,P <0.001 ),and the multiple plaque(χ2 =22.509,P <0.001 ),the carotid artery stenosis (χ2 =27.561,P <0.001),the homogeneous plaque(χ2 =4.606,P <0.050),the non -homogeneous plaque(χ2 =18.301,P <0.001),the history of hypertension(χ2 =33.709,P <0.001),the high blood fat disease(χ2 =11.262, P <0.001),and the history of diabetes(χ2 =5.525,P <0.050),the coronary heart disease history(χ2 =10.440, P <0.001),the gender(χ2 =5.606,P <0.050),the smoking(χ2 =4.823,P <0.050)and the systolic blood pressure value,were all associated with the new cardio cerebral vascular events.Multivariate analysis showed that,the heterogeneous plaque(β=0.371,P <0.050),the carotid artery stenosis(β=0.621,P <0.050),the history of hypertension(β=0.517,P <0.001)and smoking(β=0.264,P <0.050)were shown to be significantly associates with new onset cardiovascular events.Conclusion The characteristics of atherosclerotic plaque of carotid artery were significantly associated with the subsequent cardiovascular events among 60 -70 years old residence in Renqiu region,Hebei.Routine carotid ultrasound screening might be useful for identify those people with high risk of develo-ping cardiovascular events.
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Objective To investigate the relationship between snoring and newly-diagnosed type 2 diabetes mellitus among elderly urban and rural residents in Renqiu of Hebei province.Methods By random clustered sam-pling inspection,the residents aged 60 to 70 years old were selected in the study,the questionnaire investigation by an-thropometric measurements and laboratory tests were performed in 5 010 elderly people.Screen for 3 604 people who had no previous history of diabetes and currently not to control blood sugar by diet,exercise,medication.The average age was (64.32 ±3.06)years,including 1 608 male(44.6%) and 1 996 female cases(55.4%),snorers 994 cases (27.6%),non-snorers 2 610 cases(72.4%).The patients were followed up for one year.The correlation between snoring and newly-diagnosed type 2 diabetes mellitus was analyzed.Results There were 217 cases(6.0%) of new-ly-diagnosed type 2 diabetes mellitus,which accounted for 79 cases of snoring(36.4%),3 387 cases of non-dia-betic group,which accounted for 915 cases of snoring(27.0%),the difference between the two groups was significant (χ2 =9.003,P<0.05).Took the newly-diagnosed type 2 diabetes mellitus as the dependent variable,univariate analysis showed that gender(OR=0.479,95% CI:0.639~0.852),history of hypertension(OR=1.463,95% CI:1.111~1.927),family history of diabetes(OR=1.768,95% CI:1.259~2.183),history of stroke or TIA(OR=1.549,95%CI:1.106~2.168),central obesity(OR=1.658,95% CI:1.016 ~1.448),BMI≥28kg/m2 (OR=1.063,95% CI:1.025 ~1.102),fasting glucose(OR=2.065,95% CI:1.854 ~2.299),fasting insulin levels (OR=1.021,95%CI:1.008 ~1.035),cholesterol(OR=1.216,95% CI:1.051 ~1.407),triglycerides(OR=1.188,95%CI:1.089~1.296),snoring(OR=1.547,95% CI:1.161 ~2.060) were related with newly-diag-nosed type 2 diabetes mellitus.Multivariate logistic regression analysis showed that gender(OR=0.595,95% CI:0.368~0.963),history of stroke or TIA(OR=1.586,95%CI:1.085~2.318),fasting glucose(OR=2.059,95%CI:1.833~2.312),snoring(OR=1.592,95% CI:1.089~2.328) were independent risk factor for newly-diag-nosed type 2 diabetes mellitus.Conclusion People aged 60 to 70 in Renqiu suffered newly-diagnosed type 2 diabe-tes mellitus population prevalence of snoring, snoring is closely related to the occurrence and development of type 2 diabetes,type 2 diabetes is increased independent risk factor.Positive and effective screening and control on snoring can effectively reduce the incidence of type 2 diabetes.
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Objective The population -based study was conducted in Hebei Renqiu 60 -70 years old resi-dents to evaluate cardiovascular disease morbidity risk in next 10 years,to analyze the related risk factors and provide an objective basis for the prevention and control of cardiovascular diseases in the local areas.Methods Cluster sam-pling method was used to select elderly residents (aged from 60 to 70 years)in Renqiu city as the research subjects. A total of 5 010 cases,2 163 males,2 847 females were included in this study.Investigation contents included health questionnaire,anthropometric and laboratory detection.According to the Framingham Risk Score (FRS),10 -year risk probability of cardiovascular disease was calculated.Research subjects were divided into low risk group (<10%),medium risk group (≥10% and <20%),high -risk group (≥20%),and logistic regression was used to analyze the risk degree of the related risk factors.Results The 10 -year cardiovascular risk median value of 60 -70 years elderly residents was 8.0 (4.0 -16.0),among them male was 16.0 (12.0 -20.0),female was 4.0 (2.0 -6.0).Low risk group had 2 784 cases,accounted for 55.7%;medium risk group had 1 452 cases,accounted for 29.0%,high-risk group had 774 cases,accounted for 15.3%.The most important risk factors were smoking and cholesterol increasing,who contributes elderly residents aged 60 to 70 years in Renqiu cardiovascular 10 -year risk.The history of stroke,excessive drinking,waist circumference,diastolic blood pressure,elevated uric acid level and HOMA -IR were the independent risk factors in moderately high risk 10 -year probability of cardiovascular.Conclusion The elderly residents aged 60 to 70 years in Renqiu has higher cardiovascular risk of 10 years.Quitting smoking,limitting alcohol,controlling of blood pressure,blood lipids,uric acid,waist circumference and HOMA -IR are important to improve cardiovascular 10 -year risk.Among them,quit smoking and alcohol limit are the most effective measures.