Adenosinergic Modulation of Ventilation in Obese Zucker Rats

Objectives: The goal of our study was to determine whether altered adenosinergic mechanisms contribute to the depressed ventilatory response observed in obese Zucker rats. Research Methods and Procedures: Eight lean and eight obese Zucker rats were studied at 7 to 8 weeks of age. Ventilation (V˙_E) during room air, during 5‐minute hypercapnic (7% CO₂, balance O₂), and during 30‐minute sustained hypoxic (10% O₂) exposures were sequentially measured by the barometric method on three separate occasions after the randomized blinded administration of equal volumes of either saline (control), 8‐(p‐sulfophenyl)‐theophylline (8‐PST, 7 mg/kg, peripheral adenosine antagonist), or aminophylline (AMPH, 15 mg/kg, peripheral and central adenosine antagonist). Results: During room air and hypercapnic exposures, AMPH (but not 8‐PST) significantly (p < 0.05) increased V˙_E in both lean and obese rats. During acute (2 minute) hypoxic exposure, 8‐PST (but not AMPH) significantly depressed V˙_E in lean rats. In contrast, AMPH (but not 8‐PST) selectively increased V˙_E in obese rats. During sustained (10 to 30 minutes) hypoxic exposure, neither AMPH nor 8‐PST administration altered V˙_E in lean rats. In contrast, AMPH (but not 8‐PST) selectively increased V˙_E during the late response in obese rats. Discussion: Our findings indicate that obese rats possess altered adenosinergic modulation of ventilatory responses to acute and sustained hypoxia in two opposite ways. We conclude that the reduced hypoxic ventilatory response observed in obese Zucker rats is attributed to depressed adenosinergic peripheral excitatory mechanisms and to enhanced adenosinergic central depression mechanisms, both of which contribute to the blunted ventilatory response in obesity.     

Echocardiographic Predictors of Mortality in Patients with Pulmonary Hypertension and Cardiopulmonary Comorbidities

Objective

We aimed to identify the echocardiographic measures associated with survival in a patient population with a high prevalence of co-morbid cardiovascular and pulmonary disease that have significantly elevated estimated pulmonary artery systolic pressures (ePASP).

Background

Pulmonary hypertension (PH) is a clinical feature of several cardiopulmonary diseases that are prevalent among elderly. While certain echocardiographic parameters have been shown to be important in the prognosis in specific PH groups, the prognostic relevance of echocardiographic characteristics in a cohort with multiple cardiopulmonary comorbidities is unclear.

Methods

We retrospectively identified 152 patients with ePASP > 60 mmHg by echocardiography over a five year period (6/2006–11/2011) and followed until 4/2013. Candidate clinical and echocardiographic characteristics suggestive of PH severity were compared between deceased and surviving subpopulations. Cox proportional hazard modeling was used to identify echocardiographic predictors of death adjusted for age and clinical characteristics.

Results

This was a predominantly elderly (age 78.8 ± 10.2 years), male (98.7%) cohort with several cardiopulmonary comorbidities. Overall mortality was high (69.7%, median survival 129 days). After adjusting for age and clinical characteristics, decreased right ventricular (RV) systolic function assessed by tricuspid annular plane systolic excursion (HR 0.56, 95% CI 0.33–0.96, p = 0.034) and increased RV thickness (HR: 4.34, 95% CI: 1.49–12.59, p = 0.007) were independently associated with mortality. In contrast, left ventricular systolic function, left ventricular diastolic parameters, ePASP, or echo-derived pulmonary vascular resistance (PVR) were not associated with increased mortality.

Conclusion

In a cohort of patients with PH and high prevalence of cardio-pulmonary comorbidities, RV systolic function and hypertrophy are associated with mortality and may be the most relevant echocardiographic markers for prognosis.     

Impact of Comorbidities on Mortality in Patients with Idiopathic Pulmonary Fibrosis

Introduction

Comorbidities significantly influence the clinical course of idiopathic pulmonary fibrosis (IPF). However, their prognostic impact is not fully understood. We therefore aimed to determine the impact of comorbidities, as individual and as whole, on survival in IPF.

Methods

The database of a tertiary referral centre for interstitial lung diseases was reviewed for comorbidities, their treatments, their frequency and survival in IPF patients.

