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Acute exacerbation of idiopathic pulmonary fibrosis: usual interstitial pneumonitis vs.possible usual interstitial pneumonitis pattern
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作者 Meng-Shu Cao Jian Sheng +5 位作者 Tian-Zhen Wang Xiao-Hua Qiu Dong-Mei Wang Yang Wang Yong-Long Xiao Hou-Rong Cai 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第18期2177-2184,共8页
Background:The prognosis of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is very poor with a high mortality.The aim of this study was to describe the clinical features and survival of patients with AE-... Background:The prognosis of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is very poor with a high mortality.The aim of this study was to describe the clinical features and survival of patients with AE-IPF with usual pulmonary fibrosis (UIP) and possible UIP (P-UIP) pattern on chest high resolution computed tomography (HRCT).Methods:This retrospective study included 107 patients with AE-IPF admitted to Nanjing Drum Tower Hospital from January 2010 to December 2016.The subjects were divided into UIP (n =86) and P-UIP group (n=21) based on chest HRCT.Continuous variables were analyzed using Student's t test or Mann-Whimey U test.Categorical variables were analyzed using x2 test.Log-rank test was used for the survival analysis.Cox proportional models evaluated the risk factors for AE occurrence and survival.Results:The male,older patients,previous N-acetylcysteine use,elevated white blood cell (WBC) counts,and microbiology infection were more common in the UIP group than the P-UIP group (X2 =13.567,P < 0.001;z =-2.936,P =0.003;X2 =5.901,P =0.015;t =2.048,P =0.043;x2 =10.297,P =0.036,respectively).The percentage of AE with UIP pattern in idiopathic interstitial pneumonia (ⅡP) was significantly higher than P-UIP pattern (X2 =40.011,P < 0.001).Smoking was the risk factor for AE within 6 months after IPF diagnosis in the UIP group.The cumulative proportion survival of 30-days was significantly higher in the UIP group compared with the P-UIP group (x2 =5.489,P =0.019) despite of the similar overall survival in the two groups.Multivariate Cox regression analysis indicated WBC count,partial pressure of oxygen in artery (PaO2)/ffactional concentration of inspired oxygen (FiOz),and computed tomography (CT) score were the independent predictors for survival in the UIP group (hazard ratio [HR]:1.070,95% confidential interval [CI]:1.027-1.114,P=0.001;HR:0.992,95% CI:0.986-0.997,P=0.002;and HR:1.649,95% CI:1.253-2.171,P < 0.001,respectively).Conclusions:AE occurrence of UIP patients in IIP was significantly more 展开更多
关键词 IDIOPATHIC pulmonary FIBROSIS Acute EXACERBATION Usual INTERSTITIAL PNEUMONITIS
Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection 预览
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作者 Ling Yuan Bai-Mei Zeng +7 位作者 Lu-Lu Liu Yi Ren Yan-Qing Yang Jun Chu Ying Li Fang-Wan Yang Yi-Huai He Shi-De Lin 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第19期2327-2337,共11页
BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus (HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation (HD) and acut... BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus (HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation (HD) and acute-on-chronic liver failure (ACLF) in patients with severe acute exacerbation (SAE) of chronic HBV infection remain unknown. AIM To identify risk factors related to progression to HD and ACLF in compensated patients with SAE of chronic HBV infection. METHODS The baseline characteristics of 164 patients with SAE of chronic HBV infection were retrospectively reviewed. Independent risk factors associated with progression to HD and ACLF were identified. The predictive values of our previously established prediction model in patients with acute exacerbation (AE model) and the model for end-stage liver disease (MELD) score in predicting the development of ACLF were evaluated. RESULTS Among 164 patients with SAE, 83 (50.6%) had compensated liver cirrhosis (LC), 43 had progression to HD without ACLF, and 29 had progression to ACLF within 28 d after admission. Independent risk factors associated with progression to HD were LC and low alanine aminotransferase. Independent risk factors for progression to ACLF were LC, high MELD score, high aspartate aminotransferase (AST) levels, and low prothrombin activity (PTA). The area under the receiver operating characteristic of the AE model [0.844, 95% confidence interval (CI): 0.779-0.896] was significantly higher than that of MELD score (0.690, 95%CI: 0.613-0.760, P < 0.05) in predicting the development of ACLF. CONCLUSION In patients with SAE of chronic HBV infection, LC is an independent risk factor for progression to both HD and ACLF. High MELD score, high AST, and low PTA are associated with progression to ACLF. The AE model is a better predictor of ACLF development in patients with SAE than MELD score. 展开更多
关键词 Acute-on-chronic LIVER failure Chronic hepatitis B Hepatic DECOMPENSATION LIVER CIRRHOSIS Risk factors Severe ACUTE EXACERBATION
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糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期的临床价值 预览 被引量:1
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作者 蒋瑜芳 《中国继续医学教育》 2019年第2期113-115,共3页
目的探讨糖皮质激素联合特布他林治疗慢性阻塞性肺疾病(慢阻肺)急性加重期的临床价值。方法选取我院2016年7月—2018年1月80例慢阻肺急性加重期患者,根据治疗方式不同进行分组,观察组与对照组,每组各40例。观察组实施糖皮质激素联合特... 目的探讨糖皮质激素联合特布他林治疗慢性阻塞性肺疾病(慢阻肺)急性加重期的临床价值。方法选取我院2016年7月—2018年1月80例慢阻肺急性加重期患者,根据治疗方式不同进行分组,观察组与对照组,每组各40例。观察组实施糖皮质激素联合特布他林治疗,对照组仅给予特布他林治疗,对比治疗后血气指标变化、肺通气功能指标、治疗效果。结果观察组治疗后PaCO2明显低于对照组(P<0.05);PaO2、pH值明显高于对照组(P<0.05);肺通气功能各项指标、治疗总有效率明显高于对照组(P<0.05)。结论糖皮质激素联合特布他林治疗慢阻肺急性加重期的临床价值显著。 展开更多
关键词 糖皮质激素 特布他林 慢阻肺 急性 加重期 治疗效果
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Effects of the Clearing the Lung and Dissipating Phlegm Method in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
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作者 Tao Zhang Yao-Hui Li +1 位作者 Gai-Xia Liu Xiu-Lin Tang 《世界中医药杂志:英文版》 2019年第1期61-69,共9页
Objective: The objective of this study is to evaluate the efficacy and safety of the clearing the lung and dissipating phlegm method in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD... Objective: The objective of this study is to evaluate the efficacy and safety of the clearing the lung and dissipating phlegm method in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD) and to provide evidence for the treatment of the disease. Materials and Methods: Literature was searched from the United States National Library of Medicine(PubMed), Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database(Wanfang), and the Full?Text Database of Chinese Scientific and Technical Periodicals(VIP).A comprehensive collection was made of randomized controlled trials(RCTs) before June 2018, in which the treatment groups used either the clearing the lung and dissipating phlegm formulas only or combined it with routine Western medicine therapy, and the control