Реферат
Objective:To explore the correlation between middle cerebral artery (MCA) pulsatility index (PI) and total magnetic resonance imaging (MRI) burden in elderly patients with cerebral small vessel diseases (CSVD).Methods:A total of 203 CSVD inpatients aged 60 years and above who were hospitalized in the Department of Neurology of Hebei General Hospital from March 2017 to December 2020 were enrolled. The clinical data, transcranial Doppler ultrasound parameters and brain MRI data were collected. According to the total burden score, the patients were divided into low burden group (0-1 point) and high burden group (2-4 points). Univariate and multivariate Logistic regression analysis was used to analyze the correlation between MCA PI and total MRI burden in the elderly patients with CSVD. Subsequently, the receiver operating characteristic curve was used to evaluate the value of MCA PI for predicting the high MRI burden of CSVD in the elderly.Results:Hypertension ( OR=2.569, 95% CI 1.068-6.182, P=0.035), systolic blood pressure ( OR=1.033, 95% CI 1.006-1.061, P=0.016), creatinine ( OR=1.044, 95% CI 1.009-1.079, P=0.013) and MCA PI ( OR=1.125, 95% CI 1.087-1.166, P<0.001) were independently correlated with the increasing total MRI burden in the elderly patients with CSVD. Spearman rank correlation analysis revealed that there was strong and positive correlation between MCA PI and high MRI burden in the elderly patients with CSVD ( r=0.65, P<0.001). The analysis showed that when the cut-off for MCA PI was 1.11, it could identify high MRI burden of CSVD in the elderly. The area under the curve was 0.908 (95% CI 0.864-0.953, P<0.001). The sensitivity and specificity were 0.852 and 0.880, respectively. The positive predictive value was 92.38%, and the negative predictive value was 77.70%. Conclusion:The MCA PI is positively correlated with total MRI burden in the elderly patients with CSVD, and has a higher value in predicting the total MRI burden in the elderly CSVD patients, which probably bring brighter prospects for its clinical application.
Реферат
Objective:To systematically evaluate the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing hip fracture surgery.Methods:PubMed, Embase, Cochrance Library, CBM, CNKI and Wanfang Databases were searched.Search strategy was subject word combined with random word.The case control and cohort studies involving the influencing factors for PPCs in elderly patients undergoing hip fracture from January 2000 to November 2020 were retrieved.PPCs included pneumonia, aspiration pneumonitis, pulmonary infections, respiratory failure, atelectasis and pleural effusion, etc.The quality of literatures was assessed by using Newcastle-Ottawa Scale, data were extracted and analysis was performed using RevMan5.3 software.Results:A total of 18 studies were finally enrolled, including 15 case control studies and 3 cohort studies.The results of analysis showed that the advanced age, male, history of smoking, low body mass index, history of cerebrovascular accident, history of chronic obstructive pulmonary disease, history of diabetes, preoperative albumin concentration<35 g/L, preoperative hemoglobin concentration<120 g/L, American Society of Anesthesiologists Physical Status classification≥Ⅲ, operation delay≥48 h and general anesthesia were the risk factors for PPCs ( P<0.05). Conclusions:There are numerous risk factors for PPCs in elderly patients undergoing hip fracture surgery, and advanced age, male, history of smoking, low body mass index, history of cerebrovascular accident, history of chronic obstructive pulmonary disease, history of diabetes, preoperative albumin concentration<35 g/L, preoperative hemoglobin concentration<120 g/L, American Society of Anesthesiologists Physical Status classification≥Ⅲ, operation delay≥48 h and general anesthesia are the risk factors for PPCs in elderly patients undergoing hip fracture surgery.