Results

272 patients were identified of which 12% had no, 58% 1–3 and 30% 4–7 comorbidities, mainly cardiovascular, pulmonary and oncologic comorbidities. Median survival according to the frequency of comorbidities differed significantly with 66 months for patients without comorbidities, 48 months when 1–3 comorbidities were reported and 35 months when 4–7 comorbidities were prevalent (p = 0.004). A multivariate Cox proportional hazard analyses identified other cardiac diseases and lung cancer as significant predictors of death, gastro-oesophageal reflux disease (GERD) and diastolic dysfunction had a significant positive impact on survival. A significant impact of comorbidities associated therapies on survival was not discovered. This included the use of proton pump inhibitors at baseline, which was not associated with a survival benefit (p = 0.718). We also established a predictive tool for highly prevalent comorbidities, termed IPF comorbidome which demonstrates a new relationship of IPF and comorbidities.

Conclusion

Comorbidities are frequent in IPF patients. Some comorbidities, especially lung cancer, mainly influence survival in IPF, while others such as GERD may inherit a more favourable effect. Moreover, their cumulative incidence impacts survival.     

Decreased Inpatient Mortality in Obese Patients With Abdominal Nets

ObjectiveNeuroendocrine tumors (NETs) of the abdomen are rare tumors with an incidence of 3.56 per 100,000 in the general population. Obesity is a growing public health problem with varying effects on the severities of other diseases. We investigated the association between obesity and inpatient morbidity/mortality in patients with abdominal NETs utilizing the Nationwide Inpatient Sample (NIS).MethodsWe analyzed data from the NIS database to investigate the association between obesity and abdominal NETs using patient information from 22,096 patient discharges from January 1, 2009 to December 31, 2010.ResultsWe demonstrate that obesity is strongly associated with decreased rates of inpatient mortality in patients with NET (odds ratio [OR] = 0.6, multivariate P = .02) and that malnutrition is associated with a nearly 5-fold higher risk of inpatient mortality (multivariate P < .0005). We did not find a statistical interaction between obesity and malnutrition; however, patients who were both malnourished and obese had a lower mortality risk than purely malnourished patients.ConclusionsOur data suggests that nutritional status may be an important factor in inpatient mortality in patients with NETs, with obesity being protective. (Endocr Pract. 2014;20:1309-1314)     

Obesity‐related Comorbidities in Obese African Americans in an Outpatient Weight Loss Program

Objective: To identify, among obese African‐American enrollees in an outpatient weight loss program, differences between those with and without obesity‐related comorbidities (ORCMs). Research Methods and Procedures: Data were from 237 obese African Americans (BMI, 30 to 50 kg/m²; 90% women) who enrolled in a 10‐week lifestyle weight loss program. Analyses compared subgroups defined by ORCM status (from medical history) on baseline characteristics, program attendance, and postprogram weight change. Results: Most participants (76%) had one or more ORCMs. Those with versus without ORCMs, respectively, were older (mean age, 45.6 vs. 37.1 years; p < 0.001), were less educated (59.2% vs. 76.6% with >12 years; p = 0.031), were more likely to perceive a physical limitation affecting activity (22.2% vs. 1.8%; p < 0.001), and had higher waist circumference (mean, 113.7 vs. 106.9 cm; p < 0.001) but not BMI (38.3 vs. 37.0 kg/m²; p = 0.095). Logistic regression analyses confirmed the independence of these associations. Having ORCMs was not associated with class attendance or return for data collection after the 10‐week program. Postprogram weight change (n = 134) was unrelated to ORCMs, but better weight loss was seen among those without perceived physical limitations (1.9 vs. 0.4 kg in those without versus with limitations; p = 0.069). Conclusion: Data from this clinical sample of obese African Americans suggest that waist circumference is relevant to ORCM status at BMI levels up to 50 kg/m². Clear indications for tailoring of treatment based on ORCM status were not identified, although the possible influence of ORCM‐related activity limitations warrants further study.     

Programming of Obesity and Comorbidities in the Progeny: Lessons from a Model of Diet-Induced Obese Parents

Aim

To determine the impact of paternal obesity, maternal obesity or the combination of two obese parents on markers of adult offspring metabolism, with a focus on body mass (BM), lipid and carbohydrate, components of lipogenesis and beta-oxidation in the liver, sex dimorphism in the offspring that received a SC diet during the postnatal period.