group adopted routine Western medicine therapy only for the acute exacerbation of COPD. The Cochrane risk of bias method was used to evaluate the quality of the literature. The data were analyzed and retrieved independently by two reviewers before metaanalysis was carried out with RevMan 5.3 software to evaluate the primary outcome measures, including the total clinical effective rate, and the secondary outcome measures such as the pulmonary function(forced vital capacity [FVC], forced expiratory volume in the 1 s [FEV1], percentage of FEV1 [FEV1%], and FEV1/FVC)and blood gases(PaO2 and PaCo2). Results: A total of 13 RCTs involving 990 patients(496 in the treatment group and 494 in the control group)were included in this study. Metaanalysis revealed significant difference in the efficacy of the group that adopted solely the routine Western medicine method and the group that combined the Western medicine with the clearing the lung and dissipating phlegm method. Outcome measures including the pulmonary function(FVC, FEV1, FEV1%, and FEV1/FVC) and the blood gases(PaO2 and PaCo2) were significantly improved as compared to the control group(P < 0.00001). However, adverse effects in the treatment group using comb 展开更多
关键词 Acute EXACERBATION of chronic OBSTRUCTIVE pulmonary disease CLEARING the LUNG and dissipating PHLEGM method META-ANALYSIS systematic review
Effects of doxofylline combined with Dingzhang Decoction on AECOPD and its influence on NLRP3 mRNA and TLR4-MyD88 pathway
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作者 Ke Wang Qiong-Fen Wang Xi Li 《海南医科大学学报(英文版)》 2019年第3期22-26,共5页
Objective: To investigate the effect of doxofylline combined with Dingzhang Decoction on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on NLRP3 mRNA and TLR4MyD88 pathway. Methods... Objective: To investigate the effect of doxofylline combined with Dingzhang Decoction on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on NLRP3 mRNA and TLR4MyD88 pathway. Methods: 120 patients with AECOPD from May 2017 to June 2018 were randomly divided into two groups (n=60). The control group was treated with doxofylline, and the observation group was treated with Dingzhang Tangdingzhang in the control group. Blood gas index and lung function index were compared between the two groups. Serum interleukin-1 (IL-1), interleukin-18 (IL-18) and peripheral blood lymphocyte NLRP3 mRNA and TLR4MyD88 pathway were detected and compared. Protein expression level. Results: The effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the blood gas indexes of both groups were significantly improved (P<0.05). PaO2 in the observation group was higher than that in the control group and PaCO2 was significantly lower than the control group (P<0.05). After treatment, the lung function indexes of both groups were significantly increased (P<0.05). FEV1 and PEF in the observation group were significantly higher than the control group (P<0.05). After treatment, IL-1 and IL-18 were significantly decreased (P<0.05). IL-1 and IL-18 in the observation group were significantly lower than the control group (P<0.05). There was no significant difference in NLRP3 mRNA levels between the two groups before treatment (P>0.05), and it was significantly decreased after treatment (P<0.05). The level of NLRP3 mRNA in peripheral blood lymphocytes of the observation group was significantly lower than that of the control group (P<0.05). There was no significant difference in TLR4 and MyD88 protein levels between the two groups before treatment (P>0.05), and significantly decreased after treatment (P<0.05). The levels of TLR4 and MyD88 in peripheral blood lymphocytes of the observation group were significantly lower than those of the control group (P< 展开更多
