Background:Cardio-ankle vascular index (CAVI) is an important indicator to evaluate arteriosclerosis. This study was to explore the changes and related factors of CAVI in the elderly population, providing a certain basis for the prevention and control of cardiovascular and cerebrovascular diseases. Methods:1117 subjects (M/F 488/629) were divided into three groups according to age: group 1: subjects with age 60-69 years; group 2: subjects with age 70-79 years; group 3: subjects with age≧80 years. CAVI value was recorded by using the VaseraVS-1000 vascular screening system. Results:There were significant differences about body mass index (BMI), CAVI, systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure, creatinine, fasting plasma glucose (FPG), total cholesterol, high-density lipoprotein cholesterol (HDL-C) and uric acid between these three groups. CAVI value was increasing year by year, with the increasing incidence of hypertension, coronary artery disease and stroke. General Linear Model analysis showed that age, incidence of diabetes mellitus, BMI, DBP and HDL-C were independent associating factors of CAVI in elderly subjects (β = 0.048, p < 0.001; β = 0.349, p = 0.012; β = -0.060, p = 0.001; β = 0.023, p = 0.001; β = -0.530, p = 0.020; respectively). Conclusions:CAVI was increasing with ageing. The influencing factors of CAVI varied among different age groups. Subjects aged 60-69 were needed to pay close attention to blood pressure and subjects aged 70-79 were needed to focus on diabetes meillitus, providing a theoretical basis for intervening in different targets in different age groups, to reduce or delay the progression of arteriosclerosis.

Background:Ankle-brachial index (ABI) is used to diagnose peripheral artery disease. Arterial stiffness could be measured by carotid-femoral pulse wave velocity (CF-PWV). The study was to investigate relationship between ABI and CF-PWV in patients with hypertension and diabetes mellitus. Methods:1577 patients (M/F 812/765) from Department of Vascular Medicine were enrolled. ABI was recorded by VaseraVS-1000 vascular screening system (Fukuda Denshi, Tokyo, Japan). CF-PWV was recorded by Complior apparatus. Results:CF-PWV was significantly higher in hypertension patients with diabetes mellitus than hypertension patients without diabetes mellitus (13.77 ± 3.91 vs 11.83 ± 3.26 m/s, p < 0.05). Right ABI was significantly lower in hypertension patients with diabetes mellitus than hypertension patients without diabetes mellitus (1.062 ± 0.163 vs 1.102 ± 0.105, p < 0.05). Right ABI was negatively correlated with age, systolic blood pressure, CF-PWV and creatinine in entire study group (r = -0.081, p = 0.001; r = -0.069,p < 0.001; r = -0.178, p < 0.001; r = -0.124, p < 0.001, respectively). Multiple linear regressions found that CF-PWV, body mass index (BMI), gender, creatinine, total cholesterol, uric acid and diabetes mellitus were independent associating factors of RABI in all patients (β = -0.168, p < 0.001; β = 0.180, p < 0.001; β = -0.189, p < 0.001; β = -0.102, p = 0.008; β = 0.088, p = 0.004; β = -0.100, p = 0.009;β = -0.062, p = 0.043; respectively). CF-PWV, BMI, gender and HDL-C were independent associating factors of left ABI in all patients (β = -0.170, p < 0.001; β = 0.172, p < 0.001; β = -0.104, p = 0.001; β = 0.074, p = 0.023; respectively). Conclusions:ABI was significantly lower in hypertension patients with diabetes mellitus, with higher level of CF-PWV. CF-PWV was an independent associating factor of ABI, indicating the greater the elasticity of the large arteries, the higher the probability of lower limb artery occlusion.

Background:Abdominal aortic aneurysm (AAA) is a life-threatening condition in the elderly population. The insidious nature of AAA onset makes early detection difficult. Currently, there are few studies on changes in laboratory parameters during AAA development. Methods:This study included 55 elderly patients with AAA who were admitted to the Department of Vascular Medicine, Shougang Hospital, Peking University 2021-2022. Propensity score matching (PSM) in a 1:1 ratio was performed to match the 55 patients and 1,031 controls. In this population of AAA, correlation and regression analyses were used to explore the association between the level of inflammation and each laboratory parameter. Results:Compared to the control group, significant differences in inflammatory markers, transaminase and bilirubin levels, blood urea nitrogen (BUN) and creatinine (Cr) levels, and ankle-brachial index were found in the aneurysm group. After PSM, the differences between the two groups for each parameter remained statistically significant. Correlation and regression analyses showed a weak positive correlation between the inflammatory index and the BUN and Cr levels (correlation coefficient = 0.22). Conclusions:Our study demonstrates the presence of a highly inflammatory state and damage to various organs in patients with AAA. This hyperinflammatory state may be associated with kidney injury and is a cause of concern.

