Objective To determine the value of mean platelet volume (MPV) and platelet large cell ratio (P-LCR) in the diagnosis of acute coronary syndrome (ACS) in patients with chest pain. Methods A total of 83 chest pain patients with identified ACS and 56 chest pain patients without cardiovascular disease in our hospital from January to June 2013 were subjected in this study. Their venous blood samples were collected within 6 h of onset for platelet parameters. Mean comparison between the 2 groups and logistic regression analysis were used to find the effective platelet parameters, and receiver operating characteristic (ROC) curve analysis was used to evaluate their diagnostic significances for ACS. Results ACS group had significantly lower platelet than the non-cardiac chest pain group [(191.28±67.07)×109 vs (236.75±64.09)×109/L)], and significantly higher MPV [(11.88±1.24) vs (10.73±1.08)fL], platelet distribution width (PDW) [(15.54±1.87) vs (13.40±2.35)fL] and P-LCR [(47.49±9.55)%vs (35.11±10.00)%] (all P<0.05). There was no statistical difference in the platelet parameters among different types of ACS patients (P>0.05). Logistic regression analysis showed that P-LCR and MPV were auxiliary diagnostic indicatos for ACS. ROC curve analysis showed that the cut-off was 0.15μg/L, 38.5%, 11.05fL, and 19.0U/L, respectively, for troponin I (TnI), P-LCR, MPV and creatine kinase-MB (CK-MB), and their areas under the curve were 0.987, 0.817, 0.754 and 0.598, respectively. Their sensitivity was 97.3%, 92.8%, 71.1%and 45.8%respectively, the specificity were 90.3%, 64.3%62.5%, and 73.2%respectively, and the diagnostic accuracy were 100%, 80%, 72.6%, and 67.2%, respectively for TnI, P-LCR, MPV and CK-MB. Conclusion MPV and P-LCR are helpful in the early diagnosis of ACS, and can be seperately used as auxiliary diagnostic indicators of ACS in patients with chest pain. Because of their high diagnostic accuracy, the 2 parameters can be served as a reference for early prediction and differential diagnosis of ACS.

Objective:To explore the relationship between glycosylated hemoglobin (HbA1c)and carotid artery atheroscle-rosis in aged patients with normal glucose tolerance.Methods:A total of 100 aged patients with normal glucose tolerance were selected.Their bilateral carotid arteries were measured by color Doppler ultrasonography.They were grouped accord-ing to carotid intima-media thickness (C-IMT,normal,thicken and atherosclerosis)and plaque form (no plaque,hard plaque and soft plaque);blood pressure,blood lipids and HbA1c etc.were compared among groups.Results: (1)Along with CIMT rose,there was significant increase in HbA1c level [(4.98 ± 0.55)% vs.(5.51 ± 0.42)% vs.(5.92 ± 0.39)%],and there was significant difference between any two groups (P<0.01 all);(2)HbA1c level was (5.36±0.51)%,(5.89±0.44)% and (5.97±0.2)% in no plaque group,hard plaque group and soft plaque group respectively,and there was significant difference among hard plaque group,soft plaque group and no plaque group (P <0.01 all).Conclu-sion:Glycosylated hemoglobin may become an important index assessing carotid atherosclerosis in aged people.

<正>1临床资料男,84岁,以"帕金森病"于2012年10月入院治疗。给予美多巴250 mg,3/d口服后病情控制,日常生活基本能自理。患者近1年来间断出现头晕、双眼黑蒙,伴乏力及视物不清,有时不能迈步,无法辨别家人,甚至猝倒1次。上述症状持续约20 min,卧床休息10 min