Based on the analysis of the fluid inclusion homogenization temperature and apatite fission track on the northern slope zone of the Bongor Basin in Chad,this paper studied the time and stages of hydrocarbon accumulati...Based on the analysis of the fluid inclusion homogenization temperature and apatite fission track on the northern slope zone of the Bongor Basin in Chad,this paper studied the time and stages of hydrocarbon accumulation in the study area.The results show that:(1)The brine inclusions of the samples from the Kubla and Prosopis formations in the Lower Cretaceous coexisting with the hydrocarbon generally present two sets of peak ranges of homogenization temperature,with the peak ranges of low temperature and high temperature being 75–105℃ and 115–135℃,respectively;(2)The samples from the Kubla and Prosopis formations have experienced five tectonic evolution stages,i.e.,rapid subsidence in the Early Cretaceous,tectonic inversion in the Late Cretaceous,small subsidence in the Paleogene,uplift at the turn of the Paleogene and Neogene,and subsidence since the Miocene,in which the denudation thickness of the Late Cretaceous and after the turn of the Paleogene and Neogene are~1.8 km and~0.5 km,respectively.The cumulative denudation thickness of the two periods is about 2.3 km;(3)Using the brine inclusion homogenization temperature coexisting with the hydrocarbon as the capture temperature of the hydrocarbon,and combining with the apatite fission track thermal history modeling,the result shows that the Kubla and Prosopis formations in the Lower Cretaceous on the northern slope of the Bongor Basin have the same hydrocarbon accumulation time and stages,both of which have undergone two stages of hydrocarbon charging at 80–95 Ma and 65–80 Ma.The first stage of charging corresponds to the initial migration of hydrocarbon at the end of the Early Cretaceous rapid sedimentation,while the second stage of charging is in the stage of intense tectonic inversion in the Late Cretaceous.展开更多
Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a ra...Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.展开更多
The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity o...The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity of Detarium Senegalense extracts. For this purpose, sequential extraction using solvents of increasing polarity was essential. The various extracts obtained underwent phytochemical and biochemical analyses. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthocyanins and steroids/terpenes. Quantitative analysis of total polyphenols, total flavonoids and total anthocyanins yielded the following results: total flavonoids (0.803 ± 0029 mg EQ/100g P for acetone extract of roots and 0.871 ± 0.401 mg EQ/100g P for methanol extract of leaves);total polyphenols (23.298 ± 12.68 mg EAG/100g P for acetone extract of roots and 24.69 ± 0.49 401 mg EAG/100g P for methanol extract of leaves);total monomeric anthocyanins (44.697 ± 0.939 mg EC3G/100g P and 16.699 ± 0.193 mg EC3G/100g P respectively for acetone and methanol extracts of stem bark). DPPH free radical scavenging activity was 1.674 ± 0.023 mg/mL for the acetone extract and 0.934 ± 0.24 mg/mL for the methanol extract of roots. .展开更多
Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health pr...Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health problem in many countries. The aim of this study is to describe the epidemiology of tuberculosis and the strategies for controlling this disease in the Chadian prison population. During the course of our study, the prevalence of tuberculosis in prisons was 9.64%. The age group between 55 years and over (43.33%) was the most represented in this study, and all patients were men with a frequency of 62.66%. The cross-tabulation of Culture_7H9G and Culture_7H9P showed that out of our total positive sample, we found a total of 87 positive strains and 63 negative strains. Our study shows that it is essential to know the prevalence of tuberculosis in all the country’s prisons. Indeed, this can serve as an indication of the need for action in prisons to reduce TB rates, in particular by improving the structure of prison environments, diagnosing new cases quickly and accurately, identifying drug-resistant strains and implementing effective, direct treatment observed in people with tuberculosis.展开更多
Groundwater is the main source of drinking water for large cities in most African countries. In Moundou, for example, the conventional groundwater supply system is failing. To compensate for this state failure, the po...Groundwater is the main source of drinking water for large cities in most African countries. In Moundou, for example, the conventional groundwater supply system is failing. To compensate for this state failure, the population is building boreholes and wells, most of which tap the surface water table, generally referred to as the “water table”. The aim of this study is to characterize these waters in order to assess their level of contamination and, by extension, the degree of pollution of the water table. Major elements such as: Chloride (Cl<sup>-</sup>), Sulfate (SO<sub>4</sub><sup>2-</sup>), Nitrate (NO<sub>3</sub><sup>-</sup>), Calcium (Ca<sup>2+</sup>), magnesium (Mg<sup>2+</sup>), sodium (Na<sup>+</sup>) and potassium (K<sup>+</sup>) were analysed by Liquid Chromatography and the Bicarbonate ion (HCO<sub>3</sub><sup>-</sup>) was determined by the titrimetric method. The methodology applied is based on a combination of hydrochemical techniques and statistical analysis (PCA and CHA). A sampling campaign was carried out during high-water periods. The results of the physico-chemical analyses show mineralization ranging from 7.29 to 3670 μS/cm, with an average of 487.44 μS/cm. The groundwater studied is generally acidic, with a pH ranging from 3.26 to 6.41. Based on their anions, they are classified into four main hydrochemical facies: chloride and sulphate facies, calcium and magnesium facies, sodium and potassium facies and bicarbonate facies. The various correlations between major ions and statistical analyses have enabled us to identify three hydrogeochemical processes involved in water mineralization. The dominant process is silicate hydrolysis, followed by cation exchange, then anthropogenic input, which influences mineralization by polluting the water.展开更多
