全身免疫炎症指数对STEM...死相关动脉自发再通预测价值_徐杰.pdf

激发经气运行,促进胃腑顺降,同时又可减少芳香伤阴的药物不良反应。本研究结果显示,笔者医院的健脾活血疏肝解郁通络止痛方结合芳香醒胃中药香包穴位热敷治疗方案与对照组比较,能有效改善 DGP 患者临床症状,治疗 DGP 整体疗效更显著,尤其对伴有体重指数偏低或偏重的患者,能适当增减体重,双向调节 BMI,以达到更理想的体重状态,且复发率更低,不良反应更小,更能提高患者生存质量,大大提高了患者就诊的满意度。因此,笔者认为口服笔者医院院内协定处方 糖胃方并结合芳香醒胃中药穴位热敷,诸药相合能开启中焦脾胃枢纽,升降有序,运化正常,是一种值得在临床中推广运用于治疗糖尿病胃轻瘫病症的具有中医内外合治特色的治疗方案。参考文献1 闵嘉慧,杨雪丽,黄文婷,等.中医治疗糖尿病胃轻瘫的研究现状J.按摩与康复医学,2019,10(2):45-472 姚金,唐雨兰.针刺治疗糖尿病胃轻瘫的临床随机对照研究J.成都中医药大学学报,2018,41(1):75-783 高彩霞,徐志强,祝捷,等.糖尿病胃轻瘫中医研究近状 J.世界中医药,2016,11(4):748-7514 Cai H,Li G,Zhang P,et al.Effect of exercise on the quality of lifein type 2diabetes mellitus:a systematic reviewJ.Qual Life Res,2017,26(3):515-5305 郭海洋,李春雨,赵广明,等.益气健脾中药复方对糖尿病胃轻瘫大鼠胃动力的调控作用及机制J.解放军医学杂志,2019,8:659-6656 中华医学会糖尿病学分会.中国 2 型糖尿病防治指南(2020 年版)J.国际内分泌代谢杂志,2021,41(5):482-5487 Lacy BE,Tack J,Gyawali CP.AGA clinical practice update onmanagement of medically refractory gastroparesis:expert review J.Clin Gastroenterol Hepatol,2022,3:491-5008 周仲瑛.中医内科学M.北京:中国中医药出版社,2003:207-2149 Revicki DA,Camilleri M,Kuo B,et al.Evaluating symptom out-comes in gastroparesis clinical trials:validity and responsiveness of theGastroparesis Cardinal Symptom Index-Daily Diary(GCSI-DD)J.Neurogastroenterol Motil,2012,24(5):456-46310宋妍瑾,王栩,李鑫举,等.调理脾胃针法治疗糖尿病胃轻瘫及对跨膜蛋白 16A 的影响J.中国针灸,2020,40(8):811-81511陈海艳,许光远,张晓明.健脾疏肝法对糖尿病胃轻瘫患者的临床作用及焦虑状态的影响 J.医学食疗与健康,2020,18(24):28-2912王晶,张世洋,盛永成,等.白术治疗胃肠道疾病药理作用研究进展J.中华中医药学刊,2018,36(12):2854-285813张晓娟,赵良友,李建华,等.中药枳实的研究概况J.中医药学报,2021,49(1):94-10014宋金泽,衣彤彤.用水提法与醇提法提取中药枳实中辛弗林的效果比较J.当代医药论丛,2019,17(1):186-18715Namazi M,Amir Aaas,Jannesari S,et al.Effects of Citrus auranti-um(bitter orange)on the severity of first-stage labor painJ.Iran JPharm Res,2014,13(3):101116王博龙,刘志强.枳实芍药散“成分-靶点-通路”的网络药理学研究J.中药新药与临床药理,2018,29(5):586-594(收稿日期:2022-04-29)(修回日期:2022-05-05)基金项目:国家自然科学基金资助项目(81900216);江苏省徐州市科技项目(KC21067)作者单位:221000徐州医科大学附属医院心内科通信作者:钱文浩,电子信箱:xyfyqwh 全身免疫炎症指数对 STEMI 患者梗死相关动脉自发再通预测价值徐杰杲建波赵燕茹王亦骁李芳芳钱文浩摘要目的探究全身免疫炎症指数(systemic immune-inflammation index,SII)作为一种新型炎症指标对心肌梗死患者梗死相关动脉(infarct-related artery,IRA)自发再通的预测价值。方法连续纳入 2021 年 1 12 月就诊于徐州医科大学附属医院急诊科,并于发病 12h 内行直接经皮冠状动脉介入治疗术治疗的 ST 段抬高型心肌梗死(ST segment elevation myocardial infarc-tion,STEMI)患者,根据术中显示的冠状动脉造影结果将患者分为自发再通组(n=61)和非自发再通组(n=151)。回顾性分析两组 STEMI 患者的临床基线资料特征、实验室结果,并采用 Logistic 回归筛选梗死相关动脉自发再通的影响因素,采用受试者工作特征曲线评价入院 SII 水平预测梗死相关动脉自发再通的价值。结果两组患者 SII、血小板计数与淋巴细胞计数比值、高敏 C401论著J Med Res,February 2023,Vol.52 No.2反应蛋白、谷草转氨酶、左心室射血分数、肌钙蛋白 I 峰值、超敏肌钙蛋白 T 峰值等比较,差异有统计学意义(P 0.05)。二元多因素 Logistic 回归分析显示,SII 是 IRA 自发再通最强的独立预测因子(OR=0.997,95%CI:0.995 0.999,P=0.001)。