Materials and Methods

Male and female C57BL/6 mice were fed a high-fat diet (HF; 49% lipids) or standard chow (SC; 17% lipids) for 8 weeks before mating until lactation. The offspring were labeled according to sex, maternal diet (first letters), paternal diet (second letters), and received a SCdiet until 12-weeks of age when they were sacrificed. BM, eating behavior, glucose tolerance, plasma analysis, gene and protein expression of the components of lipogenesis and beta-oxidation in the liver of offspring were evaluated.

Results

HF diet-fed mothers and fathers were overweight, hyperglycemic and glucose intolerant and had a deteriorating lipid profile. The adult male and female offspring of HF-mothers were overweight, with an increased adiposity index, hyperphagic, had an impaired glucose metabolism, increased total cholesterol and triacylglycerol levels, increased lipogenesis concomitant with decreased beta-oxidation resulting in liver steatosis. The male and female offspring of HF-father had impaired glucose metabolism, exacerbated lipogenesis without influencing beta-oxidation and enhanced hepatic steatosis. These findings are independent of BM. Male and female offspring of a mother and father that received a HF diet demonstrated these effects most prominently in adult life.

Conclusion

Paternal obesity leads to alterations in glucose metabolism, increase in components of lipogenesis and liver steatosis. In contrast, maternal obesity leads to overweight and changes in the metabolic profile and liver resulting from activation of hepatic lipogenesis with impaired beta-oxidation. When both parents are obese, the effects observed in the male and female offspring are exacerbated.     

The Effects of Lung Protective Ventilation or Hypercapnic Acidosis on Gas Exchange and Lung Injury in Surfactant Deficient Rabbits

Background

Permissive hypercapnia has been shown to reduce lung injury in subjects with surfactant deficiency. Experimental studies suggest that hypercapnic acidosis by itself rather than decreased tidal volume may be a key protective factor.

Objectives

To study the differential effects of a lung protective ventilatory strategy or hypercapnic acidosis on gas exchange, hemodynamics and lung injury in an animal model of surfactant deficiency.

Methods

30 anesthetized, surfactant-depleted rabbits were mechanically ventilated (FiO₂ = 0.8, PEEP = 7cmH₂O) and randomized into three groups: Normoventilation-Normocapnia (NN)-group: tidal volume (Vt) = 7.5 ml/kg, target PaCO₂ = 40 mmHg; Normoventilation-Hypercapnia (NH)-group: Vt = 7.5 ml/kg, target PaCO₂ = 80 mmHg by increasing FiCO₂; and a Hypoventilation-Hypercapnia (HH)-group: Vt = 4.5 ml/kg, target PaCO₂ = 80 mmHg. Plasma lactate and interleukin (IL)-8 were measured every 2 h. Animals were sacrificed after 6 h to perform bronchoalveolar lavage (BAL), to measure lung wet-to-dry weight, lung tissue IL-8, and to obtain lung histology.

Results

PaO₂ was significantly higher in the HH-group compared to the NN-group (p<0.05), with values of the NH-group between the HH- and NN-groups. Other markers of lung injury (wet-dry-weight, BAL-Protein, histology-score, plasma-IL-8 and lung tissue IL-8) resulted in significantly lower values for the HH-group compared to the NN-group and trends for the NH-group towards lower values compared to the NN-group. Lactate was significantly lower in both hypercapnia groups compared to the NN-group.

Conclusion

Whereas hypercapnic acidosis may have some beneficial effects, a significant effect on lung injury and systemic inflammatory response is dependent upon a lower tidal volume rather than resultant arterial CO₂ tensions and pH alone.     

Mortality Prediction in Patients Undergoing Non-Invasive Ventilation in Intermediate Care

Background

Intermediate Care Units (ImCU) have become an alternative scenario to perform Non-Invasive Ventilation (NIV). The limited number of prognostic studies in this population support the need of mortality prediction evaluation in this context.

Objective

The objective of this study is to analyze the performance of Simplified Acute Physiology Score (SAPS) II and 3 in patients undergoing NIV in an ImCU. Additionally, we searched for new variables that could be useful to customize these scores, in order to improve mortality prediction.