Background: HIV in pregnant women presented a risk of transmission to newborns. This study was to determine HIV prevalence among pregnant women in the birthing rooms and give antiretrovirals to women infected and thei...Background: HIV in pregnant women presented a risk of transmission to newborns. This study was to determine HIV prevalence among pregnant women in the birthing rooms and give antiretrovirals to women infected and their newborns. Methods: A preliminary study was conducted from 2013 to 2015 at the Mother and Child Hospital. Pregnant women were counseled and tested for HIV-antibody according to the national algorithm using Determine HIV 1 & 2 and Immunocomb II Bispot HIV1 & 2. The women screened HIV-negative during the prenatal consultation and who accepted a second test were screened in the birth room. The data collected were processed using the Access Microsoft office 16 and SPSS software version 18. Results: A total of 6080 pregnant women were tested before and in the birth room. Of these, 5943 (97.4%) were detected as HIV-negative and 159 (2.6%) were HIV-positive. Of the 5943 with HIV-negative status, 1333 accepted the second test in the birth room, 10 of which have become HIV-positive. The rate of seroconversions was 0.75%. Conclusion: This study determined the prevalence of HIV in pregnant women. The result reveals the importance and necessity of repeating the screening test in the birth room because of the possibility of seroconversion or new infection during pregnancy.展开更多
Introduction: Salmonella and Shigella are gram-negative bacilli that are resistant to most antibiotics and play an important role in an etiology of diarrhea disease. The aim of the study was to determine the prevalenc...Introduction: Salmonella and Shigella are gram-negative bacilli that are resistant to most antibiotics and play an important role in an etiology of diarrhea disease. The aim of the study was to determine the prevalence of Salmonella spp and Shigella spp isolated from stool and blood samples in the city of N’Djamena. Materials and Method: This was a prospective study conducted in the four district hospitals of N’Djamena from 14 July 2022 to 31 December 2022. A questionnaire form was drawn up to collect the information sent to the study patients. The samples were analyzed at the CHU de la Mère et de l’Enfant, Labo-Redes laboratory according to their protocols and the standard of the antibiogram committee of the French microbiology society. Results: Of the 803 biological samples analyzed, 39 were positive for Salmonella spp and Shigella spp, including 15 for Salmonella and 24 for Shigella, giving an overall prevalence rate of 4.85%. Borehole water, uncooked food and lack of access to a latrine constitute a risk of being infected by Salmonella spp and Shigella spp species. Of the 8 antibiotics tested, Salmonella spp and Shigella spp strains showed good sensitivity to nalidixic acid (100% for Salmonella and 90 for Shigella) and to ciprofloxacin (90.9% for Salmonella and 75% for Shigella). Resistance to ampicillin was found in 81.81% of Salmonella species and 78.57% of Shigella species, as was resistance to chloramphenicol (81.81% of Salmonella species and 67.85% of Shigella species). Similarly, cleanliness of the service and equipment is an essential factor in preventing Salmonella and Shigella infections.展开更多
The objective of this work was to determine new approaches that could improve the germination quality of Burkea africana seeds under reproducible conditions and by means available to farmers with a view to its propaga...The objective of this work was to determine new approaches that could improve the germination quality of Burkea africana seeds under reproducible conditions and by means available to farmers with a view to its propagation. The tests concerned the influence of three pre-germinative treatments. It is about the light scarification (Scl), medium scarification (Scm) and deep scarification (Scd) of seeds in order to determine some parameters of germination that are the latency time, the time of germination, the rate of germination and the speed of germination. The treated seeds were sown in transparent germinators lined with hydrophilic paper and then after the appearance of radicles, the plants were transplanted on five types of substrates (black soil, fine sand, sawdust, mixtures 1/1 of sawdust-black soil and 1/1 of sawdust-fine sand). The results obtained by the deep (Scp) and medium (Scm) scarification compared to those of the light scarification and the control, showed a clear reduction of the lag time (3 days/15 days (control). At the 5% threshold, germination times 6.27 × 10<sup>-1</sup> (Scd) and 6.01 × 10<sup>-1</sup> (Scm) were significantly influenced. Germination rates 4.18 × 10<sup>-1</sup> (Scd) and 3.92 × 10<sup>-1</sup> (Scm) are also influenced by the pretreatment. Germination rates are significantly improved (80%). Regardless of the under treatment, the substrate “sawdust and fine sand” improves the germination of scarified seeds by 14.07% more compared to the substrate “fine sand” at the 5% threshold. The mechanical scarification and the type of substrates thus influence positively and homogeneously the germination of seeds of Burkea africana. The domestication of this species is thus possible and can be considered for useful purposes.展开更多
Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis ...Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis of 219 patients with hepatocellular carcinoma (HCC) attending care at the University Reference Hospital of Ndjamena between 2007 and 2016. Results: This series of HCC was characterized by a male predominance (M:F = 2.4) with a mean tumor onset at the end of the fifth decade of life (49.9 ± 14.7 years). Tumors appear on a cirrhotic liver in 70% of cases and were already multifocal at diagnosis in two thirds of the patients. Alpha-fetoprotein was above the physiological threshold (10 ng/mL) in 73.4% of cases measured and above the so-called diagnostic level (400 ng/mL) in 53.4% of patients. The principal risk factor was chronic infection with hepatitis B virus, detected in 52.6% of cases. Patients seropositive for hepatitis C virus were infrequent (8.6%) and heavy alcohol intake was even less prevalent (5.9%). Remarkably, a very large subset of patients did not present any infectious or lifestyle risk factor (43.4%). Mean AFP values or fibrosis assessment scores are usually lower in these patients than in HBV-infected ones. Conclusions: The etiological spectrum of HCC is far from being fully established in Chad. Further epidemiological research is warranted to identify risk factors involved in a large proportion of cases. Exposure to aflatoxin B1 and dysmetabolic conditions affecting the liver have to be investigated as priority.展开更多
Background: In comparison to other forms of chronic liver diseases, cirrhosis is generally poorly studied in sub Saharan Africa. In Chad, more particularly, no data are available despite the burden of liver diseases c...Background: In comparison to other forms of chronic liver diseases, cirrhosis is generally poorly studied in sub Saharan Africa. In Chad, more particularly, no data are available despite the burden of liver diseases considered as the first cause of hospitalizations in the country. Methods: We conducted a retrospective analysis of 268 patients with liver cirrhosis attending care at the University Reference Hospital between 2007 and 2016. Results: This series of liver cirrhoses was characterized by a weak mal predominance (M:F = 1.7). The age of onset occurs significantly earlier in women than in men (40.6 ± 12.0 vs. 44.4 ± 13.4, p = 0.0171). The principal risk factor was persistent infection with hepatitis B virus (49% of cases) followed distantly by infection with hepatitis C virus (13%) and excessive alcohol consumption (10%). Men were more frequently carrying HBV surface antigen than women (65.6% vs 35.9% p = 0.0019). HBV-associated liver cirrhosis was overall more severe than diseases from other causes. A large proportion of cirrhosis (30%), observed primarily in women (48.1% vs 24.1%, p = 0.0036), was considered are cryptogenic. Conclusions: The etiological spectrum of liver cirrhosis remains to be properly defined in Chad. This lack of knowledge prevents the implementation of an efficient policy of prevention. A significant effort should be secured to characterize hitherto neglected infectious, lifestyle or genetic risk factors responsible of this form of terminal disease and improve subsequently liver health of local populations.展开更多
Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteris...Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.展开更多
The objective of this research is to lift the dormancy of seeds of S. kunthianum in with a view to domesticating them. In this experiment, we used the soaking of seeds in sulfuric acid for different durations (10 min,...The objective of this research is to lift the dormancy of seeds of S. kunthianum in with a view to domesticating them. In this experiment, we used the soaking of seeds in sulfuric acid for different durations (10 min, 30 min and 1 h). The treated seeds were sown in transparent germinators. The explants obtained were then transplanted into pots containing five types of substrate (black earth, fine sand, sawdust, mixtures 1/1 of sawdust/black earth and 1/1 of sawdust/fine sand). This second test made it possible to determine the rate of germination on the substrate. The results obtained compared to those of the control showed a clear reduction in the latency time or germination time (62 hours) instead of 6 days (control), in the germination time 3 days/7 days (control) and a very high germination rate (100%). At the 5% threshold, soaking for 10 min and 30 min (100%) is the best result on the germination of S. kunthianum seeds. Soaking for 1 hour gives (7%) very low. After transplantation of the explants, the percentages obtained independently of the treatments show that the 1/1 mixtures of sawdust/black earth (75.19%), black earth (73.33%) and sawdust/fine sand (66.30%) have a higher performance than the others. The type of germination is epigeal. This work makes it possible to domesticate S. kunthianum in Chad.展开更多
Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the De...Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7<sup>TM</sup> software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.展开更多
Introduction: Acute kidney injury (AKI) is a relatively rare but serious complication during pregnancy. It is often the consequence of a delay or poor management of a given complication that constitutes as a public he...Introduction: Acute kidney injury (AKI) is a relatively rare but serious complication during pregnancy. It is often the consequence of a delay or poor management of a given complication that constitutes as a public health problem in developing countries. The objective of our study was to determine the epidemiological, diagnostic, therapeutic and evolutionary aspects of obstetric acute kidney injury in Chad. Methodology: This was a cross-sectional study with descriptive and analytical aims over a period of 6 months from June 1, 2020 to November 30, 2020 and conducted in the Gyneco-Obstetric Emergency Department of the Mother and Child University Hospital in N’Djamena. All patients admitted for obstetric AKI and requiring hemodialysis were referred to the Nephrology Department of the Renaissance University Hospital. AKI was defined according to the KDIGO 2012 classification. All pregnant women with more than 20 weeks of gestation until immediately postpartum who were admitted for acute kidney injury were included in the study. Results: During our work, 1238 patients were collected. Among them, 56 cases of obstetric AKI were included, representing a hospital prevalence of 4.5%. The average age was 26.1 ± 5.8 years (16 and 37 years). The majority of our patients