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1.
降低血粘度对慢性肺心病急性加重期疗效的影响 总被引:1,自引:0,他引:1
目的探讨血栓通降低血粘度对慢性肺心病急性加重期疗效的影响。方法将113例慢性肺心病急性加重期患者随机分为两组,观察组63例,对照组50例,两组病例均采取常规治疗(包括抗感染、改善通气、持续低流量吸氧、纠正心衰等),观察组同时应用血栓通注射液350mg加入生理盐水250ml中静滴,每日1次,15天为1疗程。两组病例治疗前、后分别检查血常规、血液流变学、血气分析和凝血常规4项。结果治疗前两组血液流变学数据无显著差异(P>0.05),治疗后观察组的血液流变学数据明显下降,组间差异非常显著(P<0.01)。组内比较观察组治疗后PaO2升高非常显著(P<0.01),PaCO2显著下降(P<0.05);对照组治疗后PaO2显著升高(P<0.05),PaCO2显著下降(P<0.05)。结论血栓通在降低血粘度,改善血液流变学的同时,使慢性肺心病急性加重期患者的低氧血症和高碳酸血症也得到显著纠正。 相似文献
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韩海峰 《中国微生态学杂志》2017,29(5)
目的 探讨盐酸莫西沙星序贯疗法治疗慢性阻塞性肺疾病急性加重期的临床疗效及安全性。方法 选取200例慢性阻塞性肺疾病急性加重期的患者,随机分为对照组和观察组,对照组静脉给予盐酸莫西沙星氯化钠注射液治疗,观察组采用莫西沙星序贯疗法进行治疗,前5日静脉给予盐酸莫西沙星氯化钠注射液,病情好转后口服盐酸莫西沙星片,考察两组治疗前、后肺功能指标参数及血液中IL-8、TNF-α水平,比较两组的临床疗效和安全性。结果 经治疗后,观察组临床总有效率为94.0%,与对照组的95.0%比较,差异无统计学意义(χ2=0.0481,P>0.05);两组患者的肺功能指标参数与治疗前比较,差异有统计学意义(P<0.05),但观察组改善程度与对照组比较,差异有统计学意义(P<0.05);两组患者血液中IL-8、TNF-α水平与治疗前比较,差异有统计学意义(P<0.05),观察组与对照组比较,差异无统计学意义(P>0.05);观察组不良反应发生率8.0%与对照组17.0%比较,差异有统计学意义(χ2=1.8514,P<0.05)。结论 采用序贯疗法治疗慢性阻塞性肺疾病,具有安全、有效等优点,有较大的临床推广意义。 相似文献
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《Biomarkers》2013,18(7):523-528
Inflammation has been identified as an important factor for disease exacerbation in obstructive lung disease. In this study, we used neutrophil and eosinophil counts as biomarkers for exacerbation in obstructive lung disease. We conducted a case–control study within a cohort of patients frequenting an outpatient clinic of Respiratory Medicine using data from the Utrecht Patient Oriented Database (UPOD). Cases were patients with a hospital admission for obstructive lung disease in 2005. For each case, one control patient was sampled from the same study base. We identified 143 cases (118 patients with chronic obstructive pulmonary disease and 25 asthma patients) and 143 controls. Admission was associated with both neutrophilia (adjusted odds ratio (OR) 4.3; 95% confidence interval (CI) 2.2–8.5), and eosinophilia (adjusted OR 2.6; 95% CI 1.1–6.2). The association with eosinophilia was only seen in asthma patients. In conclusion, neutrophil and eosinophil counts seem to be useful biomarkers for identifying exacerbations in pharmacoepidemiological studies on obstructive lung disease. 相似文献
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Dong Soon Kim 《Respiratory research》2013,14(1):86
Idiopathic pulmonary fibrosis (IPF) is a chronic, fibrosing interstitial lung disease that primarily affects older adults. Median survival after diagnosis is 2–3 years. The clinical course of IPF may include periods of acute deterioration in respiratory function, which are termed acute exacerbations of IPF (AEx-IPF) when a cause cannot be identified. AEx-IPF may represent a sudden acceleration of the underlying disease process of IPF, or a biologically distinct pathological process that is clinically undiagnosed. An AEx-IPF can occur at any time during the course of IPF and may be the presenting manifestation. The incidence of AEx-IPF is hard to establish due to variation in the methodology used to assess AEx-IPF in different studies, but AEx-IPF are believed to occur in between 5 and 10% of patients with IPF every year. Risk factors for AEx-IPF are unclear, but there is evidence that poorer lung function increases the risk of an AEx-IPF and reduces the chances of a patient surviving an AEx-IPF. The presence of comorbidities such as gastroesophageal reflux disease (GERD) and pulmonary hypertension may also increase the risk of an AEx-IPF. AEx-IPF are associated with high morbidity and mortality. Patients who experience an AEx-IPF show a worsened prognosis and AEx-IPF are believed to reflect disease progression in IPF. Current treatments for AEx-IPF have only limited data to support their effectiveness. The latest international treatment guidelines state that supportive care remains the mainstay of treatment for AEx-IPF, but also give a weak recommendation for the treatment of the majority of patients with AEx-IPF with corticosteroids. There is emerging evidence from clinical trials of investigational therapies that chronic treatment of IPF may reduce the incidence of AEx-IPF. Additional clinical trials investigating this are underway. 相似文献
