Zhonghua nei ke za zhi
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Zhonghua nei ke za zhi · Jun 2018
[The role of aquaporin 4 antibody in the injury of retinal microstructure in neuromyelitis optica spectrum disorders].
Objective: To evaluate the injury of retinal microstructure using optical coherence tomography (OCT) and investigate the role of aquaporin 4 antibody (AQP4 Ab) in this injury process. Methods: Forty patients with neuromyelitis optica spectrum disorders (NMOSD) were retrospectively studied, each of whom reported at least one episode of optic neuritis (ON), namely 59 ON eyes involved in all. All patients were divided into two subgroups based on AQP4 Ab tests including 25 patients (37 ON eyes) with AQP4 positive (Ab(+)/NMOSD group) and 15 patients (22 ON eyes) negative (Ab(-)/NMOSD group). ⋯ The thickness of superior and inferior RNFL in ON eyes of Ab(+)/NMOSD were 61.0 μm and 62.0 μm, which was thinner than those of Ab(-)/NMOSD 94.5 μm and 97.0 μm (P=0.03 and 0.01, respectively). Conclusions: RNFL reflects the injury of retinal microstructure in NMOSD patients. AQP4 Ab seropositivity is correlated to the severity of RNFL damage, implying the potential role of AQP4 Ab in this pathological process.
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Zhonghua nei ke za zhi · Jun 2018
[Preliminary study of the arm equilibrium pressure to predict the effect of fluid challenge on urine output in oliguric intensive care unit patients].
Objective: To evaluate whether arm equilibrium pressure (Parm) is helpful to predict the effect of fluid load in improving oliguria in intensive care unit(ICU) patients. Methods: Hemodynamically stable patients [mean artery pressure (MAP)>65 mmHg (1 mmHg=0.133 kPa), heart rate (HR)<120 beats/min, lactic acid<2 mmol/L] with urine output (UO)<0.5 ml·kg(-1)·h(-1) for 3 consecutive hours were enrolled. The fluid loading was performed by infusion of ringer's lactate 500 ml within 30 minute after baseline hemodynamic data were recorded. ⋯ The receiver operating curve (ROC) showed that 30s Parm had the largest area under curve (AUC) of 0.94 (95% CI 0.84-1.05, P<0.01), which 35.5 mmHg was the best threshold with sensitivity 94.4% and specificity 91.7%(likelihood ratio 11.37). Conclusion: In hemodynamically stable oliguric ICU patients, if Parm is lower than normal reference value, volume expansion is more likely to increase UO. Thus Parm can be used to predict the effect of fluid loadon UO.