Design

Cohort study with prospectively collected data from all patients admitted to a single center ImCU who received NIV. The SAPS II and 3 scores with their respective predicted mortality rates were calculated. Discrimination and calibration were evaluated by calculating the area under the receiver operating characteristic curve (AUC) and with the Hosmer-Lemeshow goodness of fit test for the models, respectively. Binary logistic regression was used to identify new variables to customize the scores for mortality prediction in this setting.

Patients

The study included 241 patients consecutively admitted to an ImCU staffed by hospitalists from April 2006 to December 2013.

Key Results

The observed in-hospital mortality was 32.4% resulting in a Standardized Mortality Ratio (SMR) of 1.35 for SAPS II and 0.68 for SAPS 3. Mortality discrimination based on the AUC was 0.73 for SAPS II and 0.69 for SAPS 3. Customized models including immunosuppression, chronic obstructive pulmonary disease (COPD), acute pulmonary edema (APE), lactic acid, pCO2 and haemoglobin levels showed better discrimination than old scores with similar calibration power.

Conclusions

These results suggest that SAPS II and 3 should be customized with additional patient-risk factors to improve mortality prediction in patients undergoing NIV in intermediate care.     

Survival Expectations of the Obese: Is Excess Mortality Reflected in Perceptions?

Objective: This study compared self‐reported subjective life expectancy (i.e., probability of living to age 75) for normal‐weight, overweight, and obese weight groups to examine whether individuals are internalizing information about the health risks due to excessive weight. Research Methods and Procedures: Using data from the Health and Retirement Study, a total of 9035 individuals 51 to 61 years old were analyzed by BMI category. The primary outcome measure was individuals’ reports about their own expectations of survival to age 75. Absolute and relative risks of survival were compared with published estimates of survival to age 75. Results: Consistently, higher levels of BMI were associated with lower self‐estimated survival probabilities. Differences relative to normal weight ranged from 4.9% (p < 0.01) for male nonsmokers to 8.8% (p < 0.001) for female nonsmokers. However, these differences were substantially less than those obtained from published survival curve estimates, suggesting that obese individuals tended to underestimate mortality risks. Discussion: Individuals appeared to underestimate the mortality risks of excessive weight; thus, knowledge campaigns about the risks of obesity should remain a top priority.     

Water Control and Survival of Ipomoea batatas Grown Photoautotrophically under Forced Ventilation and Photomixotrophically under Natural Ventilation

Water loss and its determining factors were compared in leavesof in vitro -grown sweet potato (Ipomoea batatas L. Lam, ‘Beniazuma’)plantlets cultured either photoautotrophically under forcedventilation (scaled-up vessel) or photomixotrophically undernatural ventilation. Functional stomata, a greater amount ofwax deposition on the leaves and smaller epidermal conductancewere observed in plantlets cultured photoautotrophically underforced ventilation. When transplanted directly into soil inthe greenhouse (without ex vitro hardening), plantlets grownphotoautotrophically under forced ventilation survived betterand grew faster. This was because they were better able to controltranspiration and thus lost less water and showed no signs ofwilting. In contrast, plantlets cultured under photomixotrophicconditions had open stomata which were not functional, a highertranspiration rate, and uncontrolled and rapid water loss immediatelyafter transfer ex vitro. Thus, wilting and severe desiccationwith irreversible tissue damage were observed in the leaves,which died within a few days. Copyright 2000 Annals of BotanyCompany Epicuticular wax, hardening, stomata, sweet potato, transpiration, water control     

Aging, Obesity, and Mortality: Misplaced Concern About Obese Older People?

Although there is widespread agreement that obesity (body mass index [BMI] ≥ 30 kg/m(2)) raises health risks, debate has ensued on whether obese older adults are also at greater risk. This study examines the effect of obesity on mortality for younger and older adults to determine whether the risk of obesity is lessened in later life. Data from a 20-year follow-up of a national sample of adults were used to examine the risk of obesity on mortality (N = 6,767). Cox models reveal that obesity raises mortality risk for adults of all ages, but this relationship is nearly twice as strong for persons younger than 50 years of age. Being slightly overweight in later life is associated with lower mortality risk, but obesity raises mortality risk, especially for ischemic heart disease. Obesity in middle age is a grave public health concern, but obesity in later life also merits attention.     