Early identification and management of asymptomatic carotid plaques can reduce the risk of cardiovascular and cerebrovascular events. This study aimed to explore the factors that affect carotid plaques in the Northern Chinese population and construct a nomogram for risk assessment to identify high-risk populations for carotid artery plaques. A cross-sectional study on cardiovascular factors was conducted in Shijingshan District, Beijing, from January 2022 and August to September 2023, targeting individuals aged 18 years and above. Carotid plaques were assessed via carotid ultrasound. LASSO regression was used for feature selection, logistic regression was employed to analyze risk factors, and a risk assessment nomogram was also developed.. The performance was evaluated using the area under the receiver operating characteristic curve (AUC), and the calibration was assessed through the Hosmer‒Lemeshow goodness-of-fit test. The study included a total of 828 subjects, with 558 in the normal group and 270 in the carotid plaque group. Thirty-three risk factors were included in the LASSO regression analysis as independent variables for screening. The results of the adjusted multiple logistic regression analysis show that age (OR = 6.81, 95% CI:4.371-10.758), unmarried marital status (OR = 3.475, 95% CI: 1.927-6.554), current smoking (OR = 2.318, 95% CI: 1.519-3.553), hypertension history (OR = 1.794, 95% CI: 1.123-2.860), dyslipidemia history (OR = 1.920, 95% CI: 1.149-3.215), systolic blood pressure (SBP) (OR = 1.014, 95% CI: 1.004-1.024), GLU (OR = 1.135, 95% CI: 1.017-1.272), and malondialdehyde (MDA) (OR = 1.014, 95% CI: 1.003-1.025) were associated with an increased risk of carotid plaques.In contrast, higher education levels were associated with a lower risk of carotid plaques, with education level (3) (OR = 0.436, 95% CI: 0.208-0.917) and education level (4) (OR = 0.348, 95% CI: 0.170-0.718) indicating a protective association. The constructed nomogram Risk assessment had an AUC of 0.850 (95% CI: 0.823-0.877) and demonstrated good calibration (χ2 = 13.973, P = 0.08246). By integrating age, education level, marital status, current smoking, hypertension history, dyslipidemia history, SBP, GLU and MDA, we developed a high-performance nomogram for assessment., which may be helpful for the early detection and prevention of carotid plaques in the general population. Further studies may be useful to validate the applicability in different regions and populations.

Background:Higher level of carotid-femoral pulse wave velocity (CF-PWV) is indicating higher level of arterial stiffness. China has a population of 1.4 billion, with 1.2 billion population in Han ethnicity, 9.4 million population in Miao ethnicity, 700 thousand population in She ethnicity. We chose these three ethnic groups for analysis, to find some similarities or differences in CF-PWV. Methods:We launched early vascular lesion detection technology promotion involving several regions such as the Han (Beijing), Miao (Guizhou Province), and She (Fujian Province) ethnicity. We conducted population testing in different regions and based on the inclusion and exclusion criteria, 1481 individuals were ultimately included. There were 942 han subjects, 186 Miao subjects and 353 She subjects. The CF-PWV was measured using a Complior device. Results:The CF-PWV was significantly higher in Han population than in Miao and She population. Levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly lower in Han ethnicity than in Miao and She ethnicity. The composition of male, smoking, hypertension and diabetes mellitus were significantly higher in Han ethnicity than in Miao and She ethnicity. Multiple linear regression analysis showed that age, body mass index (BMI), diabetes mellitus, creatinine, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), SBP, and ethnicity were independent associated with the CF-PWV in all subjects. And compared with the Han ethnicity, CF-PWV was significantly lower in Miao and She ethnicity (β= -0.295, β= -0.241, both p<0.001). Conclusion:CF-PWV was significantly higher in Han ethnicity than in Miao and She ethnicity. The factors associated with the CF-PWV differed among different ethnicity indicated that different prevention and control strategies needed to be adopted for different ethnic groups and risk factors in different regions to reduce the progression of arteriosclerosis in the local population.