were primigravidas which was 42%, rural women represented 35.7% of our sample and nearly 67.8% of pregnancies did not benefit from regular prenatal consultation. AKI during the 3rd trimester was found in 42.9% of cases. Oligo-anuria was present in 28.6% of cases. Acute tubular necrosis was found in 52 cases. It was secondary to preeclampsia in 60.7%, to HELLP syndrome in 17.9% and to a hemorrhagic delivery complicating a retroplacental hematoma in 7.1%. According to the KDIGO 2012 classification, Stages 1, 2 and 3 represented 32%, 23% and 25% of cases, respectively. Hemodialysis was initiated in 1/4 of cases. Recovery of renal function was complete in 78.6% of cases and partial in 7.1%. We recorded eight (14.3%) maternal deaths and twenty-four cases of in-utero fetal death. The average length of hospital stay was 9.21 ± 5 days (2 and 20 days). Conclusion: Obstetric AKI remains a serious complication of pregnancy and postpartum. Despite the good renal prognosis, severe preeclampsia is the main cause. Prevention through monitoring pregnancies would be the most effective measure.展开更多
Introduction: Low back disc disease (LSD) is a neurosurgical condition with significant socioeconomic repercussions. The objective of this study was to determine the frequency and report the modalities of management. ...Introduction: Low back disc disease (LSD) is a neurosurgical condition with significant socioeconomic repercussions. The objective of this study was to determine the frequency and report the modalities of management. Methodology: This study on lumbosciatic disc disease was carried out in the neurosurgery department of the University Hospital Center (CHU), la Renaissance in N’Djamena. It covered a period of 12 months (from September 2019 to August 2020). A descriptive and an analytical approach were used. The variables studied were epidemiology, clinic, radiology and therapy. Results: the results showed that LSD represented 14.7% of the reasons for consultation in neurosurgery. The average age was 45.8, and to some extent, it ranges between 18 and 76. Lifting was the main reason behind lumbosciatic disc disease with 35.9% of cases, followed by a sedentary life style which represents 30.8%. Lumbosciatica L5 was noted in 49.4%. Obesity and overweight were significant risk factors (P = 0.02) reported in 59% of cases. Motor and sensory deficits were observed in 14.8% and 17.3% of cases, respectively. CT of the lumbar spine was performed in 91% and MRI in 28.9%. The L4-L5 disc herniation represented 74.3% of cases, with a lateral location in 44.2% and L5 radicular impingement in 30.8%. Conservative treatment was instituted in 87.2% and surgical treatment in 12.8% of cases. Conclusion: LSD is caused by a sedentary lifestyle, physical work and overweight. Surgery deals with complicated cases and cases not responding to conservative treatment.展开更多
The pollution of sediments by inorganic pollutants requires particularly important attention because of their toxicity, their persistence in the environment and their bioaccumulation by animal and plant life. The poll...The pollution of sediments by inorganic pollutants requires particularly important attention because of their toxicity, their persistence in the environment and their bioaccumulation by animal and plant life. The pollution of sediments by inorganic pollutants requires particularly important attention because of their toxicity, their persistence in the environment and their bioaccumulation by animal and plant living beings. This study focuses on the pollution of sediments of the Chari and Logon rivers in the city of N’Djamena by heavy metals. The objective of this study is to evaluate the degree of contamination, the geo-accumulation index and the degree of the Pollutant Loading Index of some heavy metals (Pb, Cr, Cu, Mn and Cd) and iron in the sediments of the sampled sites. The average concentrations of heavy metals and iron in the sediments are: Pb (10.00 ± 00 μg/Kg to 126 ± 16.52 μg/Kg);Cr VI (0.13 ± 00 mg/Kg to 0.21 ± 00 mg/Kg);Cd (trace);Cu (0.08 ± 0.02 mg/kg to 3.23 ± 0.64 mg/kg);Fe (0.25 ± 0.00 mg/kg to 5.79 ± 0.00 mg/kg);and Mn (0.2 ± 0.00 mg/Kg to 1.1 ± 0.00 mg/Kg);in order of highest to lowest abundance: Fe > Mn > Cd > Cu > Cr VI > Pb for the Logon;Fe > Cu > Mn > Cd > Cr VI > Pb for the Chari and Fe > Mn > Cu > Cd > Cr VI > Pb for the Confluent. The contamination factors for all heavy metals range from no contamination to low contamination for the sediments analyzed. The geo-accumulation indices indicate that the sampled sites are not polluted. The same is true for Er and RI which confirm an absence of ecological risks in the analyzed sediments.展开更多
目的：探讨心力衰竭高血压、年龄、糖尿病和脑卒中（包括一过性脑缺血）（CHADS2）评分及改良CHADS评分对心房颤动（房颤）射频消融术后复发的预测价值。方法对2010年7月至2012年3月在我院行射频消融术的93例房颤患者追踪随访12个月，术...目的：探讨心力衰竭高血压、年龄、糖尿病和脑卒中（包括一过性脑缺血）（CHADS2）评分及改良CHADS评分对心房颤动（房颤）射频消融术后复发的预测价值。方法对2010年7月至2012年3月在我院行射频消融术的93例房颤患者追踪随访12个月，术后1，3，6，9，12个月行12导联心电图或长程心电图检查，结合临床症状及心电图检查结果将其分为复发组（n＝40）和未复发组（n＝53），采用单因素和多因素分析消融术后房颤复发的危险因素。结果93例房颤患者中持续性房颤35例（37.63%），随访12个月时复发40例（43.01%）。房颤复发组与未复发组在平均年龄（P＜0.01）、年龄＞70岁（P＜0.05）、病史（P＜0.05）、房颤类型（P＜0.01）、左房内径（P＜0.001）、左室射血分数（P＜0.05）、血细胞比容（P＜0.05）、是否伴心力衰竭（P＜0.05）、是否伴高血压（P＜0.01）、是否伴糖尿病（P＜0.05）、是否有一过性脑缺血或脑卒中史（P＜0.05）、术后是否服用血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体拮抗剂（ACEI/ARB，P＜0.01）、术后是否服用Ⅲ类抗心律失常药（P＜0.05）、CHADS2评分≥1（P＜0.001）等方面差异有统计学意义。logistic回归分析发现，病史、房颤类型、左房内径、CHADS2评分≥1为房颤术后复发的独立危险因素（病史长短：OR＝1.16，P＝0.020；左房内径：OR＝1.17，P＝0.025；房颤类型：OR＝3.34，P＝0.050；CHADS2评分≥1：OR＝5.93，P＝0.019）。进一步分析发现，CHADS2评分≥2、改良CHADS评分≥1、改良CHADS评分≥2亦为房颤术后复发的独立危险因素（CHADS2≥2：OR＝5.42，P＝0.028；改良CHADS评分≥1：OR＝6.64，P＝0.015；改良CHADS评分≥2：OR＝7.32，P＝0.002）。截断点分析显示，CHADS2与改良CHADS均≥1时对房颤消融预后的预测价值最高，对CHADS2评分≥1与改良CHADS评分≥1预测房颤消融预后的灵敏度、特异度、曲线下面积进行比较发现，差异均无统计学意义[分别为0.775 vs 0.800、0.358 vs 0.377、0.708（95%CI 0.601～0.806） vs 0.711（95%CI 0.605～0.818），均P＞0.05]。结论病史长短、左房内径、房颤类型、CHADS2评分≥1、CHADS2评分≥2、改良CHADS评分≥1、改良CHADS评分≥2均为心房颤动消融术后复发的独立危险因素，且改良CHADS评分与CHADS2评分对房颤消融预后具有同等的预测价值。展开更多
基金Supported by the PetroChina Science and Technology Project(2023ZZ0703)National Natural Science Foundation of China(42072229,41102131).
