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Objective To investigate the correlation of HbAlc levels with severity,prognosis and recurrence of patients with cerebral infarction during the acute stage and a year after onset.Methods Prospective cohort study was performed in the clinical data of 228 inpatients with acute cerebral infarction,admitted to our hospital from September 2006 to September 2010.Levels of glycosylated hemoglobin (HbA1c),fasting plasma glucose (FBG),systolic pressure (SBP),diastolic blood pressure (DBP),cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL-C) and high density lipoprotein cholesterol (HDL-C) at the acute stage were detected; the living activity scale (Barthel index,BI) was conducted.According to the levels of HbA1c and FBG at admission,the patients were divided into four groups:groups of HbA1c≥6.1 and FBG≥6.1,group of HbA1c≥6.1 and FBG＜6.1,group of HbA1c＜6.1 and FBG≥6.1,and group of HbA1c＜6.1 and FBG＜6.1.Single-factor analysis of variance was employed to analyze the differences of all the indexes at acute stage between each two groups;correlations of BI scores at acute stage and one year after onset with other indexes were explored; t-test was employed to analyze the differences of all the indexes between patients with and without relapsed cerebral infarction.Results During the acute stage of cerebral infarction,significant differences were noted on levels of TC,TG,LDL-C,SBP and BI scores between each groups (P＜0.05); BI scores were negatively correlated with HbA1c and SBP levels.One year after the onset,the BI scores were negatively correlated with HbA1c,FBG,SBP levels at the acute stage,and HbA1c and FBG levels one year after onset,respectively.Overall recurrence rate was 5.88％ after a year of follow up; the HbA1c,FBG and TG levels at acute stage,and FBG and PBG levels one year after onset showed significant differences between patients with and without relapsed cerebral infarction (P＜0.05).Conclusion Patients with increased HbA1c and FBG levels at the acute stage of cerebral infarction have high risk of abnormalities oflipids and blood pressure; high levels ofHbA1c,FBG and SBP at the acute stage indicate severity of the infarction,and HbA1c and SBP levels at the acute stage and HbAlc and FBG levels one year after the onset are the main factors of poor prognosis; levels ofHbA1c,FBG and TG at the acute stage and PBG and FBG levels one year after the onset are closely related to the recurrence ofischemic stroke.
RESUMO
<p><b>OBJECTIVE</b>To assess the accuracy of a wrist-worn device (Watch-PAT 200) in the diagnosis of obstructive sleep apnea syndrome (OSAHS).</p><p><b>METHODS</b>Forty-three adult subjects with suspected OSAHS simultaneously had a standard in-laboratory polysomnogram (PSG) and wore the Watch-PAT 200 during a full-night recording. PSG sleep and respiratory events were scored according to standard criteria. The PSG recordings were blindly manually analyzed, while Watch-PAT data were scored automatically based on the algorithm developed previously.</p><p><b>RESULTS</b>The mean age of the subjects was (42.2 ± 12.2) years (x(-) ± s), and mean body mass index was (28.0 ± 3.9) kg/m(2). Mean PSG apnea hypopnea index (AHI) was (34.9 ± 29.9) events per hour, and mean PAT-AHI was (36.0 ± 29.2) events per hour. There was a significant correlation between PAT AHI and AHI by PSG (r = 0.931, P < 0.01). A Bland-Altman plot of PAT AHI and PSG AHI was also used to assess the accuracy of Watch-PAT 200. At lower levels of AHI, PAT tended to overestimate disease severity, while at higher levels of AHI, Watch-PAT underestimated severity. To assess sensitivity and specificity of Watch-PAT, constructed receiver operator characteristic curves using a variety of AHI threshold values (5, 15 and 30 events per hour). For AHI ≥ 5 events per hour as threshold value, the Watch-PAT diagnosing rate was 93%, and sensitivity as well as specificity were 94.7% and 80.0%. The misdiagnosis rate and missed diagnosis rate were 20.0% and 5.3%. Optimal combinations of sensitivity and specificity for the AHI threshold values (15 and 30 events per hour) were 82.6% and 100.0%, 95.0% and 95.7% respectively.</p><p><b>CONCLUSION</b>The Watch-PAT 200 may offer an accurate, robust, and reliable ambulatory method for the detection of OSAHS, with minimal patient discomfort.</p>