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摘要目的:观察无创呼吸机对不伴有呼吸衰竭的慢性阻塞性肺疾病急性加重期(AECOPD)患者症状、体征、血气分析和肺功能的影响。方法:80例AECOPD患者随机分为对照组和试验组,对照组给予常规治疗,如常规抗感染、化痰、平喘等治疗。试验组在常规治疗的基础上给予无创呼吸机正压通气(NIPPV)治疗。评价两组患者治疗前和治疗一周后临床症状体征、血气分析和肺功能的变化。结果:两组患者治疗后临床症状及体征评分较治疗前均呈下降趋势(P〈0.05),但试验组下降更为明显(P〈0.05),并且试验组症状改善时间明显缩短(P〈0.05);治疗后两组的pH,PO2和SaO2均较治疗前升高,PC02较治疗前下降(P〈0.05),和对照组相比,治疗后试验组的PO:和PC02改善更明显(P〈0.05),而pH和Sa02无显著差异(P〉0.05);治疗后两组的FEV1,FVC,FEV1实测值/预计值和FEVI%均较治疗前升高(P〈0.05),试验组升高更明显(P〈0.05)。结论:对不伴有呼吸衰竭的AECOPD患者早期应用NIPPV治疗能有效改善临床症状和体征,缩短症状改善时间,改善通气,缓解呼吸肌疲劳,预防呼吸衰竭的发生。 相似文献
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目的:探讨利伐沙班与低分子肝素对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者症状缓解、血气分析指标及凝血功能的影响.方法:选取2016年8月~2019年11月期间我院收治的老年AECOPD患者72例,按照抽签法分为对照组(n=36,低分子肝素治疗)和研究组(n=36,利伐沙班治疗),对比两组疗效、症状缓解、血气分... 相似文献
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Arjun Chatterjee Manan Shah Anna O D'Souza Benno Bechtel Glenn Crater Anand A Dalal 《Respiratory research》2012,13(1):15
Background
This retrospective cohort study compared the risks of exacerbations and COPD-related healthcare costs between patients with chronic obstructive pulmonary disease (COPD) initiating tiotropium (TIO) alone and patients initiating triple therapy with fluticasone-salmeterol combination (FSC) added to TIO.Methods
Managed-care enrollees who had an index event of ≥ 1 pharmacy claim for TIO during the study period (January 1, 2003-April 30, 2008) and met other eligibility criteria were categorized into one of two cohorts depending on their medication use. Patients in the TIO+FSC cohort had combination therapy with TIO and FSC, defined as having an FSC claim on the same date as the TIO claim. Patients in the TIO cohort had no such FSC use. The risks of COPD exacerbations and healthcare costs were compared between cohorts during 1 year of follow-up.Results
The sample comprised 3333 patients (n = 852 TIO+FSC cohort, n = 2481 TIO cohort). Triple therapy with FSC added to TIO compared with TIO monotherapy was associated with significant reductions in the adjusted risks of moderate exacerbation (hazard ratio 0.772; 95% confidence interval [CI] 0.641, 0.930) and any exacerbation (hazard ratio 0.763; 95% CI 0.646, 0.949) and a nonsignificant reduction in COPD-related adjusted monthly medical costs.Conclusions
Triple therapy with FSC added to TIO compared with TIO monotherapy was associated with significant reductions in the adjusted risks of moderate exacerbation and any exacerbation over a follow-up period of up to 1 year. These improvements were gained with triple therapy at roughly equal cost of that of TIO alone. 相似文献9.
目的:探讨引起慢性阻塞性肺疾病合并精神神经异常的原因,以制订有针对性的治疗对策。方法:回顾性分析我院自2010
年1 月到2013 年1 月期间收治的250 例慢性阻塞性肺疾病急性发作期患者的临床资料。结果:32 例患者出现精神神经异常症
状,占12.80%。其中17 例为肺性脑病,占53.13%(17/32),8 例为低渗性脑病,占25.00%(8/32),5 例为药物的不良反应,占15.63%
(5/32),2 例为脑梗死,占6.25%(2/32)。所有患者均给予慢性阻塞性肺疾病急性发作的常规治疗方案进行治疗,同时肺性脑病患
者给予积极纠正二氧化碳潴留;低渗性脑病患者给予积极纠正电解质紊乱;脑梗死的患者根据情况给予溶栓、脱水、营养脑神经、
抗凝、抗血小板聚集等治疗;药物不良反应的患者则给予停止应用相应的药物。经过治疗后,29 例症状恢复,占90.63%,3 例最终
死亡,死亡率为9.38%,其中2 例为肺性脑病患者,1 例为低渗性脑病患者。结论:对于慢性阻塞性肺疾病急性发作合并精神神经
异常的治疗,应根据患者的症状、体征以及辅助检查结果,尽早明确诊断,及时干预,尽快控制病情,防止病情恶化。 相似文献
10.
Shyamala Ganesan Adam T Comstock Brenton Kinker Peter Mancuso James M Beck Uma S Sajjan 《Respiratory research》2014,15(1):11