文摘Based on the analysis of the fluid inclusion homogenization temperature and apatite fission track on the northern slope zone of the Bongor Basin in Chad,this paper studied the time and stages of hydrocarbon accumulation in the study area.The results show that:(1)The brine inclusions of the samples from the Kubla and Prosopis formations in the Lower Cretaceous coexisting with the hydrocarbon generally present two sets of peak ranges of homogenization temperature,with the peak ranges of low temperature and high temperature being 75–105℃ and 115–135℃,respectively;(2)The samples from the Kubla and Prosopis formations have experienced five tectonic evolution stages,i.e.,rapid subsidence in the Early Cretaceous,tectonic inversion in the Late Cretaceous,small subsidence in the Paleogene,uplift at the turn of the Paleogene and Neogene,and subsidence since the Miocene,in which the denudation thickness of the Late Cretaceous and after the turn of the Paleogene and Neogene are~1.8 km and~0.5 km,respectively.The cumulative denudation thickness of the two periods is about 2.3 km;(3)Using the brine inclusion homogenization temperature coexisting with the hydrocarbon as the capture temperature of the hydrocarbon,and combining with the apatite fission track thermal history modeling,the result shows that the Kubla and Prosopis formations in the Lower Cretaceous on the northern slope of the Bongor Basin have the same hydrocarbon accumulation time and stages,both of which have undergone two stages of hydrocarbon charging at 80–95 Ma and 65–80 Ma.The first stage of charging corresponds to the initial migration of hydrocarbon at the end of the Early Cretaceous rapid sedimentation,while the second stage of charging is in the stage of intense tectonic inversion in the Late Cretaceous.
文摘Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.
文摘The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity of Detarium Senegalense extracts. For this purpose, sequential extraction using solvents of increasing polarity was essential. The various extracts obtained underwent phytochemical and biochemical analyses. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthocyanins and steroids/terpenes. Quantitative analysis of total polyphenols, total flavonoids and total anthocyanins yielded the following results: total flavonoids (0.803 ± 0029 mg EQ/100g P for acetone extract of roots and 0.871 ± 0.401 mg EQ/100g P for methanol extract of leaves);total polyphenols (23.298 ± 12.68 mg EAG/100g P for acetone extract of roots and 24.69 ± 0.49 401 mg EAG/100g P for methanol extract of leaves);total monomeric anthocyanins (44.697 ± 0.939 mg EC3G/100g P and 16.699 ± 0.193 mg EC3G/100g P respectively for acetone and methanol extracts of stem bark). DPPH free radical scavenging activity was 1.674 ± 0.023 mg/mL for the acetone extract and 0.934 ± 0.24 mg/mL for the methanol extract of roots. .
文摘Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health problem in many countries. The aim of this study is to describe the epidemiology of tuberculosis and the strategies for controlling this disease in the Chadian prison population. During the course of our study, the prevalence of tuberculosis in prisons was 9.64%. The age group between 55 years and over (43.33%) was the most represented in this study, and all patients were men with a frequency of 62.66%. The cross-tabulation of Culture_7H9G and Culture_7H9P showed that out of our total positive sample, we found a total of 87 positive strains and 63 negative strains. Our study shows that it is essential to know the prevalence of tuberculosis in all the country’s prisons. Indeed, this can serve as an indication of the need for action in prisons to reduce TB rates, in particular by improving the structure of prison environments, diagnosing new cases quickly and accurately, identifying drug-resistant strains and implementing effective, direct treatment observed in people with tuberculosis.
文摘Groundwater is the main source of drinking water for large cities in most African countries. In Moundou, for example, the conventional groundwater supply system is failing. To compensate for this state failure, the population is building boreholes and wells, most of which tap the surface water table, generally referred to as the “water table”. The aim of this study is to characterize these waters in order to assess their level of contamination and, by extension, the degree of pollution of the water table. Major elements such as: Chloride (Cl<sup>-</sup>), Sulfate (SO<sub>4</sub><sup>2-</sup>), Nitrate (NO<sub>3</sub><sup>-</sup>), Calcium (Ca<sup>2+</sup>), magnesium (Mg<sup>2+</sup>), sodium (Na<sup>+</sup>) and potassium (K<sup>+</sup>) were analysed by Liquid Chromatography and the Bicarbonate ion (HCO<sub>3</sub><sup>-</sup>) was determined by the titrimetric method. The methodology applied is based on a combination of hydrochemical techniques and statistical analysis (PCA and CHA). A sampling campaign was carried out during high-water periods. The results of the physico-chemical analyses show mineralization ranging from 7.29 to 3670 μS/cm, with an average of 487.44 μS/cm. The groundwater studied is generally acidic, with a pH ranging from 3.26 to 6.41. Based on their anions, they are classified into four main hydrochemical facies: chloride and sulphate facies, calcium and magnesium facies, sodium and potassium facies and bicarbonate facies. The various correlations between major ions and statistical analyses have enabled us to identify three hydrogeochemical processes involved in water mineralization. The dominant process is silicate hydrolysis, followed by cation exchange, then anthropogenic input, which influences mineralization by polluting the water.