BACKGROUNDS:The cardio-ankle vascular index (CAVI) is a new index of arteriosclerosis. The present study investigated the relationship between CAVI value and stroke in hypertension patients, especially the prevalence of stroke in patients with CAVI ≧9. METHODS:735 patients (M/F 293/442) with or without hypertension from Department of Vascular Medicine from 01/01/2012-31/21/2014 were divided into four groups: group 1: non-hypertension patients with CAVI<9, group 2: non-hypertension patients with CAVI ≧9, group 3: hypertension patients with CAVI<9, group 4: hypertension patients with CAVI ≧9. CAVI was measured by VS-1000 apparatus. RESULTS:Prevalence of stroke and coronary artery disease were significantly higher in group 2 than in group 1. And the prevalence of stroke and coronary artery disease were also significantly higher in group 4 than in group 3. In addition, the level of right intima-media thickness (RIMT) was significantly higher in group 4 than in group 3 (0.102±0.025 vs 0.094±0.023, p<0.05). Multiple linear regressions showed that CAVI and age were independent associating factors of stroke in all patients (β=0.268, p=0.040; β=0.135, p<0.001; respectively). CAVI was an independent associating factors of stroke in hypertension patients (β=0.398, p<0.001). CONCLUSION:The prevalence of stroke was higher in hypertension patients with CAVI ≧9 than in hypertension patients with CAVI<9, with higher level of right intima-media thickness. CAVI was an independent associating factors of stroke in hypertension patients.

Background: Atrial fibrillation (AF) is the most prevalent sustained arrhythmia, and recent evidence indicates the presence of cardiac enlargement in patients with AF. Dilated cardiomyopathy (DCM), the most common form of cardiomyopathy, is characterized by significant heart dilation and AF. However, the risk factors and underlying mechanisms linking DCM to AF remain poorly understood. Methods: Mendelian randomization (MR) analysis was initially used to explore the potential causal relationship between AF and DCM. Data were sourced from the public database Gene Expression Omnibus (GEO), and differentially expressed genes (DEGs) and significant module genes were identified using the Limma package and weighted gene co-expression network analysis (WGCNA). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, as well as a protein-protein interaction (PPI) network analysis, were performed on the intersected genes. Hub genes were screened using machine learning algorithms. The identification of hub genes within the DCM GSE17800 dataset was achieved using the receiver operating characteristic (ROC) curve and nomogram, which were employed to assess the diagnostic efficacy of these hub genes. Finally, the immune infiltration of DCM and the microRNA (miRNA) interaction network involving hub genes were evaluated. Results: MR analysis demonstrated that genetic susceptibility to AF was significantly associated with an increased risk of DCM (β: 20.44, 95% CI: 15.00-25.88, p=0.0002). The AF dataset included 1850 DEGs and 572 significant module genes, and the DCM dataset included 6463 DEGs, which had a total of 209 intersected genes with module genes for AF. After correlation enrichment analysis and PPI interaction network on the intersected genes, machine learning was used to screen two hub genes (VSNL1 and ETNPPL) that had high diagnostic efficacy (area under the curve from 0.81 0.89). Immune infiltration analysis of these genes revealed a relatively normal immune status for DCM, with a wider miRNA interaction network for VSNL1. Conclusion: MR data suggests that genetic changes in the presence of AF are significantly associated with an increased risk of DCM. The two identified hub genes (VSNL1 and ETNPPL) can be used to diagnose comorbid DCM in patients with AF.

BACKGROUND:The aim of our study was to explore the characteristics of the arterial risk factors and ankle-brachial index (ABI) in patients with lower extremity chronic venous disease (LECVD).METHODS:A total of 2642 subjects were employed in our study. The lifestyle and clinical data were collected. The history of vascular diseases contained coronary artery disease, stroke, hypertension, and diabetes. ABI low than 0.9 was considered as lower extremity artery disease (LEAD). A series of blood indicators were measured.RESULTS:Patients with ABI low than 0.9 belonged to the group of LEAD. Age, smoking, drinking, hypertension, diabetes mellitus, lipid-lowering drug, antidiabetic, total protein, total protein, triglyceride, low-density lipoprotein cholesterol, glycosylated hemoglobin and homocysteine were the common risk factors shared by LEAD and LECVD (P<0.05). The prevalence of LEAD in patients with LECVD was higher than those without LECVD (P<0.05). In Pearson correlation analysis, LECVD was related to LEAD (P<0.05). Before and after adjusted shared factors, as the performance of the logistic regression models, LEAD was an independent risk factor for the prevalence of LECVD (OR=2.937, 95% CI: [1.956, 4.411], P<0.001).CONCLUSIONS:Our study demonstrated that an ABI lower than 0.9 is an independent risk factor for LECVD.