SII 预测IRA 自发再通的受试者工作特征曲线曲线下面积为 0.826(95%CI:0.764 0.888),截断值为 1344.12,此时敏感度为 72.2%,特异性为 80.3%,具有预测价值(P 0.001)。结论SII 可能与 STEMI 患者 IRA 自发再通独立相关,并对自发再通有一定的预测价值。关键词全身免疫炎症指数经皮冠状动脉介入治疗术急性心肌梗死梗死后自发再通冠状动脉粥样硬化性心脏病中图分类号R541文献标识码ADOI 10.11969/j.issn.1673-548X.2023.02.021Predictive Value of Systemic Immune Inflammation Index for Spontaneous Recanalization of Infarct-related Arteries in Patients with STE-MI.XU Jie,GAO Jianbo,ZHAO Yanru,et al.The Affiliated Hospital of Xuzhou Medical University,Jiangsu 221002,ChinaAbstractObjectiveTo explore the predictive value of systemic immune inflammation index(SII)as a new inflammatory makerfor spontaneous recanalization of infarct-related artery(IRA)in patients with myocardial infarction.MethodsSTEMI patients whowere admitted to Department of Emergency,the affiliated Hospital of Xuzhou Medical University from January 2021 to December 2021 andreceived direct percutaneous coronary intervention within 12h were selected,they were divided into spontaneous recanalization group(n=61)and non-spontaneous recanalization group(n=151)according to the results of coronary angiography.The clinical baseline data andlaboratory results of the two groups of patients with STEMI were analyzed retrospectively,and Logistic regression was used to screen the in-fluencing factors of spontaneous recanalization of IRA.Receiver operating characteristic curve was used to evaluate the predictive value ofadmission SII level for spontaneous recanalization of IRA.ResultsThere were significant differences in SII,ratio of platelet count tolymphocyte count,high sensitivity C-reactive protein,glutamic-oxaloacetic transaminase,left ventricular ejection fraction,peak valueof troponin I and peak value of hypersensitive troponin T between the two groups(P 0.05).Multivariate Logistic regression analysisshowed that SII was the strongest independent predictor of spontaneous recanalization of IRA(OR=0.997,95%CI:0.995-0.999,P=0.001).The area under the of receiver operating characteristic cure of IRA spontaneous recanalization predicted by SII was 0.826(95%CI:0.764-0.888),the cut-off value was 1344.12,the sensitivity was 72.2%,and the specificity was 80.3%,which hadpredictive value(P 0.001).ConclusionSII may be independently related to spontaneous recanalization of IRA in patients with STE-MI,and has a certain predictive value for spontaneous recanalization.Key wordsSystemic immune inflammatory index;Percutaneous coronary intervention;Acute myocardial infarction;Spontaneou