文摘Background: HIV in pregnant women presented a risk of transmission to newborns. This study was to determine HIV prevalence among pregnant women in the birthing rooms and give antiretrovirals to women infected and their newborns. Methods: A preliminary study was conducted from 2013 to 2015 at the Mother and Child Hospital. Pregnant women were counseled and tested for HIV-antibody according to the national algorithm using Determine HIV 1 & 2 and Immunocomb II Bispot HIV1 & 2. The women screened HIV-negative during the prenatal consultation and who accepted a second test were screened in the birth room. The data collected were processed using the Access Microsoft office 16 and SPSS software version 18. Results: A total of 6080 pregnant women were tested before and in the birth room. Of these, 5943 (97.4%) were detected as HIV-negative and 159 (2.6%) were HIV-positive. Of the 5943 with HIV-negative status, 1333 accepted the second test in the birth room, 10 of which have become HIV-positive. The rate of seroconversions was 0.75%. Conclusion: This study determined the prevalence of HIV in pregnant women. The result reveals the importance and necessity of repeating the screening test in the birth room because of the possibility of seroconversion or new infection during pregnancy.
文摘Introduction: Salmonella and Shigella are gram-negative bacilli that are resistant to most antibiotics and play an important role in an etiology of diarrhea disease. The aim of the study was to determine the prevalence of Salmonella spp and Shigella spp isolated from stool and blood samples in the city of N’Djamena. Materials and Method: This was a prospective study conducted in the four district hospitals of N’Djamena from 14 July 2022 to 31 December 2022. A questionnaire form was drawn up to collect the information sent to the study patients. The samples were analyzed at the CHU de la Mère et de l’Enfant, Labo-Redes laboratory according to their protocols and the standard of the antibiogram committee of the French microbiology society. Results: Of the 803 biological samples analyzed, 39 were positive for Salmonella spp and Shigella spp, including 15 for Salmonella and 24 for Shigella, giving an overall prevalence rate of 4.85%. Borehole water, uncooked food and lack of access to a latrine constitute a risk of being infected by Salmonella spp and Shigella spp species. Of the 8 antibiotics tested, Salmonella spp and Shigella spp strains showed good sensitivity to nalidixic acid (100% for Salmonella and 90 for Shigella) and to ciprofloxacin (90.9% for Salmonella and 75% for Shigella). Resistance to ampicillin was found in 81.81% of Salmonella species and 78.57% of Shigella species, as was resistance to chloramphenicol (81.81% of Salmonella species and 67.85% of Shigella species). Similarly, cleanliness of the service and equipment is an essential factor in preventing Salmonella and Shigella infections.
文摘The objective of this work was to determine new approaches that could improve the germination quality of Burkea africana seeds under reproducible conditions and by means available to farmers with a view to its propagation. The tests concerned the influence of three pre-germinative treatments. It is about the light scarification (Scl), medium scarification (Scm) and deep scarification (Scd) of seeds in order to determine some parameters of germination that are the latency time, the time of germination, the rate of germination and the speed of germination. The treated seeds were sown in transparent germinators lined with hydrophilic paper and then after the appearance of radicles, the plants were transplanted on five types of substrates (black soil, fine sand, sawdust, mixtures 1/1 of sawdust-black soil and 1/1 of sawdust-fine sand). The results obtained by the deep (Scp) and medium (Scm) scarification compared to those of the light scarification and the control, showed a clear reduction of the lag time (3 days/15 days (control). At the 5% threshold, germination times 6.27 × 10<sup>-1</sup> (Scd) and 6.01 × 10<sup>-1</sup> (Scm) were significantly influenced. Germination rates 4.18 × 10<sup>-1</sup> (Scd) and 3.92 × 10<sup>-1</sup> (Scm) are also influenced by the pretreatment. Germination rates are significantly improved (80%). Regardless of the under treatment, the substrate “sawdust and fine sand” improves the germination of scarified seeds by 14.07% more compared to the substrate “fine sand” at the 5% threshold. The mechanical scarification and the type of substrates thus influence positively and homogeneously the germination of seeds of Burkea africana. The domestication of this species is thus possible and can be considered for useful purposes.
文摘Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis of 219 patients with hepatocellular carcinoma (HCC) attending care at the University Reference Hospital of Ndjamena between 2007 and 2016. Results: This series of HCC was characterized by a male predominance (M:F = 2.4) with a mean tumor onset at the end of the fifth decade of life (49.9 ± 14.7 years). Tumors appear on a cirrhotic liver in 70% of cases and were already multifocal at diagnosis in two thirds of the patients. Alpha-fetoprotein was above the physiological threshold (10 ng/mL) in 73.4% of cases measured and above the so-called diagnostic level (400 ng/mL) in 53.4% of patients. The principal risk factor was chronic infection with hepatitis B virus, detected in 52.6% of cases. Patients seropositive for hepatitis C virus were infrequent (8.6%) and heavy alcohol intake was even less prevalent (5.9%). Remarkably, a very large subset of patients did not present any infectious or lifestyle risk factor (43.4%). Mean AFP values or fibrosis assessment scores are usually lower in these patients than in HBV-infected ones. Conclusions: The etiological spectrum of HCC is far from being fully established in Chad. Further epidemiological research is warranted to identify risk factors involved in a large proportion of cases. Exposure to aflatoxin B1 and dysmetabolic conditions affecting the liver have to be investigated as priority.