关键词 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Acute exacerbation of CHRONIC OBSTRUCTIVE PULMONARY DISEASE DOXOFYLLINE Dingzhang DECOCTION NOD-like receptors protein 3
Acute exacerbation of chronic obstructive pulmonary disease treated by extracorporeal carbon dioxide removal
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作者 Min Li Si-Chao Gu +1 位作者 Jin-Gen Xia Qing-Yuan Zhan 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第20期2505-2507,共3页
To the Editor: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients often required mechanical ventilation support. But ventilator-related side effects are still inevitable, leading to treatmen... To the Editor: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients often required mechanical ventilation support. But ventilator-related side effects are still inevitable, leading to treatment failure. The extracorporeal carbon dioxide removal (ECCO2R) technique drains blood to artificial membrane lungs, performing oxygenation and removing carbon dioxide without mechanical ventilation. ECCO2R has been widely used outside China, but there is no official report of its use in China. Recently, we treated two AECOPD patients using ECCO2R. 展开更多
关键词 EXACERBATION ACUTE OBSTRUCTIVE
优化病区管理模式对COPD急性加重期患者院内感染的控制效果 预览
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作者 韩晨旭 贾媛媛 +4 位作者 王红 陈蕾 韩妮 王薇 张宁悦 《临床医学研究与实践》 2019年第11期185-186,共2页
目的分析优化病区管理模式对COPD急性加重期患者院内感染的控制效果。方法将我院呼吸科住院部收治的90例COPD急性加重期患者按照病室序号分为观察组和对照组,各45例。对照组实施常规护理管理,观察组实施优化病区管理。比较两组的护理效... 目的分析优化病区管理模式对COPD急性加重期患者院内感染的控制效果。方法将我院呼吸科住院部收治的90例COPD急性加重期患者按照病室序号分为观察组和对照组,各45例。对照组实施常规护理管理,观察组实施优化病区管理。比较两组的护理效果。结果观察组院内感染发生率、护理满意度均优于对照组(P<0.05)。护理后,两组CD64感染指数、PCT水平、住院时间、FRC、RV/TLC、FEV1、FEV1/FVC均改善,且观察组均优于对照组(P<0.05)。结论优化病区管理模式能够有效控制COPD急性加重期患者院内感染的发生,提高护理满意度,临床应用价值高。 展开更多
关键词 优化病区管理 COPD 急性加重期 院内感染
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Correlation between serum PCT, IL-6 and CRP levels and pulmonary ventilation function in AECOPD patients
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作者 Tian-Biao He Yan-Cong Li Jian-Zhi Yuan 《海南医科大学学报(英文版)》 2019年第6期47-50,共4页
Objective: To investigate the correlation of serum calcitonin (PCT), interleukin -6 (IL-6), C reactive protein (CRP) and pulmonary ventilation function in patients with acute exacerbation of chronic obstructive pulmon... Objective: To investigate the correlation of serum calcitonin (PCT), interleukin -6 (IL-6), C reactive protein (CRP) and pulmonary ventilation function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: 70 patients with AECOPD in our hospital from May 2017 to May 2018 were selected to be included in the case group, and 70 healthy persons in the same period were selected as the control group. The serum levels of PCT, IL-6, CRP and lung function were compared between the two groups, and the relationship between the serum levels of PCT, IL-6 and CRP and the pulmonary ventilation function of the patients was analyzed. Results: the levels of PCT, IL-6 and CRP in the case group were significantly higher than those in the control group. The difference was statistically significant (P < 0.05), and the FEV1, FEV1/FVC and FEV1% in the case group were significantly lower than those in the control group (P < 0.05), and the difference of PCT, IL-6 and CRP was