Spontaneous celiac artery dissection is uncommon. Abdominal pain is a common clinical presentation. Conservative medical treatments, endovascular interventions, and open surgery are used to treat spontaneous celiac artery dissection. A 49-year-old male patient visited our hospital, with back and subxiphoid pain that had persisted for 11 hours. He has been smoking 40 cigarettes a day for 20 years. The blood pressure was 180/100mmHg. Aortic computed tomography angiography (CTA) images revealed dissection of the celiac artery, common hepatic artery, left hepatic artery, right hepatic artery, and splenic artery. Urapidil hydrochloride and isosorbide dinitrate were administered to lower the blood pressure to approximately 110/70 mmHg. However, the back and subxiphoid pain persisted without relief. Angiography was performed and a vascular stent (BARD, LIFE STENT, VASCULAR, 8 × 60) was implanted into the celiac artery without involving the branches. Pain was immediately relieved after interventional therapy. The patient was discharged after 4 days. A subsequent aortic CTA after 10 months confirmed that the celiac artery dissection had still not reoccurred.

Objective:To investigate the correlation between the neutrophil/high-density lipoprotein ratio (NHR) and lower extremity atherosclerotic disease (LEAD) in middle-aged and elderly people.Methods:A total of 644 middle-aged and elderly inpatients treated at the Department of Vascular Medicine, Peking University Shougang Hospital from January 2016 to October 2017 were selected. According to brachial and ankle index, the patients were divided into either a non-LEAD group (n=578) or an LEAD group (n=66). Data collected at baseline included participants' demographic data, lifestyle, disease history, routine blood examination, and biochemistry examination. Pearson correlation analysis was used to analyze the correlation between NHR and LEAD. ROC curves were plotted to determine the predictive performance of NHR for LEAD. Multivariate Logistic regression was used to analyze the influencing factors of LEAD. One-way analysis of variance was used to compare the vascular function of different NHR groups.Results:There was no significant difference in age, sex, smoking history, drinking history, hypertension, diabetes, hyperuricemia, medication history, MON, TC, TG, AST, ALT, TBIL, DBIL, Cr, hsCRP, or HCY between the non-LEAD group and the LEAD group (P＞0.05). WBC and NEU in the LEAD group were significantly higher than those in the non-LEAD group, while LYM, LDL, and HDL in the non-LEAD group were significantly higher than those in the LEAD group (P＜0.05 or P＜0.01). Pearson correlation analysis showed that there was a negative correlation between NHR and ABI in the middle-aged and elderly population (P＜0.01). Multivariate Logistic regression showed that NHR was an independent risk factor for LEAD (P＜0.05). One-way ANOVA showed that there were significant differences in ABI, CAVI, and CF-PWV among the groups with different levels of NHR (P＜0.05). ABI in the high NHR group was smaller than that in the low NHR group, while CAVI and CF-PWV were higher in the high NHR group.Conclusion:The increase of NHR in middle-aged and elderly people is associated with LEAD, which has important value in predicting the incidence of LEAD in this population.

Cardiovascular disease(CVD) has become a major disease burden affecting people's health in China. Blood vessels are very important for human health and are the "sentinel" for the development of many cardiovascular and cerebrovascular diseases. The key to effectively preventing fatal, disabling heart, brain and peripheral vascular events lies in controlling traditional and non-traditional risk factors for vascular health from the source, and early assessment and intervention of early vascular lesions. Since 2004, China government promoted the early detection technology of vascular lesions and vascular medicine, and proposed the Beijing Vascular Health Stratification (BVHS) to provide suggestions for the examination, evaluation and management of risk factors, and to provide new ideas for lifelong maintenance of vascular health. This review mainly introduces the establishment and development of the clinical discipline of "vascular medicine" in the past 20 years in China, introduces the indicators for detecting vascular function and structure and the predictive value of vascular events, and carries out intelligent and digital management of vascular health throughout the life cycle of individualized prevention, treatment and rehabilitation for people with different parts or degrees of lesions, effectively reducing the occurrence and development of cardiovascular and cerebrovascular diseases, and the prospect of new technology in maintaining vascular health.