文摘Background: In comparison to other forms of chronic liver diseases, cirrhosis is generally poorly studied in sub Saharan Africa. In Chad, more particularly, no data are available despite the burden of liver diseases considered as the first cause of hospitalizations in the country. Methods: We conducted a retrospective analysis of 268 patients with liver cirrhosis attending care at the University Reference Hospital between 2007 and 2016. Results: This series of liver cirrhoses was characterized by a weak mal predominance (M:F = 1.7). The age of onset occurs significantly earlier in women than in men (40.6 ± 12.0 vs. 44.4 ± 13.4, p = 0.0171). The principal risk factor was persistent infection with hepatitis B virus (49% of cases) followed distantly by infection with hepatitis C virus (13%) and excessive alcohol consumption (10%). Men were more frequently carrying HBV surface antigen than women (65.6% vs 35.9% p = 0.0019). HBV-associated liver cirrhosis was overall more severe than diseases from other causes. A large proportion of cirrhosis (30%), observed primarily in women (48.1% vs 24.1%, p = 0.0036), was considered are cryptogenic. Conclusions: The etiological spectrum of liver cirrhosis remains to be properly defined in Chad. This lack of knowledge prevents the implementation of an efficient policy of prevention. A significant effort should be secured to characterize hitherto neglected infectious, lifestyle or genetic risk factors responsible of this form of terminal disease and improve subsequently liver health of local populations.
文摘Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.
文摘The objective of this research is to lift the dormancy of seeds of S. kunthianum in with a view to domesticating them. In this experiment, we used the soaking of seeds in sulfuric acid for different durations (10 min, 30 min and 1 h). The treated seeds were sown in transparent germinators. The explants obtained were then transplanted into pots containing five types of substrate (black earth, fine sand, sawdust, mixtures 1/1 of sawdust/black earth and 1/1 of sawdust/fine sand). This second test made it possible to determine the rate of germination on the substrate. The results obtained compared to those of the control showed a clear reduction in the latency time or germination time (62 hours) instead of 6 days (control), in the germination time 3 days/7 days (control) and a very high germination rate (100%). At the 5% threshold, soaking for 10 min and 30 min (100%) is the best result on the germination of S. kunthianum seeds. Soaking for 1 hour gives (7%) very low. After transplantation of the explants, the percentages obtained independently of the treatments show that the 1/1 mixtures of sawdust/black earth (75.19%), black earth (73.33%) and sawdust/fine sand (66.30%) have a higher performance than the others. The type of germination is epigeal. This work makes it possible to domesticate S. kunthianum in Chad.
文摘Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7<sup>TM</sup> software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.
文摘Introduction: Acute kidney injury (AKI) is a relatively rare but serious complication during pregnancy. It is often the consequence of a delay or poor management of a given complication that constitutes as a public health problem in developing countries. The objective of our study was to determine the epidemiological, diagnostic, therapeutic and evolutionary aspects of obstetric acute kidney injury in Chad. Methodology: This was a cross-sectional study with descriptive and analytical aims over a period of 6 months from June 1, 2020 to November 30, 2020 and conducted in the Gyneco-Obstetric Emergency Department of the Mother and Child University Hospital in N’Djamena. All patients admitted for obstetric AKI and requiring hemodialysis were referred to the Nephrology Department of the Renaissance University Hospital. AKI was defined according to the KDIGO 2012 classification. All pregnant women with more than 20 weeks of gestation until immediately postpartum who were admitted for acute kidney injury were included in the study. Results: During our work, 1238 patients were collected. Among them, 56 cases of obstetric AKI were included, representing a hospital prevalence of 4.5%. The average age was 26.1 ± 5.8 years (16 and 37 years). The majority of our patients were primigravidas which was 42%, rural women represented 35.7% of our sample and nearly 67.8% of pregnancies did not benefit from regular prenatal consultation. AKI during the 3rd trimester was found in 42.9% of cases. Oligo-anuria was present in 28.6% of cases. Acute tubular necrosis was found in 52 cases. It was secondary to preeclampsia in 60.7%, to HELLP syndrome in 17.9% and to a hemorrhagic delivery complicating a retroplacental hematoma in 7.1%. According to the KDIGO 2012 classification, Stages 1, 2 and 3 represented 32%, 23% and 25% of cases, respectively. Hemodialysis was initiated in 1/4 of cases. Recovery of renal function was complete in 78.6% of cases and partial in 7.1%. We recorded eight (14.3%) maternal deaths and twenty-four cases of in-utero fetal death. The average length of hospital stay was 9.21 ± 5 days (2 and 20 days). Conclusion: Obstetric AKI remains a serious complication of pregnancy and postpartum. Despite the good renal prognosis, severe preeclampsia is the main cause. Prevention through monitoring pregnancies would be the most effective measure.