significant between the patients with different pulmonary function levels, and the statistics were statistically significant. The study significance (P < 0.05), and the level of PCT, IL-6 and CRP increased gradually with the increase of lung function grade, and the level of PCT, IL-6 and CRP in AECOPD patients were negatively correlated with FEV1, FEV1/FVC and FEV1%, and the difference was statistically significant (P < 0.05). Conclusion: the serum levels of PCT, IL-6 and CRP in patients with AECOPD are abnormal increased and are closely related to the pulmonary ventilation function of the patients, which can be used as an important indicator of the monitoring of the patient's condition in AECOPD. 展开更多
关键词 Acute EXACERBATION of chronic OBSTRUCTIVE PULMONARY disease PROCALCITONIN INTERLEUKIN - 6 C REACTIVE protein PULMONARY function
戒烟对COPD患者肺功能、CAT评分和急性发作的影响 预览
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作者 张勃 白吉明 +5 位作者 王少飞 李金玲 郑洪飞 张庆 庞桂芬 杨林瀛 《重庆医学》 CAS 2019年第9期1527-1530,共4页
目的探讨戒烟对慢性阻塞性肺疾病(COPD)患者肺功能、COPD测试问卷(CAT)评分和急性发作的影响。方法对405例COPD患者进行为期1年的随访,吸烟者给予劝导戒烟干预,根据戒烟成功与否将其分为戒烟组193例、吸烟组93例和已戒烟组119例。每隔3... 目的探讨戒烟对慢性阻塞性肺疾病(COPD)患者肺功能、COPD测试问卷(CAT)评分和急性发作的影响。方法对405例COPD患者进行为期1年的随访,吸烟者给予劝导戒烟干预,根据戒烟成功与否将其分为戒烟组193例、吸烟组93例和已戒烟组119例。每隔3个月检测其肺功能各项指标,随时记录其急性发作,总结随访1年的CAT评分。结果在调整各组年龄、性别、COPD全球倡议解读(GOLD)分级后,戒烟组和吸烟组在同一随访时间点较已戒烟组的一秒用力呼气容积(FEV1)、最大呼气流量(PEF)值高约500mL和900mL,差异有统计学意义(P<0.05)。随访9个月时戒烟组肺功能指标FEV1较初始时明显增高(平均180mL),差异有统计学意义(P<0.05)。随访12个月时吸烟组肺功能指标FEV1较初始时明显降低(平均106mL),差异有统计学意义(P<0.05);戒烟组PEF值较初始时有明显增高(平均318mL),差异有统计学意义(P<0.05)。结论早期戒烟可以延缓COPD患者肺功能各项指标的恶化,提高其生活质量和CAT评分,并减少急性发作次数。 展开更多
关键词 戒烟 肺疾病 慢性阻塞性 急性加重期 慢性阻塞性肺疾病评估测试评分
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Effects of Suhuang Zhike Capsule on Pulmonary Function, Blood Gas Analysis Index, Serum PCT and CRP Expression in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease 预览
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作者 任君清 《世界中西医结合杂志(英文)》 2019年第2期32-38,共7页
OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. ME... OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People’s Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days’ treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV1), forced expiratory volume occupancy in the 1st second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO2) and arterial blood carbon dioxide partial pressure(PaCO2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV1, FEV1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO2 and OI were significantly increased after the treatment(P < 0.05), PaCO2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the contro 展开更多
关键词 Chronic OBSTRUCTIVE pulmonary disease Acute EXACERBATION Suhuang Zhike CAPSULE Lung function BLOOD gas analysis index PROCALCITONIN C-reactive protein
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我国城区支气管哮喘急性发作住院患者死亡及危险因素情况调查分析 被引量:6
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作者 林江涛 邢斌 +27 位作者 唐华平 杨岚 袁雅冬 顾玉海 陈萍 刘晓菊 张捷 刘辉国 王长征 周玮 孙德俊 陈一强 陈卓昌 黄茂 林其昌 胡成平 杨晓红 霍建民 叶贤伟 周新 蒋萍 张伟 黄奕江 戴路明 刘荣玉 蔡绍曦 许建英 周建英 《中华医学杂志》 CSCD 北大核心 2018年第34期2760-2763,共4页
目的 调查分析我国城区因哮喘急性发作住院患者的死亡及危险因素情况.方法回顾性调查并分析我国29个省/自治区/直辖市的29家医院2013—2014年间因哮喘急性发作入院的患者.搜集患者的一般资料、入院时间、合并症情况、急性发作的严重程... 目的 调查分析我国城区因哮喘急性发作住院患者的死亡及危险因素情况.方法回顾性调查并分析我国29个省/自治区/直辖市的29家医院2013—2014年间因哮喘急性发作入院的患者.搜集患者的一般资料、入院时间、合并症情况、急性发作的严重程度、死亡危险因素、是否入住重症监护病房(ICU)、是否应用机械通气以及转归情况等信息.计算哮喘急性发作住院患者的病死率,统计死亡患者的基本信息及死因,并据此分组比较死亡组与存活组的并发症及死亡危险因素分布情况.结果共纳入患者3240例,中位年龄57.0岁,共有8例患者死亡,中位年龄68.5岁,哮喘急性发作住院患者的病死率为0.25%.死亡组入院时间均为冬春季.死亡原因:急性心肌梗死1例,心源性休克1例,张力性气胸1例,猝死1例,呼吸衰竭1例,死因不详3例.死亡组平均合并症数高于存活组(1.10比0.83项),合并糖尿病、冠心病及高血压的比例(均为2/8)也均高于存活组的7.6%(246/3232)、7.6%(246/3232)及22.6%(731/3232),但差异均无统计学意义(均P〉0.05).结论我国哮喘急性发作患者的住院病死率较低.死亡患者年龄较大,冬春季入院比例高,合并症数较多,合并糖尿病、冠心病及高血压者比例高. 展开更多