家庭应用无创机械通气对COPD患者肺功能及医疗费用的影响

目的:在COPD急性发作期无创机械通气治疗已经被临床医生重视并广泛应用于临床治疗.但对于家庭应用无创机械通气治疗缓解期的患者是否获益,目前尚无明确结论.本试验旨在探讨家庭应用无创机械通气对COPD患者生活质量、运动耐量、肺功能及医疗费用的影响.方法:随机观察103例慢性阻塞性肺疾病急性发作合并 Ⅱ型呼吸衰竭患者,于医院应用无创辅助通气治疗缓解后出院.其中39例继续应用无创机械通气治疗(治疗组),其余64停止无创机械通气治疗(对照组),观察6个月,比较家庭应用无创机械通气治疗后生活质量、运动耐量、肺功能变化、血气分析、心率、呼吸频率及急性发作的间隔期、医疗费用状况.结果:治疗组较对照组生活质量、运动耐量明显改善(P＜0.05),肺功能下降明显减慢(P＜0.05),平均医疗费用明显减少(P＜0.05).结论:家庭应用无创机械通气能够延缓COPD患者肺功能下降速度,减少医疗费用近万元,延长急性加重间隔时间6个月以上,减少住院次数,提高生存质量.     

Uric Acid as a Risk Factor for Cardiovascular Disease and Mortality in Overweight/Obese Individuals

Background

The predictive value of serum uric acid (SUA) for adverse cardiovascular events among obese and overweight patients is not known, but potentially important because of the relation between hyperuricaemia and obesity.

Methods

The relationship between SUA and risk of cardiovascular adverse outcomes (nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death) and all-cause mortality, respectively, was evaluated in a post-hoc analysis of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Participants enrolled in SCOUT were obese or overweight with pre-existing diabetes and/or cardiovascular disease (CVD). Cox models were used to assess the role of SUA as an independent risk factor.

Results

9742 subjects were included in the study; 83.6% had diabetes, and 75.1% had CVD. During an average follow-up time of 4.2 years, 1043 subjects had a primary outcome (myocardial infarction, resuscitated cardiac arrest, stroke, or cardiovascular death), and 816 died. In a univariate Cox model, the highest SUA quartile was associated with an increased risk of cardiovascular adverse outcomes compared with the lowest SUA quartile in women (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.20–2.10). In multivariate analyses, adjusting for known cardiovascular risk factors the increased risk for the highest SUA quartile was no longer statistically significant among women (HR: 0.99; 95% CI: 0.72–1.36) nor was it among men. Analyses of all-cause mortality found an interaction between sex and SUA. In a multivariate Cox model including women only, the highest SUA quartile was associated with an increased risk in all-cause mortality compared to the lowest SUA quartile (HR: 1.51; 95% CI: 1.08–2.12). No relationship was observed in men (HR: 1.06; 95% CI: 0.82–1.36).

Conclusion

SUA was not an independent predictor of cardiovascular disease and death in these high-risk overweight/obese people. However, our results suggested that SUA was an independent predictor of all-cause mortality in women.     

Cut‐off Point of BMI and Obesity‐Related Comorbidities and Mortality in Middle‐Aged Koreans

Objective: The need for a lower BMI to classify overweight in Asian populations has been controversial. Using both disease and mortality outcomes, we investigated whether lower BMI cut‐off points are appropriate for identifying increased health risk in Koreans. Research Methods and Procedures: We conducted a cohort study among 773, 915 men and women from 30 to 59 years old with 8‐ to 10‐year follow‐up periods. Primary outcomes were change of obesity prevalence, obesity‐related disease incidence, and all‐cause mortality. Results: Prevalence of overweight (BMI of 25.0‐29.9) has steadily increased (1.3% annually), whereas obesity (BMI ≥ 30) showed a lower prevalence and only a slight increase (0.1%‐0.2% annually). Our study revealed that dose‐response relationships exist between obesity and related disease incidences (hypertension, type 2 diabetes, and hypercholesterolemia) beginning at lower BMI levels than previously reported. Compared with those in the healthy weight range, Koreans with a BMI ≥ 25 were not at greater risk of hypertension, type 2 diabetes, or hypercholesterolemia than has been reported for whites in similar studies. Obesity‐related all‐cause mortality also did not seem so different from that of whites. Discussion: Our findings did not support the use of a lower BMI cut‐off point for defining overweight in Koreans compared with whites for the purpose of identifying different risks. However, populations with BMI ≥ 25 are rapidly increasing and have substantial risks of diseases. To preempt the rapid increases in obesity and related health problems that are occurring in Western countries, Korea should consider using a BMI of 25 as an action point for obesity prevention and control interventions.     