文摘Introduction: Low back disc disease (LSD) is a neurosurgical condition with significant socioeconomic repercussions. The objective of this study was to determine the frequency and report the modalities of management. Methodology: This study on lumbosciatic disc disease was carried out in the neurosurgery department of the University Hospital Center (CHU), la Renaissance in N’Djamena. It covered a period of 12 months (from September 2019 to August 2020). A descriptive and an analytical approach were used. The variables studied were epidemiology, clinic, radiology and therapy. Results: the results showed that LSD represented 14.7% of the reasons for consultation in neurosurgery. The average age was 45.8, and to some extent, it ranges between 18 and 76. Lifting was the main reason behind lumbosciatic disc disease with 35.9% of cases, followed by a sedentary life style which represents 30.8%. Lumbosciatica L5 was noted in 49.4%. Obesity and overweight were significant risk factors (P = 0.02) reported in 59% of cases. Motor and sensory deficits were observed in 14.8% and 17.3% of cases, respectively. CT of the lumbar spine was performed in 91% and MRI in 28.9%. The L4-L5 disc herniation represented 74.3% of cases, with a lateral location in 44.2% and L5 radicular impingement in 30.8%. Conservative treatment was instituted in 87.2% and surgical treatment in 12.8% of cases. Conclusion: LSD is caused by a sedentary lifestyle, physical work and overweight. Surgery deals with complicated cases and cases not responding to conservative treatment.
文摘The pollution of sediments by inorganic pollutants requires particularly important attention because of their toxicity, their persistence in the environment and their bioaccumulation by animal and plant life. The pollution of sediments by inorganic pollutants requires particularly important attention because of their toxicity, their persistence in the environment and their bioaccumulation by animal and plant living beings. This study focuses on the pollution of sediments of the Chari and Logon rivers in the city of N’Djamena by heavy metals. The objective of this study is to evaluate the degree of contamination, the geo-accumulation index and the degree of the Pollutant Loading Index of some heavy metals (Pb, Cr, Cu, Mn and Cd) and iron in the sediments of the sampled sites. The average concentrations of heavy metals and iron in the sediments are: Pb (10.00 ± 00 μg/Kg to 126 ± 16.52 μg/Kg);Cr VI (0.13 ± 00 mg/Kg to 0.21 ± 00 mg/Kg);Cd (trace);Cu (0.08 ± 0.02 mg/kg to 3.23 ± 0.64 mg/kg);Fe (0.25 ± 0.00 mg/kg to 5.79 ± 0.00 mg/kg);and Mn (0.2 ± 0.00 mg/Kg to 1.1 ± 0.00 mg/Kg);in order of highest to lowest abundance: Fe > Mn > Cd > Cu > Cr VI > Pb for the Logon;Fe > Cu > Mn > Cd > Cr VI > Pb for the Chari and Fe > Mn > Cu > Cd > Cr VI > Pb for the Confluent. The contamination factors for all heavy metals range from no contamination to low contamination for the sediments analyzed. The geo-accumulation indices indicate that the sampled sites are not polluted. The same is true for Er and RI which confirm an absence of ecological risks in the analyzed sediments.
文摘目的：探讨心力衰竭高血压、年龄、糖尿病和脑卒中（包括一过性脑缺血）（CHADS2）评分及改良CHADS评分对心房颤动（房颤）射频消融术后复发的预测价值。方法对2010年7月至2012年3月在我院行射频消融术的93例房颤患者追踪随访12个月，术后1，3，6，9，12个月行12导联心电图或长程心电图检查，结合临床症状及心电图检查结果将其分为复发组（n＝40）和未复发组（n＝53），采用单因素和多因素分析消融术后房颤复发的危险因素。结果93例房颤患者中持续性房颤35例（37.63%），随访12个月时复发40例（43.01%）。房颤复发组与未复发组在平均年龄（P＜0.01）、年龄＞70岁（P＜0.05）、病史（P＜0.05）、房颤类型（P＜0.01）、左房内径（P＜0.001）、左室射血分数（P＜0.05）、血细胞比容（P＜0.05）、是否伴心力衰竭（P＜0.05）、是否伴高血压（P＜0.01）、是否伴糖尿病（P＜0.05）、是否有一过性脑缺血或脑卒中史（P＜0.05）、术后是否服用血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体拮抗剂（ACEI/ARB，P＜0.01）、术后是否服用Ⅲ类抗心律失常药（P＜0.05）、CHADS2评分≥1（P＜0.001）等方面差异有统计学意义。logistic回归分析发现，病史、房颤类型、左房内径、CHADS2评分≥1为房颤术后复发的独立危险因素（病史长短：OR＝1.16，P＝0.020；左房内径：OR＝1.17，P＝0.025；房颤类型：OR＝3.34，P＝0.050；CHADS2评分≥1：OR＝5.93，P＝0.019）。进一步分析发现，CHADS2评分≥2、改良CHADS评分≥1、改良CHADS评分≥2亦为房颤术后复发的独立危险因素（CHADS2≥2：OR＝5.42，P＝0.028；改良CHADS评分≥1：OR＝6.64，P＝0.015；改良CHADS评分≥2：OR＝7.32，P＝0.002）。截断点分析显示，CHADS2与改良CHADS均≥1时对房颤消融预后的预测价值最高，对CHADS2评分≥1与改良CHADS评分≥1预测房颤消融预后的灵敏度、特异度、曲线下面积进行比较发现，差异均无统计学意义[分别为0.775 vs 0.800、0.358 vs 0.377、0.708（95%CI 0.601～0.806） vs 0.711（95%CI 0.605～0.818），均P＞0.05]。结论病史长短、左房内径、房颤类型、CHADS2评分≥1、CHADS2评分≥2、改良CHADS评分≥1、改良CHADS评分≥2均为心房颤动消融术后复发的独立危险因素，且改良CHADS评分与CHADS2评分对房颤消融预后具有同等的预测价值。