目的 分析血管危险因素与下肢动脉硬化闭塞症合并慢性静脉功能不全(LEAOD-CVI)患者的关系以及其踝肱指数(ABI)的特征.方法 选择2016—2019年于北京大学首钢医院血管医学科就诊的LEAOD患者562例.CVI患者纳入合并组共94例,无CVI纳入单病组共468例.采用Pearson相关性分析、logistic回归分析分析血管危险因素和ABI与LEAOD-CVI的关系.结果 合并组具有更低的糖尿病和高脂血症的患病率、空腹血糖和糖化血红蛋白水平(Z=4.93,P=0.02;Z=4.46,P=0.04;Z=-1.97,P=0.04;Z=-2.42,P=0.02),更高的高同型半胱氨酸血症患病率和ABI(Z=5.75,P=0.02;Z=-3.79,P<0.01).糖尿病、糖化血红蛋白和高脂血症与LEAOD-CVI具有负相关关系(r=-0.10,P=0.03;r=-0.11,P=0.01;r=-0.09,P=0.04).高同型半胱氨酸血症与LEAOD-CVI具有正相关关系(r=0.10,P=0.02).糖尿病、空腹血糖、糖化血红蛋白、高脂血症和高同型半胱氨酸血症是LEAOD-CVI的影响因素(β=-0.51,P=0.03;β=-0.12,P=0.04;β=-0.28,P=0.01;β=-0.54,P=0.04;β=0.58,P=0.02).调整多影响因素的作用后,仅高同型半胱氨酸血症是LEAOD-CVI的独立影响因素(调整后β=0.52,P=0.02).结论 与未合并CVI的LEAOD患者相比,LEAOD-CVI具有更高的ABI水平和高同型半胱氨酸血症患病率.高同型半胱氨酸血症是LEAOD-CVI的独立影响因素.当LEAOD-CVI时,需慎重考量把ABI作为LEAOD严重程度分级的标准.

目的:研究下肢动脉硬化闭塞症患者踝肱指数(ABI)异常与冠状动脉狭窄严重程度的相关性.方法:选取2017年11月至2019年9月,73例在我院接受治疗并行冠状动脉CTA检查的下肢动脉粥样硬化闭塞症患者,取双下肢ABI最低值,按照ABI的缺血程度,ABI＜0.5重度缺血,ABI 0.5～0.75中度缺血,ABI 0.75-0.9轻度缺血,将下肢动脉粥样硬化闭塞症患者分为轻、中、重3组,同时通过冠状动脉CTA分析这些患者冠状动脉病变的严重程度,分析与冠状动脉严重程度的相关性.结果:73例下肢动脉粥样硬化闭塞症患者,ABI≤0.90可诊断为下肢动脉缺血,下肢血管病变越严重,ABI越低,冠状动脉血管发生病变的支数也越多.ABI与冠状动脉病变支数呈现负的相关趋势.结论:下肢动脉病变可以间接的反映冠状动脉病变严重程度.

Objective:To conduct a cluster analysis on the medication of 606 patients with CHD to explore the drug therapy mode and population heterogeneity of the patients.Methods:This study enrolled 606 patients with CHD who were hospitalized at Vascular Department of Shougang Hospital from October 2016 to October 2017. The data of demographic characteristics, medication, carotid artery ultrasound, pulse wave conduction velocity measurement, blood pressure, and related biochemical examinations were retrospectively analyzed. The patients were divided into new categories by clustering medication status through k-means method. The demographic characteristics, vascular function, and blood pressure status of patients in different categories were compared.Results:The 606 patients with CHD were divided into five categories (1-5), which included 136, 129, 110, 171, and 60 patients, respectively. The comparison of demographic characteristics, vascular function, and blood pressure showed that there were significant differences in age and complications among different categories. Patients treated with β blockers, antiplatelet drugs (aspirin and clopidogrel), nitrates, and statins had the lowest age (66.5 years [SD=10.6]), the shortest duration of CHD (61.0 years [SD=11.7]), the lowest prevalence of hypertension, and the least other complications. What's more, their cardiovascular function was good and their current recovery of blood pressure was better. Patients with CHD in categories 2 and 4 were second only to those in category 3 in age and duration of illness. Patients in category 2 had the highest prevalence of hypertension, while patients in category 5 had the highest prevalence of diabetes. Patients in category 1 did not receive any treatment, possibly due to patients' poor compliance or improper data collection.Conclusion:Complications are an important factor in the selection of different drug treatment modes. Attention should be paid to the population heterogeneity presented by different drug treatment modes in clinical practice. This study provides ideas for the development of personalized treatment and precision medicine research.