关键词 哮喘 急性发作 死亡率 危险因素
慢性阻塞性肺疾病稳定期患者共患疾病与一年急性加重风险的关系研究 被引量:4
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作者 黄亚玲 毛兵 +6 位作者 闵婕 李官红 郑玉琼 吴丽华 汪胜军 瞿波 付娟娟 《中华结核和呼吸杂志》 CSCD 北大核心 2018年第5期349-354,共6页
目的 探讨慢性阻塞性肺疾病(慢阻肺)共患疾病与1年急性加重风险的关系.方法 前瞻性顺序纳入四川大学华西医院中西医结合科就诊的2014年5月至2015年12月233例慢阻肺患者,排除其中肺癌、肺结核、支气管哮喘及闭塞性细支气管炎患者13例,... 目的 探讨慢性阻塞性肺疾病(慢阻肺)共患疾病与1年急性加重风险的关系.方法 前瞻性顺序纳入四川大学华西医院中西医结合科就诊的2014年5月至2015年12月233例慢阻肺患者,排除其中肺癌、肺结核、支气管哮喘及闭塞性细支气管炎患者13例,220例中64例慢阻肺稳定期患者,其中男46例,女18例,年龄47~86岁,平均(68 ±9)岁.收集患者临床资料并统计共患疾病数量、种类及Charlson合并症指数(CCI),根据CCI将患者分为高分组与低分组,比较2组临床表现,观察共患疾病数量和种类与患者肺功能的关系.对64例患者进行3个月1次的电话随访,记录至入组1年期间慢阻肺急性加重次数.结果 CCI高分组[(75 ±6)岁]较低分组[(62 ±8)岁]年龄更大,肺功能更差[FEV1占预计值%分别为(40 ±18)%和(52 ±18)%],伴随慢阻肺共患疾病种类更多[4(3,7)、1(1, 3)],高分组患者在随访期间因慢阻肺急性加重住院次数更多[1(0, 2)、0(0, 0.25)].共患疾病种类更多的慢阻肺患者的评估改良呼吸困难量表评分更高[(2(1,3)、2(1,2)]、肺功能更差[FEV1占预计值%分别为(42 ±19)%和(53 ±19)%],年龄校正后CCI评分更高[5(3, 5)、3(2,3)],随访期间全身糖皮质激素[2(0,3)、0(0,0.75)]及抗生素治疗次数更多[3(2,4)、1.5 (1,2.75)].伴随有支气管扩张的慢阻肺患者住院次数及急性加重总次数均高于不伴有支气管扩张者(P〈0.05).结论 慢阻肺患者共患疾病的种类以及如何评价共患疾病对慢阻肺的综合评估和预后判断的作用值得重视. 展开更多
关键词 肺疾病 慢性阻塞性 并发症 急性加重 预测
支气管哮喘急性发作评估及处理中国专家共识 被引量:16
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《中华内科杂志》 CSCD 北大核心 2018年第1期4-14,共11页
支气管哮喘(以下简称哮喘)的管理目标是达到疾病的总体控制,包括控制疾病的当前症状和降低疾病的未来风险。在未来风险中,哮喘急性发作是非常重要的一个方面,可对机体产生一系列的危害,并消耗了额外的医疗资源,造成了严重的社会... 支气管哮喘(以下简称哮喘)的管理目标是达到疾病的总体控制,包括控制疾病的当前症状和降低疾病的未来风险。在未来风险中,哮喘急性发作是非常重要的一个方面,可对机体产生一系列的危害,并消耗了额外的医疗资源,造成了严重的社会经济负担,是哮喘致残和致死的重要原因。因此,预防和减少哮喘的急性发作对提高疾病的总体控制水平具有重要意义。 展开更多
关键词 支气管哮喘急性发作 专家 中国 评估 社会经济负担 管理目标 医疗资源 疾病
哮喘急性发作的病例分析及药物治疗
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作者 朱烨轩 刘传合 《临床药物治疗杂志》 2018年第6期26-28,共3页
目的:为提高临床医生对支气管哮喘及其急性发作的认识,做出及时正确诊断并给予规范化治疗,以减少误诊和医疗资源的浪费。方法:分析2例哮喘急性发作的病例并进行总结。结果:患儿均属于哮喘的急性发作,在明确的诊断和正确治疗下病情好... 目的:为提高临床医生对支气管哮喘及其急性发作的认识,做出及时正确诊断并给予规范化治疗,以减少误诊和医疗资源的浪费。方法:分析2例哮喘急性发作的病例并进行总结。结果:患儿均属于哮喘的急性发作,在明确的诊断和正确治疗下病情好转,并给予长期规范化管理。结论:哮喘急性发作治疗的关键是缓解气道痉挛、消除气道炎症。尽早明确诊断并给予正确规范化治疗对哮喘的愈后有积极的影响。 展开更多
关键词 哮喘 急性发作 治疗
基于Apriori算法探讨姚梅龄教授诊治哮喘发作期病案的辨证规律 预览
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作者 陈聪 谌松霖 +2 位作者 王永华 陈孝红 石强 《世界科学技术:中医药现代化》 CSCD 北大核心 2018年第7期1210-1214,共5页
目的:探讨名老中医姚梅龄运用六经辨证体系辨证哮喘发作期的病因、病机及其证候类型的特征。方法:运用Apriori算法对姚梅龄教授哮喘诊疗医案中病因、病所、病机进行关联分析。结果:哮喘发作期病所以手太阴肺经为主;病因均涉及痰饮,主要... 目的:探讨名老中医姚梅龄运用六经辨证体系辨证哮喘发作期的病因、病机及其证候类型的特征。方法:运用Apriori算法对姚梅龄教授哮喘诊疗医案中病因、病所、病机进行关联分析。结果:哮喘发作期病所以手太阴肺经为主;病因均涉及痰饮,主要合并热邪、风邪;主导证型有手太阴肺风湿饮郁热证7种证候类型。结论:姚梅龄教授辨治哮喘发作期时注重辨别痰、饮之邪,分清六经表里,认为哮喘发作期病所主要在手太阴肺之表里;证候类型以痰饮病因为核心,共有手太阴肺风湿饮郁热证等7种。 展开更多
关键词 姚梅龄 哮喘 发作期 数据挖掘
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Neural Respiratory Drive Measured Using Surface Electromyography of Diaphragm as a Physiological Biomarker to Predict Hospitalization of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients
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作者 Dan-Dan Zhang Gan Ln +5 位作者 Xaan-Feng Zhu Ling-Ling Zhang Jia Gao Li-Cheng Shi Jian-Hua Gu Jian-Nan Liu 《中华医学杂志:英文版》 SCIE CAS CSCD 2018年第23期2800-2807,共8页
Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi?electrode catheter can be used as a feasible clinical physiological parameter in patients with chro... Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi?electrode catheter can be used as a feasible clinical physiological parameter in patients with chronic obstructive pulmonary disease (COPD) to provide useful information on the treatment response. However, it remains unknown whether the surface diaphragm electromyogram (EMGdi) could be used to identify the deterioration of clinical symptoms and to predict the necessity of hospitalization in acute exacerbation of COPD (AECOPD) patients. Methods: COPD patients visiting the outpatient department due to acute exacerbation were enrolled in this study. All patients who were subjected to EMGdi and classical parameters such as spirometry parameters, arterial blood gas analysis, COPD assessment test (CAT) score, and the modified early warning score (MEWS) in outpatient department, would be treated effectively in the outpatient or inpatient settings according to the Global Initiative for Chronic Obstructive Lung Disease guideline. When the acute exacerbation of the patients was managed, all the examination above would be repeated. Results: We compared the relationships of admission?to?discharge changes (Δ) in the normalized value of the EMGdi, including the change of the percentage of maximal EMGdi (ΔEMGdi%max) and the change of the ratio of minute ventilation to the percentage of maximal EMGdi (ΔVE/EMGdi%max) with the changes of classical parameters. There was a significant positive association between ΔEMGdi%max and ΔCAT,ΔPaCO2, and ΔpH. The change (Δ) of EMGdi%max was negatively correlated with ΔPaO2/FiO2 in the course of the treatment of AECOPD. Compared with the classical parameters including forced expiratory volume in 1 s, MEWS, PaO2/FiO2, the EMGdi%max (odds ratio 1.143, 95% confidence interval 1.004–1.300) has a higher sensitivity when detecting the early exacerbation and enables to predict the admission of hospital in the whole cohort. Conclusions: The changes of surface EMGdi parameter 展开更多
关键词 Acute EXACERBATION of Chronic OBSTRUCTIVE Pulmonary Disease NEURAL Respiratory Drive Surface DIAPHRAGM ELECTROMYOGRAPHY
COPD加重期患者肺功能、血气指标及炎症指标的变化分析 预览 被引量:1
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作者 罗倩 《医学信息》 2018年第9期114-116,共3页
目的研究慢性阻塞性肺疾病急性加重期患者的肺功能指标、血气以及炎性指标的变化,为临床制定诊疗方案提供参考依据。方法将我院2014年1月~2016年10月呼吸内科收治的42例慢阻肺急性加重期患者纳入A组,对其采用相应的治疗措施,另选取42例... 目的研究慢性阻塞性肺疾病急性加重期患者的肺功能指标、血气以及炎性指标的变化,为临床制定诊疗方案提供参考依据。方法将我院2014年1月~2016年10月呼吸内科收治的42例慢阻肺急性加重期患者纳入A组,对其采用相应的治疗措施,另选取42例同期收治的慢阻肺稳定期患者纳入B组,并选取同期42例正常体检者为对照组。对三组患者的肺功能指标、血气分析以及炎性指标进行分析对比。结果A组、B组三项指标均比正常体检者低,差异有统计学意义(P<0.05);A组三项指标均低于B组,差异有统计学意义(P<0.05);血气指标、炎性因子表达变化与急性加重期患者肺功能改变均具有相关性(P<0.05)。结论急性加重期患者肺功能、血气及炎性指标与其他分期或健康者有较大的差异,在临床上需要对病情进行详尽分析,确定合适的治疗方案。 展开更多
关键词 慢性阻塞性肺疾病 加重期 肺功能 血气
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2013-2014年我国中心城市29家医院支气管哮喘急性发作住院患者诱发因素的回顾性调查 被引量:6
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作者 邢斌 林江涛 +27 位作者 唐华平 杨岚 袁雅冬 顾玉海 陈萍 刘晓菊 张捷 刘辉国 王长征 周玮 孙德俊 陈一强 陈卓昌 黄茂 林其昌 胡成平 杨晓红 霍建民 叶贤伟 周新 蒋萍 张伟 黄奕江 戴路明 刘荣玉 蔡绍曦 许建英 周建英 《中华内科杂志》 CSCD 北大核心 2018年第1期21-26,共6页
目的 了解我国支气管哮喘(以下简称哮喘)急性发作住院患者的发作诱因.方法 在全国哮喘研究协作组成员所在29个城市的29家三级甲等医院呼吸内科进行哮喘急性发作住院患者的回顾性调查,分析哮喘急性发作住院患者的诱发因素、发作严重程... 目的 了解我国支气管哮喘(以下简称哮喘)急性发作住院患者的发作诱因.方法 在全国哮喘研究协作组成员所在29个城市的29家三级甲等医院呼吸内科进行哮喘急性发作住院患者的回顾性调查,分析哮喘急性发作住院患者的诱发因素、发作严重程度的影响因素.结果 共纳入3240例哮喘患者,男性1369例(42.3%),女性1871例(57.7%).因哮喘急性发作住院人数占同期呼吸科住院总人数的2.95%(6375/215955).发作诱因中急性上呼吸道感染[42.3%(1370/3240)]、天气变化[22.8%(738/3240)]、有害气体[4.3%(140/3240)]、过敏原刺激[3.5%(115/3240)]、剧烈运动[1.8%(57/3240)]以及空气污染[1.5%(49/3240)]居前6位.老年人诱发因素中天气变化比例更高;青年人和老年人上呼吸道感染比例高于中年人,青年人和中年人过敏原刺激比例高于老年人,但差异均无统计学意义(P〉0.05).冬季诱发因素上呼吸道感染比例较高,秋季天气变化、剧烈运动及空气污染比例较高;春季和夏季过敏原刺激比例高于秋冬季,但差异无统计学意义(P〉0.05).北方患者诱发因素中上呼吸道感染的比例高于南方;而南方患者有害气体比例高于北方;北方患者过敏原刺激、空气污染比例亦高于南方,但差异无统计学意义(P〉0.05).不同性别、有无吸烟史者、不同程度哮喘患者间哮喘发作诱因均差异无统计学意义(P〉0.05).重度及危重度发作者年龄≥60岁、男性、病程≥10年、有吸烟史及1年内有因哮喘急性发作住院或急诊就诊史者的比例均显著高于轻中度发作者.结论 哮喘急性发作患者中以急性上呼吸道感染为诱因者的比例最高.高龄、男性、病程长、有吸烟史及因哮喘急性发作反复就诊可能为导致重度及危重度哮喘急性发作的危险因素. 展开更多