无创通气在AECOPD机械通气患者撤机中的研究

目的：通过前瞻性随机对照研究比较应用NIPPV与PSV两种撤机方法在治疗AECOPD合并II型呼吸衰竭进行机械通气撤机困难患者中的优越性。方法：达到撤机标准但经两小时自主呼吸试验（SBT）失败的患者被分为两组：PSV组和无创通气组。观测有创通气时间、机械通气总时间、再插管率、住呼吸重症监护室时间和VAP发生率等指标。结果：NIPPV组较PSV组气管插管时间显著缩短,VAP发生率、再插管率及住院费用均较PSV通气组显著降低。结论：采用无创通气撤机法治疗AECOPD合并II型呼吸衰竭较传统的机械通气方式在有效缩短有创通气时间,降低VAP发生率,改善患者预后方面更优越。     

Domiciliary cockroaches and their oothecal parasites in India

In a survey for oothecal parasites of cockroaches in India, 6 species of cockroaches were recorded. Of theseNeostylopyga rhombifolia (Stoll.) was restricted to thatched huts whileBlattella germanica (L.),Periplaneta americana (L.),P. australasiae (F.),P. brunnea Burmeister andSupella longipalpa (F.) were common in other types of buildings. Eight species of parasites, of which 4 are new records, were reared:Anastatus tenuipes Bolivar.,Comperia merceti Compere,Evania appendigaster (L.),Evania sp. nearantennalis Westw., Genus et sp. nov. nearAnastatus. Tetrastichus asthenogmus (Waterston),T. hagenowii (Ratzeburg) andTetrastichus sp. (miser group) which is hyperparasitic. The natural and experimental hosts of these parasites are discussed. The low levels of field parasitism suggest there is scope for introducing more promising parasite species into India for biological control of cockroaches.     

The Challenges of Living in Hypoxic and Hypercapnic Aquatic Environments

Organisms living in coastal waters, and especially estuaries,have long been known to have behavioral or physiological mechanismsthat enable them toexist in water containing low amounts ofoxygen. However, the respiratory consumption of oxygen thatgenerates hypoxia is also responsible for producing significantamounts of carbon dioxide. An elevation of carbon dioxide pressurein water will cause a significant acidosis in most aquatic organisms.Thus, the combination of low oxygen and elevated carbon dioxidethat occurs in estuaries represents a significant environmentalchallenge to organisms living in this habitat. Organisms maymaintain oxygen uptake in declining oxygen conditions by usinga respiratory pigment and/or by making adjustments in the convectiveflow of water and blood past respiratory surfaces (i.e., increasecardiac output and ventilation rate). Severe hypoxia may resultin an organism switching partially or completely to anaerobicbiochemical pathways to sustain metabolic rate. There is alsoevidence to suggest that organisms lower their metabolism duringhypoxic stress. Elevated water CO₂ (hypercapnia) produces anacidosis in the tissues of organisms that breathe it. This acidosismay be wholly or partially compensated (i.e., mechanisms returnpH to pre-exposure levels), or may be uncompensated. Some studieshave examined the effects on organisms of exposure simultaneouslyto hypoxia and hypercapnia. This article reviews some of thespecific adaptations and responses of organisms to low oxygen,to high carbon dioxide, and to the cooccurrence of low oxygenand high carbon dioxide     

无创正压通气治疗慢性阻塞性肺病的临床观察及护理效应

目的:探讨无创正压通气治疗慢性阻塞性肺病的临床疗效和护理效应。方法:本科收治的慢性阻塞性肺病患者90例,随机分为对照组和观察组。对照组给予常规治疗及常规专业护理措施。在对照组的治疗方式的基础上,应用无创性呼吸机治疗;并在进行无创正压通气及常规专业护理措施的同时,患者行综合护理干预措施。结果:治疗后,观察组心率、呼吸频率与对照组相比下降更明显,差异显著(P<0.01)。治疗后,观察组动脉血气指标与对照组相比改善更明显,差异具有显著性(P<0.01)。观察组住院时间少于对照组,差异具有显著性(P<0.01)。结论:采用无创正压通气治疗慢性阻塞性肺病患者疗效可靠,辅以综合护理干预措施,能够有效的促进患者恢复。