Whether arteriosclerosis can influence the hypertension control remains incompletely understood. We hypothesized that higher arteriosclerosis may be associated with uncontrolled hypertension. Arteriosclerosis was assessed by carotid femoral artery pulse wave velocity (CF-PWV) and uncontrolled hypertension (systolic blood pressure [BP] ≥130 mm Hg or diastolic BP ≥80 mm Hg). The multivariable-adjusted logistic regression was used for analysis. A total of 1,428 patients with essential hypertension (mean age 68 years, 49.6% male) were enrolled into the study from 2010 to 2017. The BP was uncontrolled in 50.7% of the participants and the mean level of CF-PWV was 12.3 m/s. All the cardiovascular risk factors were worse and CF-PWV was higher in patients with uncontrolled hypertension (all p < 0.05). Multivariable-adjusted logistic regression analysis showed that CF-PWV as a continuous variable (odd ratio [OR] 1.093, 95% confidence interval [CI] 1.046–1.142) was independently associated with uncontrolled hypertension, after male (OR 1.511) and total cholesterol (OR 1.167), followed by body mass index (OR 1.092), fasting plasma glucose (OR 1.075), and creatinine (OR 1.010) (all p < 0.05). As a binary variable, CF-PWV >12 m/s was also independently associated with uncontrolled hypertension (OR 1.690, 95% CI 1.320–2.164, p < 0.05). Arteriosclerosis is independently associated with uncontrolled BP in patients with hypertension.

目的 探讨静脉血栓栓塞症(VTE)患者血浆生物标志物与肺栓塞(PE)的关联性.方法 选取2016年1月—2019年12月在北京大学首钢医院血管医学中心确诊VTE的348例患者作为研究对象,根据是否患有PE,分为无PE组和PE组,分别统计并比较两组患者的一般临床资料,检测并比较两组患者的D-二聚体、脑钠肽、C反应蛋白、肌钙蛋白I和中性粒细胞/淋巴细胞比值等血浆生物标志物水平.再根据肺栓塞严重指数评分和简化肺栓塞严重指数评分将PE组分成低危组和中高危组,比较两组患者的血浆生物标志物水平.行Spearman相关性分析,分析各生物标志物与PE发生与否以及其疾病危险程度的相关性.行logistic回归分析,分析各生物标志物与PE的关系.结果(1)无PE组和PE组患者收缩压、舒张压和心率有统计学差异(P<0.05);血浆生物标志物D-二聚体、C反应蛋白、肌钙蛋白I和平均血小板体积有统计学差异(P<0.05).(2)PE组,低危组、中高危组的血浆生物标志物水平比较,脑钠肽、中性粒细胞/淋巴细胞比值和尿素氮有统计学差异(P<0.05).(3)VTE患者的血浆生物标志物与是否发生PE、PE疾病危险分层的相关性分析,D-二聚体、脑钠肽、C反应蛋白、红细胞容积分布宽度、平均血小板体积与是否发生PE呈正相关(r=0.444,P<0.001;r=0.219,P=0.001;r=0.313,P<0.001;r=0.129,P=0.047;r=0.185,P=0.004),肌钙蛋白I与是否发生PE呈负相关(r=-0.181,P=0.042);脑钠肽、中性粒细胞/淋巴细胞比值、尿素氮与PE疾病危险分层呈正相关(r=0.358,P=0.003;r=0.259,P=0.028;r=0.345,P=0.002).(4)经logistic回归分析,VTE患者的血浆生物标志物中D-二聚体、脑钠肽、C反应蛋白、肌钙蛋白I、红细胞容积分布宽度、平均血小板体积与PE具有显著相关性.结论 VTE患者中,部分血浆生物标志物与是否发生PE及病情危险程度有关,可辅助临床应用.