关键词 哮喘 急性发作 诱发因素 严重程度
慢性阻塞性肺疾病急性加重期嗜酸性粒细胞水平与预后关系的分析 预览 被引量:12
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作者 陆召辉 杨刚 +1 位作者 金炬 袁义 《临床肺科杂志》 2017年第3期407-410,共4页
目的 探讨慢性阻塞性肺疾病(慢阻肺)急性加重期血嗜酸性粒细胞水平与预后的关系。方法回顾分析2013年3月至2015年3月在我科住院的慢阻肺急性加重期患者。入院时均进行相关资料登记,出院后对其随访1年。对病人的基本情况、血常规中嗜... 目的 探讨慢性阻塞性肺疾病(慢阻肺)急性加重期血嗜酸性粒细胞水平与预后的关系。方法回顾分析2013年3月至2015年3月在我科住院的慢阻肺急性加重期患者。入院时均进行相关资料登记,出院后对其随访1年。对病人的基本情况、血常规中嗜酸性粒细胞百分比、中性粒细胞/淋巴细胞比值、CRP水平、D-二聚体水平、住院时间(天)、再住院与否、是否死亡进行资料统计。根据嗜酸性粒细胞水平进行分组:组1(嗜酸性粒细胞组),嗜酸性粒细胞百分比〉2%;组2(非嗜酸性粒细胞组),嗜酸性粒细胞百分比≤2%。出院后患者生存情况采用K-M生存分析评估。结果 共有1200位慢阻肺急性加重期患者最终入组。35%的患者嗜酸性粒细胞升高。嗜酸性粒细胞组(组1)D-二聚体水平、CRP水平、中性粒细胞/淋巴细胞比值(NLR)、住院时间均较非嗜酸性粒细胞组(组2)低,有统计学差异(P〈0.05)。随访1年后两组患者再住院率分别为40.7%、63.7%,有统计学差异(P〈0.05)。根据K-M生存分析发现两组随访1年病死率无明显差异(P〉0.05)。结论 慢阻肺急性加重期患者非嗜酸性粒细胞组再住院率高、住院时间延长,D-二聚体、CRP、NLR值较高,随访1年两组病死率无明显差异。外周血嗜酸性粒细胞水平能够指导临床判断预后。 展开更多
关键词 慢阻肺 加重期 C-反应蛋白 嗜酸性粒细胞
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Expressions and significance of plasma ET-1 and IL-8 in patients with AECOPD merged with CHD 被引量:1
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作者 Dong-Bo Xu Chang-Li Yu +1 位作者 Bo Wu Zhong-Hua Zhang 《海南医科大学学报(英文版)》 2017年第2期44-47,共4页
Objective:To observe the expressions and clinical significance of plasma ET-1 and IL-8 in patients with AECOPD merged with CHD.Methods: A total of 120 patients with AECOPD who were admitted in our hospital from Februa... Objective:To observe the expressions and clinical significance of plasma ET-1 and IL-8 in patients with AECOPD merged with CHD.Methods: A total of 120 patients with AECOPD who were admitted in our hospital from February, 2015 to December, 2015 were included in the study and divided into observation 1 group (AECOPD merged with CHD) and observation 2 group (pure AECOPD) with 60 cases in each group. Moreover, 30 healthy individuals who came for physical examinations in the same period were served as the control group. ELISA was used to detect the plasma ET-1 and IL-8 levels, and their correlation was analyzed. The arterial blood gas and coagulation fibrinolysis indicators among the three groups were compared.Results: The plasma ET-1 and IL-8 levels in observation 1 and 2 groups were significantly higher than those in the control group. The plasma ET-1 and IL-8 levels in observation 1 group were significantly higher than those in observation 2 group. PaO2 in observation 1 and 2 groups was significantly lower than that in the control group, while PaCO2 was significantly higher than that in the control group. The comparison of PaO2 and PaCO2 between the two groups was not statistically significant. PT and APTT in observation 1 and 2 groups were significantly shortened when compared with the control group, while TT was significantly delayed. PT in observation 1 group was significantly shortened when compared with observation 2 group. Fbg and t-PA contents in observation 1 and 2 groups were significantly higher than those in the control group. Fbg, t-PA, and D-D contents in observation 1 group were significantly higher than those in observation 2 group.Conclusions:The hypercoagulation state is presenting in patients with AECOPD merged with CHD, with increased ET-1 and IL-8, both of which can play a synergistic effect, and are involved in the pathogenesis. 展开更多
关键词 COPD Acute EXACERBATION CHD ET-1 IL-8
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