Background:Massive or submassive pulmonary embolism (PE) carries a high mortality. Percutaneous mechanical thrombectomy using the Angiojet system is accepted for the treatment of PE. Here, we reported two submassive PE cases who were treated with the Angiojet system successfully, to provide some advice for the therapy of submassive PE.Method:Two patients with suffocation were admitted to our hospital. One patient was accompanied by lower blood pressure (20% lower than basal blood pressure) and higher pulmonary artery pressure (89 mmHg); the other patient had larger right ventricular transverse diameter (46 mm), decreased left ventricular end diastolic anteroposterior diameter (34 mm), and higher heartbeats (107 heartbeats per minute). Pulmonary artery computed tomography angiography showed bilateral pulmonary embolism.Result:The Angiojet system with a high-pressure jet spray pattern (urokinase 25 wiu + sodium chloride injection 50 ml) was used. Intravascular thrombolysis by urokinase (100 wiu/day for 1 day) was done after being back in the ward. And low molecular weight heparin was used in hospitalization, and rivaroxaban was used after discharge. Both patients were treated successfully. However, the level of platelet was significantly lower in one patient after Angiojet system usage and recovered to the preoperative level the next day. Another patient suffered from bradyarrhythmias during the usage of Angiojet, and bradyarrhythmias disappeared when the Angiojet system stopped. Pulmonary embolism was cured after 3 months in both patients.Conclusion:Angiojet could be a simple, safe, and well-tolerated treatment for massive or submassive PE. And hematocrit, platelet, kidney function, and heart rhythm should be monitored during perioperation.

目的 探讨全身动脉粥样硬化斑块与脑梗死的关系.方法 本研究纳入411例患者[(66.3±13.5)岁,男性52.9％],均进行全身血管超声检查.使用逻辑回归评估全身动脉粥样硬化斑块累及血管床数目、斑块部位与脑梗死的关系.结果 脑梗死组的3～5个部位斑块检出率和颈动脉合并其他部位斑块检出率高于无脑梗死组,伴随白介素-6和心-踝血管指数的明显升高.在未调整的模型中,3～5个部位粥样硬化斑块组、颈动脉合并其他部位粥样硬化斑块组发生脑梗死风险分别是无斑块组的2.595倍(95％CI 1.338～5.031,P<0.01)和2.551倍(95％CI 1.317～4.942,P<0.01).调整了性别和年龄后,斑块累及血管床数目和斑块部位与脑梗死的关系不显著.结论 在未调整的模型中,与无斑块组相比,3～5个部位血管床粥样硬化斑块组和颈动脉合并其他部位粥样硬化斑块组发生脑梗死的风险更高.

肺血栓栓塞症和下肢深静脉血栓形成统称为静脉血栓栓塞症,在全世界范围内二者的发病率很高,肺血栓栓塞症亦是一种病死率很高的疾病.目前在指导临床应用中生物标志物的作用越来越受到重视,如何合理选用生物标志物并正确分析其临床应用价值的侧重点,尚缺乏系统性的认识.现对不同生物标志物在静脉血栓栓塞症中的应用价值做一综述.

Background: Vascular endothelial dysfunction, arteriosclerosis and atherosclerotic plaque are well-known risk factors for cardiovascular disease (CVD). Studies on vascular health markers have been well-established, however, there is still a lack of related research on combined vascular structure and function indicators. A variety of CVD prediction models are proposed, all of which are aimed at the traditional risk factors. Beijing vascular health stratification (BVHS) aiming at vascular health, combined the endothelial function, arteriosclerosis, atherosclerotic plaque and vascular lumen stenosis to comprehensively assess the vascular health and grade it. This study will take the BVHS as the guiding ideology to explore the predictive value of the combined evaluation of vascular structure and function for cardiovascular events and assess the predictive value of BVHS and compare it with the existing risk assessment systems. Methods: A total of 1,500 subjects will be enrolled into the prospective cohort study from a community and will be followed up for 3 years from July 1, 2020 to June 30, 2023. Subjects aged 40 or above, without coronary heart disease, stroke or peripheral artery disease, with written informed consent will be included; subjects with end-stage hepatorenal diseases (uremia, renal failure, cirrhosis, liver failure), mental disorders or cognitive disorders, with any other factors that the researcher thinks are not suitable for the study will be excluded. Conclusions: The study will be the first to grade vascular health by combing various vascular indicators and explore the prediction value and compare with other risk prediction system in general Chinese population.